DR CARLES PEDRET, DR RAMON BALIUS, DR JOSÉ PEÑA-AMARO, DR TERO JÄRVINEN

Cells and tissue morphology seem to be very far from our daily practice, but it is very important to notice that if we want to understand in the best possible return-to- play from a myoaponeurotic injury in our players, skeletal muscle morphology plays a crucial role.

Several classification systems for muscle injuries have been proposed in recent years.1,2,3 They take into consideration the location of the injury and the injured structures as a key point for the diagnosis and prognosis. The problem is that, despite significant amount of research invested in the topic, disagreement persists among healthcare practitioners regarding the proper application/use of such basic anatomical terms such as tendon, aponeurosis, and fascia. To achieve clarity on this issue, specifically ensuring uniformity in our terminology, it is essential to first comprehend the unique properties of each anatomical component.

Let’s try to think about a very simple example. We are facing an injury in a player that has been classified as a BAMIC 2B. By definition, this is a moderate muscle/myoaponeurotic tear. But the key question remains: do we really understand what exactly an aponeurosis is? Which type of connective tissue is it and what are its functional characteristics?