scholarly journals Intramuscular tendon injury is not associated with an increased hamstring reinjury rate within 12 months after return to play

2018 ◽  
Vol 52 (19) ◽  
pp. 1261-1266 ◽  
Author(s):  
Anne D van der Made ◽  
Emad Almusa ◽  
Gustaaf Reurink ◽  
Rod Whiteley ◽  
Adam Weir ◽  
...  
Keyword(s):  
Hamstring Tendon ◽  
Tendon Injury ◽  
Acute Onset ◽  
Rehabilitation Programme ◽  
Thigh Pain ◽  
Return To Play ◽  
Hamstring Injury ◽  
Football Players ◽  
Significant Difference ◽  
Injury Treatment

BackgroundAcute hamstring injury that includes intramuscular tendon injury has been suggested to be associated with increased reinjury risk. These observations were based on a relatively small number of retrospectively analysed cases.ObjectiveTo determine whether intramuscular tendon injury is associated with higher reinjury rates in acute hamstring injury.MethodsMRIs of 165 athletes with an acute hamstring injury were obtained within 5 days of injury. Treatment consisted of a standardised criteria-based rehabilitation programme. Standardised MRI parameters and intramuscular tendon injury, the latter subdivided into tendon disruption and waviness, were scored. We prospectively recorded reinjuries, defined as acute onset of posterior thigh pain in the same leg within 12 months after return to play.ResultsParticipants were predominantly football players (72%). Sixty-four of 165 (39%) participants had an index injury with intramuscular hamstring tendon disruption, and waviness was present in 37 (22%). In total, there were 32 (19%) reinjuries. There was no significant difference (HR: 1.05, 95% CI 0.52 to 2.12, P=0.898) in reinjury rate between index injuries with intramuscular tendon disruption (n=13, 20%) and without tendon disruption (n=19, 20%). There was no significant difference in reinjury rate (X²(1)=0.031, P=0.861) between index injuries with presence of waviness (n=7, 19%) and without presence of waviness (n=25, 20%).ConclusionIn athletes with an acute hamstring injury, intramuscular tendon injury was not associated with an increased reinjury rate within 12 months after return to play.

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 Central Tendon Injuries of Hamstring Muscles: Case Series of Operative Treatment

2018 ◽  
Vol 6 (2) ◽  
pp. 232596711875599 ◽  
Author(s):  
Lasse Lempainen ◽  
Jussi Kosola ◽  
Ricard Pruna ◽  
Jordi Puigdellivol ◽  
Janne Sarimo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Case Series ◽  
Hamstring Tendon ◽  
Tendon Injury ◽  
Tendon Injuries ◽  
Return To Play ◽  
Resonance Imaging ◽  
Hamstring Muscles

Background: As compared with injuries involving muscle only, those involving the central hamstring tendon have a worse prognosis. Limited information is available regarding the surgical treatment of central tendon injuries of the hamstrings. Purpose: To describe the operative treatment and outcomes of central tendon injuries of the hamstrings among athletes. Study Design: Case series; Level of evidence, 4. Methods: Eight athletes (6 top level, 2 recreational) with central hamstring tendon injuries underwent magnetic resonance imaging and surgical treatment. The indication for surgery was recurrent (n = 6) or acute (n = 2) central hamstring tendon injury. All patients followed the same postoperative rehabilitation protocol, and return to play was monitored. Results: Magnetic resonance imaging found a central tendon injury in all 3 hamstring muscles (long head of the biceps femoris, semimembranosus, and semitendinosus) with disrupted tendon ends. In acute and recurrent central tendon injuries, full return to play was achieved at 2.5 to 4 months. There were no adverse events during follow-up. Conclusion: Central tendon injuries of the hamstrings can be successfully repaired surgically after acute and recurrent ruptures.

Effect of Concussions on the Performance of Running Backs and Wide Receivers in the National Football League

2019 ◽  
Vol 47 (11) ◽  
pp. 2717-2722 ◽  
Author(s):  
Toufic R. Jildeh ◽  
Kelechi R. Okoroha ◽  
Kevin A. Taylor ◽  
Patrick Buckley ◽  
Samir Mehta ◽  
...  
Keyword(s):  
National Football League ◽  
Individual Performance ◽  
High Rate ◽  
Return To Play ◽  
Control Group ◽  
Football Players ◽  
Professional Football ◽  
Significant Difference ◽  
Before And After ◽  
Player Performance

Background: Concussion injuries are common in professional football players; however, their effect on player performance remains unclear. Purpose: To quantify the effect of concussions on the performance of running backs and wide receivers in professional football players. Study Design: Cohort study; Level of evidence, 3. Methods: Concussion data from the National Football League were collected for a period of 4 seasons (2012-2015) for running backs and wide receivers. Age, experience, position, time to return to play, yearly total yards, and touchdowns were recorded. A power rating (total yards divided by 10 plus touchdowns multiplied by 6) was calculated for each player’s injury season as well as for the 3 seasons before and after their respective injury. A control group of running backs and wide receivers without an identified concussion injury who competed in the 2012 season was assembled for comparison. Player performance up to 3 seasons before and after the injury season was examined to assess acute and longitudinal changes in player performance. Results: A total of 38 eligible running backs and wide receivers sustained a concussion during the study period. Thirty-four (89%) players were able to return to competition in the same season, missing an average of 1.5 ± 0.9 games; the remaining 4 players returned in the subsequent season. Power ratings for concussed players were similar to those of controls throughout the study period. Concussed players did not suffer an individual performance decline upon returning within the same season. Furthermore, no significant difference in change of power rating was observed in concussed players in the acute (±1 year from injury; −1.2 ± 4.8 vs –1.1 ± 3.9, P = .199) or chronic (±3 years from injury; –3.6 ± 8.0 vs –3.0 ± 4.5, P = .219) setting compared with controls. All concussed players successfully returned to competition in either the index or next season. Conclusion: A high rate of National Football League running backs and wide receivers are able to return to play after a concussion injury. These players were found to perform at a similar level in both the acute and long-term period after concussion.

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.

Characteristics and Outcomes of Arthroscopic Femoroacetabular Impingement Surgery in the National Football League

2017 ◽  
Vol 46 (1) ◽  
pp. 144-148 ◽  
Author(s):  
Benedict U. Nwachukwu ◽  
Asheesh Bedi ◽  
Ajay Premkumar ◽  
Pete Draovitch ◽  
Bryan T. Kelly
Keyword(s):  
Femoroacetabular Impingement ◽  
National Football League ◽  
Arthroscopic Surgery ◽  
High Rate ◽  
Return To Play ◽  
Labral Repair ◽  
Control Group ◽  
Football Players ◽  
Level Of Evidence ◽  
Significant Difference

Background: Previous studies have reported that hip abnormalities may account for 10% of injuries in professional football players. The effect of femoroacetabular impingement (FAI) and arthroscopic FAI surgery in National Football League (NFL) athletes has not been well studied. Purpose: To investigate the effect of arthroscopic FAI surgery on return to play (RTP) and RTP performance in NFL players. Study Design: Cohort study; Level of evidence, 3. Methods: NFL athletes undergoing arthroscopic FAI surgery at a single institution between 2006 and 2014 were identified. Medical records were reviewed for demographic, clinical, and operative variables. RTP and RTP performance were assessed based on a review of publicly available NFL player statistics. RTP and RTP performance data included time to RTP; games played before and after the injury; yearly total yards and touchdowns for offensive players; and yearly total tackles, sacks, and interceptions for defensive players. The offensive power rating (OPR = [total yards/10] + [total touchdowns × 6]) and defensive power rating (DPR = total tackles + [total sacks × 2] + [total interceptions × 2]) were calculated. Paired t tests comparing preinjury and postinjury seasons were performed. A matched cohort of NFL players was created to compare trends for OPR, DPR, and career longevity. Results: Forty-eight hips in 40 NFL players (mean age, 25.6 years) with symptomatic FAI were included; 8 players underwent staged bilateral hip arthroscopic procedures. The majority of players were offensive (n = 24; 60.0%), with offensive lineman (n = 11; 27.5%) being the most common of all positions. Of the 48 included hips, all had labral tears, and 41 (85.4%) underwent labral repair. Forty-two of the 48 hips (87.5%) underwent cam decompression, and 10 (20.8%) underwent rim decompression. Of the 40 included players, 37 (92.5%) achieved RTP to professional competition after their hip arthroscopic surgery at a mean of 6.0 months. Before the injury, included patients played in a mean of 11.0 games compared with 9.5 games in their postoperative season ( P = .26). The mean OPR and DPR demonstrated a nonsignificant decline in the postoperative season (preinjury OPR, 40.2; postinjury OPR, 32.3; P = .34) (preinjury DPR, 49.6; postinjury DPR, 36.4; P = .10). A similar decline in the OPR and DPR across seasons was observed in the control group. NFL athletes played, on average, 3.3 ± 1.5 seasons after undergoing hip arthroscopic surgery; this was not significantly different from the controls (2.5 ± 1.5 seasons; P = .47). There was no significant difference in mean annual salaries based on contracts negotiated before the injury and the first negotiated contract after surgery ($3.3 million vs $3.6 million, respectively; P = .58). Conclusion: There was a very high rate of RTP in the NFL after arthroscopic FAI surgery; this rate is higher than what has been previously reported for other orthopaedic procedures in NFL athletes. Additionally, these NFL athletes achieved RTP at a faster time frame (6 months) than previously reported for other procedures. These findings have important implications for counseling elite football players about the expected outcome of arthroscopic FAI surgery.

scholarly journals At return to play following hamstring injury the majority of professional football players have residual isokinetic deficits

2014 ◽  
Vol 48 (18) ◽  
pp. 1364-1369 ◽  
Author(s):  
Johannes L Tol ◽  
Bruce Hamilton ◽  
Cristiano Eirale ◽  
Patrice Muxart ◽  
Philipp Jacobsen ◽  
...  
Keyword(s):  
Return To Play ◽  
Hamstring Injury ◽  
Football Players ◽  
Professional Football

scholarly journals Platelet-Rich Plasma Shortens Return to Play in National Football League Players With Acute Hamstring Injuries

2020 ◽  
Vol 8 (4) ◽  
pp. 232596712091173 ◽  
Author(s):  
James P. Bradley ◽  
Tracye J. Lawyer ◽  
Sonia Ruef ◽  
Jeffrey D. Towers ◽  
Justin W. Arner
Keyword(s):  
National Football League ◽  
Platelet Rich Plasma ◽  
Nonoperative Treatment ◽  
Return To Play ◽  
Professional Athletes ◽  
Hamstring Injury ◽  
Level Of Evidence ◽  
Hamstring Injuries ◽  
Recurrent Injury ◽  
Significant Difference

Background: Hamstring injuries are prevalent in professional athletes and can lead to significant time loss, with recurrent injury being common. The efficacy of platelet-rich plasma (PRP) for augmentation of nonoperative treatment of partial musculotendinous hamstring injuries is not well established. Hypothesis: The addition of PRP injections to nonoperative treatment for acute partial musculotendinous hamstring injuries will lead to a shortened return to play in National Football League (NFL) players. Study Design: Cohort study; Level of evidence, 3. Methods: NFL players from a single team who sustained acute grade 2 hamstring injuries, as diagnosed on magnetic resonance imaging (MRI) by a musculoskeletal radiologist from 2009 to 2018, were retrospectively reviewed. Average days, practices, and games missed were recorded. Players who did and did not receive PRP (leukocyte-poor) injections were compared. Those who received PRP did so within 24 to 48 hours after injury. Results: A total of 108 NFL players had MRI evidence of a hamstring injury, and of those, 69 athletes sustained grade 2 injuries. Thirty players received augmented treatment with PRP injections and 39 players underwent nonoperative treatment alone. Average time missed in those treated with PRP injections was 22.5 days, 18.2 practices, and 1.3 games. In those who did not receive PRP injections, time missed was 25.7 days ( P = .81), 22.8 practices ( P = .68), and 2.9 games ( P < .05). Conclusion: Augmentation with PRP injections for acute grade 2 hamstring injuries in NFL players showed no significant difference in days missed or time to return to practice but did allow for faster return to play, with a 1 game overall difference. Owing to the possible large financial impact of returning to play 1 game sooner, PRP injections for treatment of grade 2 hamstring injuries may be advantageous in professional athletes.

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