[Muscle injuries in sport : High clinical relevance and diagnostic challenges]

Muscle injuries are among the most frequent sports-related injuries, particularly affecting the lower extremities in high-performance sports. This article provides a structured, evidence-based approach to diagnostics, treatment and prevention. A key aspect is the differentiation between functional and structural muscle injuries, as this distinction determines the treatment strategies. Despite modern imaging the clinical examination remains the diagnostic gold standard, while magnetic resonance imaging (MRI) findings must always be critically interpreted in the clinical context due to relevant discrepancies. Acute management is based on the POLICE principle, emphasizing early functional, load-adapted treatment. Eccentric strengthening exercises represent the most effective preventive strategy and significantly reduce the risk of injury. Return to play decisions should not rely solely on pain resolution but must include functional and structural recovery criteria to minimize reinjury risk.