Background: Muscle injuries may affect elite athletes including those competing at the Paralympic Games. We aimed to describe the frequencies, anatomic distribution, and severity of muscle injuries involving Paralympic athletes during the Rio de Janeiro 2016 Summer Paralympic Games.Methods: Imaging-depicted muscle injuries in Paralympic athletes were identified upon retrospective review of all MRI studies performed at the Games. Images were evaluated retrospectively by five board-certified musculoskeletal radiologists with expertise in sports injuries. We recorded the distribution of muscle injuries by sports discipline, athletes' impairment type, anatomic location and severity of injuries using the modified Peetrons classification and the British Athletics Muscle Injury Classification (BAMIC). Demographic characteristics including impairment type were also analyzed.Results: 4378 para athletes from 160 teams were included. 242 MRI exams were performed and there were 35 MRI-depicted muscle injuries in 33 athletes (73% male, mean age: 28.7 years -range 20-41). Para athletes from track and field (athletics) disciplines were most commonly affected by muscle injuries (N = 23, 66%), followed by football players (N = 4, 11%) and power lifters (N = 4, 11%). The majority of injuries affected lower limb muscles (N = 28, 80%), with the biceps femoris being the most common (N = 10, 29%). Most frequent injuries were modified Peetrons grade 1 injuries (N = 15, 43%), and BAMIC grade 2a injuries (N = 7, 20%).
Conclusion:Muscle injuries in this population were rare. Hamstring muscle injuries were the most common and were observed most frequently in ambulatory para athletes competing in athletics.