A Histoarchitectural Approach to Skeletal Muscle Injury: Searching for a Common Nomenclature

Abstract

In recent years, different classifications for muscle injuries have been proposed based on the topographic location of the injury within the bone-tendon-muscle chain. We hereby propose that in addition to the topographic classification of muscle injuries, a histoarchitectonic (description of the damage to connective tissue structures) definition of the injury be included within the nomenclature. Thus, the nomenclature should focus not only on the macroscopic anatomy but also on the histoarchitectonic features of the injury.

Differentiation Between Tendinous, Myotendinous and Myofascial Injuries by L-BIA in Professional Football Players

“…The classification proposed by Pollock et al (2014) agree with the idea of a histoarchitectural approach to skeletal muscle injury from Balius et al (2020) describing that when myoconnective junction is affected, the injury can be located either in a MTJ (the injury affects an aponeurosis or a tendinous expansion attached to muscle fibers) or in the myofascial junction (MFJ) (when the injury involves muscle fiber and their perimysium and/or epimysium). And when an injury in the myoconnective junction has a tendon gap (by MRI), the injury will have worst prognosis, require longer time to RTP and could present greater risk of re-injury compared to others injuries.…”

“…This second project of L-BIA developed by FCB Medical Department evaluates the capacity of the L-BIA method to differentiate muscle injuries according to anatomical location in tendinous, MTJ and MFJ, which are diagnosed by MRI exam 24 h after injury and classified according to The British Athletics Muscle Injury Classification (Pollock et al, 2014) considering the histoarchitectural approach to skeletal muscle injury (Balius et al, 2020). The most important finding is the good association between both MRI and L-BIA methods in myotendinous junction (MTJ) and myofascial junction (MFJ) injuries.…”

“…The decision on the days to RTP, is conditioned by the severity of the injury (Pedret et al, 2015;Balius et al, 2018, Balius et al, 2020 and by the myoconnective junction involved. The days to RTP are strongly associated with changes in Xc (muscular fibers retraction quantified by % different of Xc) i.e., the severity of injuries is reflected by higher changes in Xc and longer time to RTP.…”

“…After MRI exam, 37 muscle injuries were categorized according to The British Athletics Muscle Injury Classification (Pollock et al, 2014) and considering the histoarchitectural approach to skeletal muscle injury (Balius et al, 2020) taking to account:…”

“…However, a study of full-thickness intramuscular tendon damage, did not show re-injury after 12 months (Vermeulen et al, 2019). Regarding MTJ and MFJ injuries, it is not clear which one has better prognosis and, consequently, less time to RTP (Balius et al, 2020).…”