Return-to-Play after Lower Limb Muscle Injury in Football: The Italian Consensus Conference Guidelines

Introduction
Contents
1: The Italian Consensus Conference on Return to Play After Lower Limb Muscle Injury in Football
1.1 Introduction
1.2 The Italian Consensus Conference on Return to Play After Lower Limb Muscle Injury in Football
1.3 Consensus Conference Proceedings
References
2: General Principles for Return to Training and Return to Play
2.1 The Appropriateness of the RTP Term
2.2 The RTT Basic Principles
2.3 The RTP Basic Principles
2.4 The Evaluation of Physical Fitness
2.5 Evidence on RTT and RTP
2.6 Risk in the Short, Medium, and Long Term
2.7 The Concept of “Tolerable Risk” in RTT-DMP
2.8 The “Intensity-Type-Timing” Principle
2.9 The Basic Principles of Functional Tests
2.10 The Objectivity of the Decision Criteria
2.11 The Patient Centrality
2.12 The Different Focus Types
2.13 The Decision-Making Process
2.14 Closed and Open Skill Tests
2.15 The Biopsychosocial Model
2.16 Conclusions
References
3: The Structure of the Return to Training Decision-Making Process
3.1 Introduction to RTT Assessment
3.2 Clinical Assessment
3.3 The Role of Imaging in the RTT-DMP
3.4 Laboratory Tests
References
4: The Structure of the Return to Play Decision-Making Process
4.1 The RTP Basic Principles
4.2 Quantitative Evaluation (QNE)
4.3 Qualitative Evaluation (QLE)
4.4 Parameter Analysis (PA)
References
5: The Role of Imaging in the Return to Training and Return to Play Decision-Making Process
5.1 Introduction
5.2 The Current State of Art
5.3 The Italian Consensus Conference Suggestions
5.4 When Progress Unmasks the Dangerous Violation of the Wisdom of Nature
5.5 Conclusions
References
6: Basic Principles of Dynamometric Test
6.1 Introduction
6.2 The Dynamometric Assessment of the Isometric Contraction
6.3 Isotonic Assessment Versus Isokinetic Assessment
6.4 The Interpretation of the Isokinetic Test
6.4.1 Torque Parameters
6.4.2 The Time Rate to Torque Development
6.4.3 Force Decay Rate
6.4.4 Range of Motion
6.4.5 Reciprocal Innervation Time
References
7: The Use of Global Positioning System in the Return to Play Decision-Making Process
7.1 Introduction
7.2 Acquisition of Different Variables
7.3 The Classification of the Intensity Zones
7.4 GPS for Evaluating Impact and Collision Data
7.5 The Use of GPS in Different Age Groups and in Different Levels of Athletic Performance
7.6 The Use of GPS for Injuries Prevention
7.7 Conclusions
References
8: Return to Training and Return to Play Following Quadriceps Injury
8.1 Anatomical Description
8.2 Epidemiological Notes
8.3 Clinical and Imaging Assessments for RTT
8.3.1 General Assessment
8.3.2 Specific Assessment
8.4 Laboratory Tests for RTT
8.5 Field Tests for RTT
8.6 RTP Tests after QS Injury
References
9: Return to Training and Return to Play Following Hamstring Injury
9.1 Anatomical Description
9.2 Epidemiological Notes
9.3 Clinical and Imaging Assessments for RTT
9.3.1 General Assessment
9.3.2 Specific Assessment
9.4 Laboratory Tests for RTT
9.5 Field Tests for RTT
9.6 RTP Tests after HS Injury
References
10: Return to Training and Return to Play Following Adductor Injury
10.1 Anatomical Description
10.1.1 Adductor Longus
10.1.2 The External Obturator
10.1.3 Adductor Brevis
10.1.4 Adductor Magnus
10.1.4.1 Pubofemoral (Adductor) Portion
10.1.4.2 Ischiocondylar (Hamstring) Portion
10.1.5 Pectineus
10.1.6 Gracilis Muscle
10.2 Epidemiological Notes
10.3 Clinical and Imaging Assessments for RTT
10.3.1 General Assessment
10.3.2 Specific Assessment
10.4 Laboratory Tests for RTT
10.5 Field Tests for RTT
10.6 RTP Tests after Adductor Injury
References
11: Return to Training and Return to Play Following Soleus-Gastrocnemius Injury
11.1 Anatomical Description
11.1.1 Soleus Muscle
11.1.2 Gastrocnemius Muscle
11.2 Epidemiological Notes
11.3 Clinical and Imaging Assessments for RTT
11.3.1 General Assessment
11.3.2 Specific Assessment
11.4 Laboratory Tests for RTT
11.5 Field Tests for RTT
11.6 RTP Tests After SGMC Injury
References
12: Return to Training and Return to Play Following Hip Short External Rotator Muscle Injury
12.1 Anatomical Description
12.1.1 The Piriformis
12.1.2 The Internal Obturator
12.1.3 Gemellus Muscles
12.1.3.1 Superior Gemellus
12.1.3.2 Inferior Gemellus
12.1.4 The Quadratus Femoris
12.1.5 The External Obturator
12.2 Epidemiological Notes
12.3 Clinical and Imaging Assessments for RTT
12.3.1 General Assessment
12.3.2 Specific Assessment
12.4 Laboratory Tests for RTT
12.5 Field Tests for RTT
12.6 RTP Tests After Short External Hip Rotator Muscles Injuries
References
13: Return to Training and Return to Play Following Iliopsoas Injury
13.1 Anatomical Description
13.2 Epidemiological Notes
13.3 Clinical and Imaging Assessments for RTT
13.3.1 General Assessment
13.3.2 Specific Assessment
13.4 Laboratory Tests for RTT
13.5 Field Tests for RTT
13.6 RTP Tests after Iliopsoas Injury
References
14: The Clinical Tests for RTT Decision-Making Process
14.1 Introduction
14.2 Quadriceps RTT Clinical Tests
14.3 Hamstring RTT Clinical Tests
14.3.1 Straight Leg Raise Test
14.3.2 Dynamic Flexibility H Test
14.4 Adductors RTT Clinical Tests
14.4.1 Pubic Stress Test
14.4.2 Resisted Hip Adduction Test
14.4.3 The Squeeze Test
14.5 Soleus-Gastrocnemius RTT Clinical Tests
14.5.1 Weight Bearing Lunge Test
14.5.2 Heel-Raise Test
14.6 Short External Hip Rotator Injury RTT Clinical Tests
14.6.1 Pace and Nagle Maneuver Tests
14.6.2 Beatty Maneuver Test
14.6.3 Freiberg Maneuver Test
14.6.4 Internal Rotation Test
14.7 Iliopsoas Injury RTT Clinical Tests
References
15: The Laboratory Tests for RTT Decision-Making Process
15.1 Introduction
15.2 Quadriceps RTT Laboratory Tests
15.2.1 Isometric Tests
15.2.2 Isotonic Tests
15.2.3 Isokinetic Tests
15.2.3.1 Concentric Modality
15.2.3.2 Eccentric Modality
15.3 Hamstring RTT Laboratory Tests
15.3.1 Isometric Test
15.3.2 Isotonic Test
15.3.3 Isokinetic Tests
15.4 Adductor RTT Laboratory Tests
15.4.1 Isometric Tests
15.4.2 Isotonic Test
15.4.3 Isokinetic Tests
15.5 Soleus-Gastrocnemius RTT Laboratory Tests
15.5.1 Isometric Tests
15.5.2 Isotonic Test
15.5.3 Synchro Plates Test Specific for Calves Muscles
15.5.4 Drop Test Performed with Synchro Plates
15.6 Short External Hip Rotator Muscles RTT Laboratory Tests
15.6.1 Isometric Tests
References
16: The Field Tests for RTT Decision-Making Process
16.1 Introduction
16.2 Braking Test
16.2.1 Protocol
16.2.2 Indication
16.3 Illinois Agility Test
16.3.1 Protocol
16.3.2 Indication
16.4 Agility T-Test
16.4.1 Indication
16.5 Carioca Test
16.5.1 Protocol
16.5.2 Indication
16.6 Kicking Test
16.6.1 Protocol
16.6.2 Indication
16.7 Retro-Run Test
16.7.1 Protocol
16.7.2 Indication
References
17: Case Report: Return to Play and Return to Training After Quadriceps Injury
17.1 Introduction
17.2 Case Report
17.2.1 Phase I
17.2.2 Phase II
17.2.3 Phase III
17.3 Clinical Test for Return to Training
17.3.1 Specific Assessment
17.4 Laboratory Tests for RTT
17.5 Field Tests for RTT
17.6 Return to Play Tests
17.7 Discussion
17.8 Conclusions
References
18: Case Report: Return to Play and Return to Training After Hamstring Injury
18.1 Introduction
18.2 Case Report
18.2.1 Phase II (20 Days)
18.2.2 Phase III (30 Days)
18.3 Clinical Test for Return to Training
18.3.1 Specific Assessment
18.4 Laboratory Tests for RTT
18.5 Field Tests for RTT
18.6 Return to Play Tests
18.7 Discussion
18.8 Conclusions
References
19: Case Report: Return to Play and Return to Training after Adductor Injury
19.1 Introduction
19.2 Case Report
19.2.1 Anamnesis
19.2.2 Inspection
19.2.3 Clinical Examination
19.2.4 Therapeutic Path
19.3 Clinical Test for Return to Training
19.3.1 Specific Assessment
19.4 Laboratory Tests for RTT
19.5 Field Tests for RTT
19.6 Return to Play Tests
19.7 Discussion
19.7.1 Scientific Rationale for Phase 1
19.7.2 Scientific Rationale for Phase 2
19.7.3 Scientific Rationale for Phase 3
19.8 Conclusions
Anamnestic Form
References
20: Case Report: Return to Play and Return to Training After Soleus-Gastrocnemius Injury
20.1 Introduction
20.2 Case Report
20.2.1 Anamnesis
20.2.2 Inspection
20.2.3 Clinical Examination
20.2.4 Therapeutic Path
20.3 Clinical Test for Return to Training
20.3.1 Specific Assessment
20.4 Laboratory Tests for RTT
20.5 Field Tests for RTT
20.6 Return to Play Tests
20.7 Discussion
20.8 Conclusion
References
21: Case Report: Return to Play and Return to Training After Hip Short External Rotator Muscles Injury
21.1 Introduction
21.2 Case Report
21.2.1 Phase I (5 days)
21.2.2 Phase II (7 Days)
21.2.3 Phase III (7 Days)
21.3 Clinical Test for Return to Training
21.3.1 Specific Assessment
21.4 Laboratory Tests for RTT
21.5 Field Tests for RTT
21.6 Return to Play Tests
21.7 Discussion
21.8 Conclusions
References
22: Case Report: Return to Play and Return to Training After Iliopsoas Injury
22.1 Introduction
22.2 Case Report
22.2.1 Phase I (7 Days)
22.2.2 Phase II (7 Days)
22.2.3 Phase III (7 Days)
22.3 Clinical Test for Return to Training
22.3.1 Specific Assessment
22.3.2 Laboratory Tests for RTT
22.4 Field Tests for RTT
22.5 Return to Play Tests
22.6 Discussion
22.7 Conclusions
References