Muscle Injury Classification Part 1

Muscle Injury Classification Part 1: The British Athletic System

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Muscle injuries are a very common issue in sports and are the reason for a significant amount of time lost from training and competition. In recent years, muscle injuries were responsible for 48% of all injuries in international track and field competitions and more than 30% of injuries in professional football!

For such a prevalent injury, it is common for people to rely on a rudimentary system of classification for muscle injury. You probably have used it and heard about it if you have ever had a muscle injury – we are talking about the system of grading the injury from Grade 1-3.

In this system, Grade 1 refers to a minor muscle injury where maybe some muscle fibres are torn, Grade 2 is a moderate muscle injury with more pronounced tearing, while Grade 3 is a severe or total tear of the muscle. This system is categorically limited and it does not allow for more broad descriptions between more subtle differences in the type of injury. However, it is often used as a shortcut to estimate the time frame for recovery for each grade (ie. 2-4 weeks, 4-6 weeks and 6-8 weeks accordingly).

There are now several new ways to think about muscle injuries that allow for a bit more consideration of what part of the muscle has been damaged and the more in-depth ways to describe the extent of the injury. In this two-part blog series, we will discuss 2 of those systems; (1) The British Athletics Muscle Injury Classification (BAMIC) and The Munich Consensus Statement.

NOTE : It’s about to get a bit more complicated – so if you would like to revisit some muscle anatomy you can do so at a previous blog.

The British Athletics Muscle Injury Classification (BAMIC)

The BAMIC has been around since 2014, and is a system of classification that is based on MRI findings for a muscle injury. It was originally developed as a  classification tool for hamstring injury, but its key concepts are often applied to other muscle injuries (calf, quad etc).

Using the BAMIC, the severity of a muscle injury is indicated by using 5 grades (Grade 0-4). These grades of severity are based exclusively on MRI findings, and relate to how much damage there is in an MRI scan. 

There is a further classification based on the location of the muscle injury. The location of the injury is nominated as follows; a) the myofascia; b) the junction between muscle and tendon ; c) tearing into the tendon.

See the below illustration describing these locations of injury in the hamstrings.         

Muscle Injury illustration
British Athletics muscle injury classification

It is important to note that this is just one diagnostic tool that helps to describe muscle injury types. It is becoming quite common and we see it being used when a MRI is taken of a muscle injury. However, if you have suffered a muscle injury, you do not require an MRI for diagnosis or prognosis. The extent of damage on MRI is not the best indicator of how your recovery will go, and a thorough clinical assessment is always best. Your rehab progression should be also be criteria based, and you should never progress your rehabilitation based on timeframes determined by structural damage.

Our next blog will explore the Munich Consensus Statement on Muscle Injury – another muscle injury classification system that based a bit more on clinical findings.

Further Readings:

Grassi, A., Quaglia, A., Canata, G. L., & Zaffagnini, S. (2016). An update on the grading of muscle injuries: a narrative review from clinical to comprehensive systems. Joints, 4(01), 039-046.

Pollock, N., James, S. L., Lee, J. C., & Chakraverty, R. (2014). British athletics muscle injury classification: a new grading system. British journal of sports medicine, 48(18), 1347-1351.

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