Return to play and recurrence rate following hamstring injury in elite football: use of the British Athletic Muscle Injury Classification

Physiotherapy ◽  
2019 ◽  
Vol 105 ◽  
pp. e45 ◽  
Author(s):  
A. Rushton ◽  
K.A. Khurniawan ◽  
S. James ◽  
R. Botchu ◽  
R. Shamji
Keyword(s):  
Recurrence Rate ◽  
Muscle Injury ◽  
Return To Play ◽  
Hamstring Injury ◽  
Injury Classification

Hamstring rehabilitation in elite track and field athletes: applying the British Athletics Muscle Injury Classification in clinical practice

2019 ◽  
Vol 53 (23) ◽  
pp. 1464-1473 ◽  
Author(s):  
Ben Macdonald ◽  
Stephen McAleer ◽  
Shane Kelly ◽  
Robin Chakraverty ◽  
Michael Johnston ◽  
...  
Keyword(s):  
Muscle Injury ◽  
Clinical Presentation ◽  
Classification Systems ◽  
Track And Field ◽  
Hamstring Injury ◽  
Shared Decision ◽  
Injury Rehabilitation ◽  
Hamstring Injuries ◽  
Elite Sports ◽  
Injury Classification

RationaleHamstring injuries are common in elite sports. Muscle injury classification systems aim to provide a framework for diagnosis. The British Athletics Muscle Injury Classification (BAMIC) describes an MRI classification system with clearly defined, anatomically focused classes based on the site of injury: (a) myofascial, (b) muscle–tendon junction or (c) intratendinous; and the extent of the injury, graded from 0 to 4. However, there are no clinical guidelines that link the specific diagnosis (as above) with a focused rehabilitation plan.ObjectiveWe present an overview of the general principles of, and rationale for, exercise-based hamstring injury rehabilitation in British Athletics. We describe how British Athletics clinicians use the BAMIC to help manage elite track and field athletes with hamstring injury. Within each class of injury, we discuss four topics: clinical presentation, healing physiology, how we prescribe and progress rehabilitation and how we make the shared decision to return to full training. We recommend a structured and targeted diagnostic and rehabilitation approach to improve outcomes after hamstring injury.

A 4-year study of hamstring injury outcomes in elite track and field using the British Athletics rehabilitation approach

2021 ◽  
pp. bjsports-2020-103791
Author(s):  
Noel Pollock ◽  
Shane Kelly ◽  
Justin Lee ◽  
Ben Stone ◽  
Michael Giakoumis ◽  
...  
Keyword(s):  
Muscle Injury ◽  
Tendon Injury ◽  
Track And Field ◽  
Return To Play ◽  
Hamstring Injury ◽  
Cross Sectional ◽  
Entire Cohort ◽  
Hamstring Injuries ◽  
Longitudinal Length ◽  
Tendon Tension

ObjectivesThe British Athletics Muscle Injury Classification (BAMIC) correlates with return to play in muscle injury. The aim of this study was to examine hamstring injury diagnoses and outcomes within elite track and field athletes following implementation of the British Athletics hamstring rehabilitation approach.MethodsAll hamstring injuries sustained by elite track and field athletes on the British Athletics World Class Programme between December 2015 and November 2019 that underwent an MRI and had British Athletics medical team prescribed rehabilitation were included. Athlete demographics and specific injury details, including mechanism of injury, self-reported gait phase, MRI characteristics and time to return to full training (TRFT) were contemporaneously recorded.Results70 hamstring injuries in 46 athletes (24 women and 22 men, 24.6±3.7 years) were included. BAMIC grade and the intratendon c classification correlated with increased TRFT. Mean TRFT was 18.6 days for the entire cohort. Mean TRFT for intratendon classifications was 34±7 days (2c) and 48±17 days (3c). The overall reinjury rate was 2.9% and no reinjuries were sustained in the intratendon classifications. MRI variables of length and cross-sectional (CSA) area of muscle oedema, CSA of tendon injury and loss of tendon tension were associated with TRFT. Longitudinal length of tendon injury, in the intratendon classes, was not associated with TRFT.ConclusionThe application of BAMIC to inform hamstring rehabilitation in British Athletics results in low reinjury rates and favourable TRFT following hamstring injury. The key MRI variables associated with longer recovery are length and CSA of muscle oedema, CSA of tendon injury and loss of tendon tension.

scholarly journals Association of the British Athletic Muscle Injury Classification and anatomic location with return to full training and reinjury following hamstring injury in elite football

2021 ◽  
Vol 7 (2) ◽  
pp. e001010
Author(s):  
Ricky Shamji ◽  
Steven L J James ◽  
Rajesh Botchu ◽  
Kent A Khurniawan ◽  
Gurjit Bhogal ◽  
...  
Keyword(s):  
Muscle Injury ◽  
Biceps Femoris ◽  
Tendon Injury ◽  
Hamstring Injury ◽  
Football Players ◽  
Muscle Injuries ◽  
Muscle Involvement ◽  
Significant Difference ◽  
Distal Tendon ◽  
Injury Classification

BackgroundThe relationship between hamstring muscle injuries (HMIs) that involve the intramuscular tendon and prolonged recovery time and increased reinjury rate remains unclear in elite footballers.ObjectiveTo determine the association of time to return to full training (TRFT) and reinjury of HMIs using the British Athletic Muscle Injury Classification (BAMIC) and specific anatomical injury location in elite-level football players.MethodsThe electronic medical records of all players at an English Premier League club were reviewed over eight consecutive seasons. All players who sustained an acute HMI were included. Two experienced musculoskeletal radiologists independently graded each muscle using the BAMIC, categorised each injury location area (proximal vs middle vs distal third and proximal vs distal tendon) and reported second muscle involvement. TRFT and reinjury were recorded.ResultsOut of 61 HMIs, the intramuscular tendon (BAMIC ‘c’) was involved in 13 (21.3%). HMI involving the intramuscular tendon (‘c’) had a mean rank TRFT of 36 days compared with 24 days without involvement (p=0.013). There were 10 (16.4%) reinjuries with a significant difference of 38.5% reinjury rate in the group with intramuscular tendon injury (‘c’) and 12.5% in the group without (p=0.031). TRFT and reinjury involving a second muscle was statistically significantly higher than without. Most of the HMIs to the biceps femoris with reinjury (5 out of 9) were in the distal third section related to the distal tendon site involving both the long and short head.ConclusionTRFT in HMI involving the intramuscular tendon (‘c’) of the Biceps femoris is significantly longer with significantly higher reinjury rate compared with injuries without, in elite football players. The finding that most reinjures of the biceps femoris occurring in the distal third muscle at the distal tendon site, involving both the long and short head, merits further investigation.

scholarly journals The Current Implementation of an Evidence-Based Hamstring Injury Prevention Exercise (Nordic Hamstring Exercise) among Athletes Globally

2021 ◽  
Vol 21 (3) ◽  
pp. 273-280
Author(s):  
Wesam Saleh A. Al Attar
Keyword(s):  
Muscle Injury ◽  
Female Athletes ◽  
Lower Limbs ◽  
Hamstring Injury ◽  
Evidence Based ◽  
Hamstring Muscle ◽  
Injury Rates ◽  
Current Implementation ◽  
Self Administered Questionnaire ◽  
Gender Type

Purpose. The Nordic hamstring exercise (NHE) has been shown to be successful in reducing hamstring muscle injury (HMI), which is one of the most common non-contact injuries of the lower limbs. This is especially pertinent in sports that require acceleration, maximal sprints, and sudden changes in the direction of running and sprinting, such as soccer and rugby. This study aimed to evaluate the awareness, implementation, and opinions of athletes worldwide regarding the effectiveness of NHE in preventing hamstring injury. Materials and methods. A self-administered questionnaire was distributed to 1500 athletes from different sports. The survey consisted of six questions covering country, gender, type of sport, awareness, implementation, and opinions of athletes worldwide regarding the effectiveness of NHE in preventing hamstring injury. The survey was available in ten different languages. Results. A total of 1142 male and female athletes from different sports participated in the survey. More than half of the athletes 641 (56%) were aware of NHE, and only 519 (45.4 %) were implementing NHE in their current training routines. Athletes who implemented NHE reported a positive opinion regarding the program’s effectiveness with a score of 8.4 ± 1 out of 10. Conclusions. Many athletes were aware of NHE and implemented it in their training routine since they found it to be effective in decreasing hamstring injury rates. However, additional work must be done to educate athletes about the importance of implementing this exercise and its effectiveness in preventing hamstring injury.

Return to Training and Return to Play Following Hamstring Injury

2021 ◽  
pp. 55-59
Author(s):  
Gian Nicola Bisciotti ◽  
Alessandro Corsini ◽  
Piero Volpi
Keyword(s):  
Return To Play ◽  
Hamstring Injury

scholarly journals Return to play after hamstring injuries in football (soccer): a worldwide Delphi procedure regarding definition, medical criteria and decision-making

2017 ◽  
Vol 51 (22) ◽  
pp. 1583-1591 ◽  
Author(s):  
Nick van der Horst ◽  
FJG Backx ◽  
Edwin A Goedhart ◽  
Bionka MA Huisstede
Keyword(s):  
Decision Making ◽  
Field Testing ◽  
Return To Play ◽  
Hamstring Injury ◽  
Feedback Report ◽  
Hamstring Injuries ◽  
Starting Point ◽  
Delphi Procedure ◽  
Hamstring Flexibility ◽  
The Moment

There are three major questions about return to play (RTP) after hamstring injuries: How should RTP be defined? Which medical criteria should support the RTP decision? And who should make the RTP decision? The study aimed to provide a clear RTP definition and medical criteria for RTP and to clarify RTP consultation and responsibilities after hamstring injury. The study used the Delphi procedure. The results of a systematic review were used as a starting point for the Delphi procedure. Fifty-eight experts in the field of hamstring injury management selected by 28 FIFA Medical Centres of Excellence worldwide participated. Each Delphi round consisted of a questionnaire, an analysis and an anonymised feedback report. After four Delphi rounds, with more than 83% response for each round, consensus was achieved that RTP should be defined as ‘the moment a player has received criteria-based medical clearance and is mentally ready for full availability for match selection and/or full training’. The experts reached consensus on the following criteria to support the RTP decision: medical staff clearance, absence of pain on palpation, absence of pain during strength and flexibility testing, absence of pain during/after functional testing, similar hamstring flexibility, performance on field testing, and psychological readiness. It was also agreed that RTP decisions should be based on shared decision-making, primarily via consultation with the athlete, sports physician, physiotherapist, fitness trainer and team coach. The consensus regarding aspects of RTP should provide clarity and facilitate the assessment of when RTP is appropriate after hamstring injury, so as to avoid or reduce the risk of injury recurrence because of a premature RTP.

Sign in / Sign up

Export Citation Format

Share Document