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 A Longitudinal Investigation of Muscle Injuries in an Elite Spanish Male Academy Soccer Club: A Hamstring Injuries Approach

2020 ◽  
Vol 10 (5) ◽  
pp. 1610 ◽  
Author(s):  
Javier Raya-González ◽  
Mark de Ste Croix ◽  
Paul Read ◽  
Daniel Castillo
Keyword(s):  
Muscle Injury ◽  
Injury Rate ◽  
Hamstring Injury ◽  
Anatomical Site ◽  
Injury Incidence ◽  
Age Group ◽  
Muscle Injuries ◽  
Match Play ◽  
Youth Soccer ◽  
Hamstring Injuries

The aims of this study were to analyze the muscle injury incidence in an elite Spanish soccer academy during three consecutive seasons attending to different chronological age groups (i.e., U14, U16, U19 and senior) and to examine the hamstring injury incidence in this elite soccer academy. Elite male youth soccer players (227) participated in this study. A total of 207 time-loss injuries (i.e., injuries that involve at least one absence day) were observed during this study period. The overall incidence rate of muscle injury was 1.74 muscle injuries/1000 h. In addition, higher muscle injury incidence was observed during match play in comparison to training sessions (6.78 vs. 3.20 muscle injuries/1000 h, p < 0.05). The oldest age group presented the highest injury rate (2.73 muscle injuries/1000 h, p < 0.05), with the burden (i.e., number of absence days per 1000 h of exposure) peak values recorded in the U16 age group (26.45 absence days/1000 h). In addition, muscle tears accounted for the greatest percentage of muscle injuries (43.5%), and the most frequent anatomical site of injury was the hamstring (30.4%). Muscle tear was the most common type of hamstring injury (49.2%), with the biceps femoris the most commonly injured muscle of the hamstring complex (39.7%). Fullbacks (FB), wide midfielders (WM) and forwards (F) suffered a greater number of hamstring injuries. Hamstring injury incidence showed a seasonal variation, as indicated by peaks in August and October. Specifically, the highest injury incidence was observed in the final part of each period during match play. These results reinforce the necessity to implement individual preventive strategies according to each specific injury profile across the youth soccer development phase.

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 Endovascular Considerations in Traumatic Injury of the Carotid and Vertebral Arteries

2021 ◽  
Vol 38 (01) ◽  
pp. 053-063
Author(s):  
Ananth K. Vellimana ◽  
Jayson Lavie ◽  
Arindam Rano Chatterjee
Keyword(s):  
Natural History ◽  
Clinical Presentation ◽  
Traumatic Injury ◽  
Classification Systems ◽  
Endovascular Techniques ◽  
Traumatic Injuries ◽  
Cerebrovascular Injury ◽  
Vertebral Arteries ◽  
Carotid And Vertebral Arteries

AbstractCervical carotid and vertebral artery traumatic injuries can have a devastating natural history. This article reviews the epidemiology, mechanisms of injury, clinical presentation, and classification systems pertinent to consideration of endovascular treatment. The growing role of modern endovascular techniques for the treatment of these diseases is presented to equip endovascular surgeons with a framework for critically assessing patients presenting with traumatic cervical cerebrovascular injury.

scholarly journals An update on the grading of muscle injuries: a narrative review from clinical to comprehensive systems

Joints ◽  
2016 ◽  
Vol 04 (01) ◽  
pp. 039-046 ◽  
Author(s):  
Alberto Grassi ◽  
Alberto Quaglia ◽  
Gian Canata ◽  
Stefano Zaffagnini
Keyword(s):  
Prognostic Value ◽  
Muscle Injury ◽  
Clinical Signs ◽  
Classification Systems ◽  
Soccer Players ◽  
Muscle Injuries ◽  
Mri Findings ◽  
Professional Soccer ◽  
Magnetic Resonance Imaging Mri ◽  
Comprehensive Classification

Muscle injuries are recognized to be among the most frequent injuries occurring in the sporting and athletic population, and they account for more than 30% of all injuries in professional soccer players. Despite their considerable frequency and impact, there is still a lack of uniformity in the categorization, description and grading of muscle injuries.Dozens of systems based on clinical signs, ultrasound imaging (US) appearance or magnetic resonance imaging (MRI) findings have been proposed over the years. Most of them are three-grade systems that take into account pain, ROM limitation, swelling and hematoma, hypoechoic or hyperintense areas on US or MRI, and muscle gap or tendon involvement; however, they still lack evidence-based prognostic value. Recently, new comprehensive classification systems have been proposed, with the aim of developing uniform muscle injury terminology and giving each severity grade prognostic value.The systems that combine detailed MRI and US features with the clinical presentation, such as the Munich Muscle Injury Classification, the ISMuLT classification, and the British Athletic Classification, if used extensively, could improve the diagnosis, prognosis and management of muscle injuries.

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.

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