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BackgroundMuscle injuries are some of the most common injuries in sports; they have a high recurrence rate and can result in the loss of ability to participate in training or competition. In clinical practice, a wide variety of treatment strategies are commonly applied. However, a limited amount of evidence-based data exists, and most therapeutic approaches are solely based on “best practice”. Thus, there is a need for consensus to provide strategies and recommendations for the treatment of muscle injuries.MethodsThe 2016 GOTS Expert Meeting, initiated by the German-Austrian-Swiss Society for Orthopaedic Traumatologic Sports Medicine (GOTS), focused on the topic of muscle and tendon injuries and was held in Spreewald/Berlin, Germany. The committee was composed of twenty-two medical specialists. Nine of them were delegated to a subcommittee focusing on the nonoperative treatment of muscle injuries. The recommendations and statements that were developed were reviewed by the entire consensus committee and voted on by the members.ResultsThe committee reached a consensus on the utility and effectiveness of the management of muscle injuries. Main results: the “PRICE” principle to target the first inflammatory response is one of the most relevant steps in the treatment of muscle injuries. Haematoma aspiration may be considered in the early stages after injury. There is presently no clear evidence that intramuscular injections are of use in the treatment of muscle injuries. The ingestion of non-steroidal anti-inflammatory drugs (NSAIDs) should be regarded critically because there is currently no hard evidence to support their use, although they are appropriate in exceptional cases.ConclusionsThe present work provides a structured overview of the various nonoperative treatment strategies of muscle injuries and evaluates their effectiveness with respect to the existing scientific evidence and clinical expertise in the context of basic science on the healing process of muscle injuries. The committee agreed that there is a compelling need for further studies, including high-quality randomized investigations to completely evaluate the effectiveness of the existing therapeutic approaches. The given recommendations may be updated and adjusted as further evidence will be generated.

Background Decreased leg muscle strength is a major determinant of reduced function in patients with knee osteoarthritis (OA). The identification of a strength parameter that is best correlated with functional performance is important for monitoring rehabilitation results. Objective To determine which muscle strength measurements show the highest correlation with functional capacity in patients with severe knee OA shortly before total knee arthroplasty (TKA). Design Cross‐sectional exploratory study. Setting Outpatient rehabilitation department at a university teaching hospital. Patients The sample included 75 patients (51 female) scheduled for primary TKA, recruited through multistage sampling. Methods or Interventions Independent variables were peak isometric, isokinetic concentric, and eccentric leg extensor strength measured on the leg press, as well as peak isometric knee extensor strength measured on the strength chair. Two multiple regression analyses were performed, one including all strength measures and the other including all of the strength ratios. Pearson correlation coefficients were calculated between the strength measures and functional test scores. Main Outcome Measurements Dependent variables were the Timed Up and Go Test (TUG) and the Stair Test (ST). Results The regression analysis including all strength measures could explain 11.9% of the variance of the TUG (P = .068, not significant [NS]) and 21.5% of the variance of the ST (P = .009, significant). The regression model for the strength ratios explained 11.8% of the variance of the TUG (P = .090, NS) and 6.3% of the ST (P = .217, NS). Conclusions Although univariate analysis confirmed significant correlations between strength measurements and functional tests, multiple regression analysis revealed a higher predictive value for the ST than for the TUG. The use of both muscle strength tests and performance‐based function tests is advisable to evaluate functional impairments of patients with knee OA. Level of Evidence III

Muscle injuries are, with 6 to 14%, the most common but neglected and under-estimated sport injuries. Certain muscle groups are predisposed to injury depending on the type of sport. There are many hypothesis as to the cause of muscular injury. The prognosis and the length of treatment are greatly influenced by the quality of the first aid administered at the accident site. Simple measures such as compression, elevation, ice and rest can easily be carried out at this site. The further rehabilitation includes bandages and accompanying measures, such as physical therapy and medication. An early functional and conservative therapy is the treatment of choice. The classification of the extent of injury should be carried out by an experienced sportmedic with regard to a differential diagnosis. Sonography and MRI can supply additional information when it is not clear as to the extent of injury. Resulting from an exact as possible classification can the further treatment and planning of the progress of the rehabilitation be established. The necessary length of the pause from sport and of the rehabilitation depend on the seriousness of the injury.