Isolated Tears of the Gracilis Muscle

Abstract

Background: Although posterior thigh muscle strains are common in athletes, there are no reports regarding isolated gracilis muscle injuries. The authors present a case series of 7 elite athletes with isolated gracilis muscle ruptures. Purpose: To present the injury pattern, clinical presentation, diagnosis, and outcome of gracilis muscle ruptures. Study Design: Case series; Level of evidence, 4. Methods: This is a retrospective review of 7 elite athletes with posterior thigh pain (3 dancers, 2 soccer players, 1 tae kwon do player, 1 tennis player). In all athletes, the injury occurred during thigh adduction with the hip internally rotated, as clearly evident at ultrasound scans performed 1 to 20 days after the injury. Management included an initial rest period, followed by physiotherapy and gradual return to sports activities. Results: According to the ultrasound scans, the lesions were in the proximal-middle third junction of the thigh, at the muscle-tendon junction. The lesions were classified as grade 2 (partial discontinuity). The muscle injury area was, on average, 17.1 × 23.7 mm (range, 10-31 × 9-46 mm). The average length of the lesions was 40.14 mm (range, 20-52 mm). All athletes recovered and returned to full performance within 6 weeks of the injury (average, 35.6 days). Conclusion: Medial thigh pain after eccentric contraction during hip adduction should raise suspicion of a gracilis muscle tear. Ultrasound is useful, and full recovery occurs within 6 weeks from the injury.