Koscso Jonathan M, McElheny Kathryn, Carr James B, Hippensteel K J
Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA.
Curr Rev Musculoskelet Med. 2022 Dec;15(6):500-512. doi: 10.1007/s12178-022-09786-z. Epub 2022 Aug 1.
Lower extremity (LE) injuries are a common source of disability and time-loss for overhead athletes, and muscles have been found to be the predominant soft tissue structure affected. The current review highlights the orthopaedic literature examining lower extremity muscle injuries in overhead athletes in regard to epidemiology, diagnosis, and conventional and emerging treatment measures.
The hamstring muscles have been found to be the most commonly injured lower extremity muscle group in professional baseball, followed by the adductors, quadriceps, iliopsoas, and gastrocnemius-soleus complex. Strains and contusions comprise over 90% of these muscle injuries. Various advanced imaging grading systems have been developed to help characterize the nature of a muscle injury, although a clear and consistent prognostic utility of these systems is still unclear. The vast majority of lower extremity muscle injuries in overhead athletes are managed nonoperatively, and there is promising data on the use of emerging treatments such as platelet-rich plasma and blood flow restriction therapy. Lower extremity muscle injuries-often referred to as strains-are a relatively common issue in high-demand overhead athletes and can be a significant source of time-loss. Within baseball, position players are affected far more often than pitchers, and sprinting and fielding are the most common activities leading to strains. Magnetic resonance imaging (MRI) is considered the gold standard imaging modality to evaluate these muscle injuries and will allow for a detailed assessment of tissue damage. Nonetheless, return-to-play is often dictated by a given athlete's progression through a nonoperative rehabilitation protocol, with surgical intervention reserved for less common, select injury patterns.
下肢损伤是上肢运动员残疾和误工的常见原因，肌肉是受影响的主要软组织结构。本综述重点介绍了骨科文献中关于上肢运动员下肢肌肉损伤的流行病学、诊断以及传统和新兴治疗措施。
在职业棒球运动中，腘绳肌是最常受伤的下肢肌肉群，其次是内收肌、股四头肌、髂腰肌和腓肠肌-比目鱼肌复合体。拉伤和挫伤占这些肌肉损伤的90%以上。虽然尚不清楚这些系统明确且一致的预后效用，但已开发出各种先进的影像学分级系统来帮助描述肌肉损伤的性质。上肢运动员的绝大多数下肢肌肉损伤采用非手术治疗，关于使用富血小板血浆和血流限制疗法等新兴治疗方法的数据很有前景。下肢肌肉损伤（通常称为拉伤）在高需求的上肢运动员中是一个相对常见的问题，并且可能是误工的重要原因。在棒球运动中，内场手比投手更容易受到影响，短跑和防守是导致拉伤的最常见活动。磁共振成像（MRI）被认为是评估这些肌肉损伤的金标准成像方式，并且可以对组织损伤进行详细评估。尽管如此，恢复比赛通常取决于特定运动员通过非手术康复方案的进展情况，手术干预仅适用于不太常见的特定损伤类型。
