Discussion Author(s): Christina Waite
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The exact musculoskeltal injury can be difficult to assess clinically due to patient pain, swelling, and hematoma. An MRI is the best imaging modality to evaluate musculotendinous injuries. Indirect exertional injury is a common cause of injury in athletes, which can be classified into two types: muscle strain and a sprain. Muscle strain is â€śa defined painful event that a patient can recount and relate as a source of injury with resultant acute symptoms.â€ť1 A sprain usually refers to ligamentous injury. Clinically, strains can be classified into grades depending upon the extent of functional disruption. Grade I strains have no significant loss of function. Grade II strains (or â€śpartial tearsâ€ť) have impaired function/strength, but not complete loss. Grade III is a complete loss of function. Grade III myotendinous juncture disruptions often show a frayed or â€śmop-endâ€ť appearance. 1
The adductor longus muscle is a common muscle to be injured, causing a strain. However, Grade III strains are not as common.2 Clinically, it is characterized by the appearance of a swelling on the medial aspect of the upper third of the thigh. The probable mechanism of injury is a combination of wide abduction of the thighs with flexion of one hip and internal rotation of the other. 2 Recommended treatment is direct surgical repair is fresh ruptures or excision of the muscle in late cases (only if severely symptomatic).2 However, if the rupture is at the musculotendinous junction, it can be very difficult to repair, and conservative therapy (ice, thigh compression, and rest using crutches) is usually successful and recommended.
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