The MLG-R Muscle Injury Classification for Hamstrings

Muscle injuries are very common in sport. Over the past decade several classification and grading systems for muscle injuries have been published. This FastFact highlights the MLG-R system that has been developed in collaboration with the FC Barcelona medical department1.

A good classification system is necessary, which allows to have reliable epidemiological data, which are the base to improve our knowledge about muscle injuries; better knowledge leads to better therapeutic options, prognosis, RTP criteria or lower re-injury rates.

The MLG-R proposal is an acronym which refers to the mechanism of injury (M), location of injury (L), grading of severity (G), and number of muscle re-injuries (R). The aim of the proposal was to describe a classification system for muscle injuries with easy clinical application, adequate grouping of injuries with similar functional impairment, and potential prognostic value (which still need to be proved). 

To achieve classification objectives, the study was designed in three phases: 

(1) identify the existing evidence related to risk and prognostic factors for muscle injuries; 

(2) discuss these factors between two of the institutions and establish a consensus based on the quality of studies in combination with experts’ experience; and 

(3) elaborate the final classification.

The grading category, is based on the muscle injury radiological features. All these features are globally evaluated and the quantification of edema is not a parameter taken into account. The most important thing is to evaluate the connective tissue injured. The MLG-R is not the best and it will not be the last proposal, but its strongest point is to be a flexible and open system, allowing future adaptation to incorporate any subsequent knowledge shown to be relevant to prognosis or diagnosis. Our final aim is to create a better and more accepted proposal in the future.

Reference

1. FIFA Medical

2. Valle X, Mechó S, Pruna R, Pedret C, Isern J, Monllau JC, Rodas G. The MLG-R muscle injury classification for hamstrings. Examples and guidelines for its use. Apunts Medicina de l’Esport. 2019;54:73-9. doi:10.1016/j.apunts.2018.11.002