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

Abstract Background and Aims Percutaneous needle electrolysis has shown to be effective for the treatment of chronic tendinopathies, however, the scientific evidence available regarding acute muscle lesions is scarce. Lesions to the hamstrings caused by indirect mechanisms represent the most common muscle lesion in football (its incidence increases each year) with a high rate of recurrence. The aim was to evaluate whether the application of percutaneous needle electrolysis and a program of functional exercise decreases the times for return to competition after an injury to the hamstrings in athletes, and to compare performance data of subjects during competition before and after the injury. Methods A case series. Two professional football players, belonging to a first league team in Spain with a grade 2 lesion in the semitendinosus muscle on the proximal level. The affected muscle structure was assessed using ultrasound (Logiq GE E9, probe ML6–12) and functionality was evaluated based on data of the Global Positioning System (GPS), comparing the data obtained during the process of re-adaptation with data prior to the lesion. Percutaneous needle electrolysis was performed under ultrasound guidance at 48 hours after the injury following the protocol defined by Valera & Minaya (2:3:5). The indoor recovery of players began 24 hours after the percutaneous needle electrolysis. Initially, the exercise program included activities of mobility and controlled loading. Thereafter, the players completed their readaptation program in the training field with exercises of progressive complexity and intensity (biomechanical patterns and neuromuscular control of the central zone and the lower limbs, sprint). Results Player A returned to competition in 16 days, player B returned in 14 days. No adverse effects were identified during or after the percutaneous needle electrolysis technique. The players only missed one competition game and the process of readaptation allowed them to return to play registering parameters which were similar to the values prior to the lesion, and maintaining the performance during the four matches following the intervention protocol. The players were followed up to eight months after the injury and neither player suffered a relapse during this period, which indicates the complete recovery of the injured muscle both on a structural and functional level. Conclusions The combined treatment using percutaneous needle electrolysis and a functional exercise program reduces the time for return to competition after a grade 2 muscle lesion in the hamstrings, with a level of performance that is similar to prior to the lesion, without relapses, in an 8 month follow up period. The criteria we use to determine when a player can return to train with the team and compete after an acute muscle injury are: the time that has passed since the lesion, structural changes and the ability to perform tasks.

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Return-to-Play Practices Following Hamstring Injury: A Worldwide Survey of 131 Premier League Football Teams

Sports Medicine ◽

10.1007/s40279-019-01199-2 ◽

2019 ◽

Vol 50 (4) ◽

pp. 829-840 ◽

Cited By ~ 1

Author(s):

Gordon Dunlop ◽

Clare L. Ardern ◽

Thor Einar Andersen ◽

Colin Lewin ◽

Gregory Dupont ◽

...

Keyword(s):

Decision Making ◽

Online Survey ◽

Return To Play ◽

Hamstring Injury ◽

Professional Football ◽

Multiple Stakeholders ◽

Related Factors ◽

Beliefs And Practices ◽

Premier League ◽

Key Stakeholders

Abstract Purpose Return-to-play (RTP) is an on-going challenge in professional football. Return-to-play related research is increasing. However, it is unknown to what extent the recommendations presented within research are being implemented by professional football teams, and where there are gaps between research and practice. The purposes of this study were (1) to determine if premier-league football teams worldwide follow a RTP continuum, (2) to identify RTP criteria used and (3) to understand how RTP decision-making occurs in applied practice. Methods We sent a structured online survey to practitioners responsible for the RTP programme in 310 professional teams from 34 premier-leagues worldwide. The survey comprised four sections, based on hamstring muscle injury: (1) criteria used throughout RTP phases, (2) the frequency with which progression criteria were achieved, (3) RTP decision-making process and (4) challenges to decision-making. Results One-hundred and thirty-one teams responded with a completed survey (42%). One-hundred and twenty-four teams (95%) used a continuum to guide RTP, assessing a combination of clinical, functional and psychological criteria to inform decisions to progress. One-hundred and five (80%) teams reported using a shared decision-making approach considering the input of multiple stakeholders. Team hierarchy, match- and player-related factors were common challenges perceived to influence decision-making. Conclusions General research recommendations for RTP and the beliefs and practices of practitioners appear to match with, the majority of teams assessing functional, clinical and psychological criteria throughout a RTP continuum to inform decision-making which is also shared among key stakeholders. However, specific criteria, metrics and thresholds used, and the specific involvement, dynamics and interactions of staff during decision-making are not clear.

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High‐grade intramuscular tendon disruption in acute hamstring injury and return to play in Australian Football players

Scandinavian Journal of Medicine and Science in Sports ◽

10.1111/sms.13642 ◽

2020 ◽

Vol 30 (6) ◽

pp. 1073-1082

Author(s):

Luke Eggleston ◽

Morgan McMeniman ◽

Craig Engstrom

Keyword(s):

Return To Play ◽

Hamstring Injury ◽

Football Players ◽

High Grade ◽

Australian Football

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Aplicación de la dinamometría isocinética para establecer perfiles de riesgo de lesión isquiosural en futbolistas profesionales. [The use of isokinetic dynamometry to establish risk profiles of hamstring injury in professional football players].

RICYDE Revista Internacional de Ciencias del Deporte ◽

10.5232/ricyde2013.03403 ◽

2013 ◽

Vol 10 (34) ◽

pp. 333-341 ◽

Cited By ~ 1

Author(s):

Víctor Moreno-Perez ◽

David Barbado-Murillo ◽

Casto Juan-Recio ◽

Cesar M. Quesada-de-la-Gala ◽

Francisco J. Vera-Garcia

Keyword(s):

Hamstring Injury ◽

Football Players ◽

Professional Football ◽

Isokinetic Dynamometry ◽

Risk Profiles

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Match High-Speed Running Distances Are Often Suppressed After Return From Hamstring Strain Injury in Professional Footballers

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738120964456 ◽

2020 ◽

pp. 194173812096445

Author(s):

Rodney Whiteley ◽

Andrew Massey ◽

Tim Gabbett ◽

Peter Blanch ◽

Matthew Cameron ◽

...

Keyword(s):

High Speed ◽

Rugby Union ◽

Return To Play ◽

Hamstring Injury ◽

Professional Football ◽

Linear Regression Models ◽

Post Injury ◽

Level Of Evidence ◽

Running Performance ◽

Hamstring Strain

Background: High-speed running is commonly implicated in the genesis of hamstring injury. The success of hamstring injury management is typically quantified by the duration of time loss or reinjury rate. These metrics do not consider any loss in performance after returning to play from hamstring injury. It is not known to what extent high-speed running is altered on return to play after such injury. Hypothesis: Match high-speed running distance will change after returning from hamstring injury. Study Design: Non-randomized cohort. Level of Evidence: Level 3. Methods: Match high-speed running distance in highest level professional football (soccer, Rugby League, Rugby Union, and Australian Rules) were examined for a minimum of 5 games prior and subsequent to hamstring strain injury for individual differences using a linear regression models approach. A total of 22 injuries in 15 players were available for analysis. Results: Preinjury cumulative high-speed running distances were strongly correlated for each individual ( r2 = 0.92-1.0; P < 0.0001). Pre- and postinjury high-speed running data were available for a median of 15 matches (range, 6-15). Variance from the preinjury high-speed running distance was significantly less ( P = 0.0005) than the post injury values suggesting a suppression of high-speed running distance after returning from injury. On return to play, 7 of the 15 players showed a sustained absolute reduction in preinjury high-speed running distance, 7 showed no change, and 1 player (only) showed an increase. Analysis of subsequent (second and third injury) return to play showed no differences to return from the index injury. Conclusion: Return to play was not associated with return to high-speed running performance for nearly half of the players examined, although the same number showed no difference. Persisting deficits in match high-speed running may exist for many players after hamstring strain injury. Clinical Relevance: Returning to play does not mean returning to (high-speed running) performance for nearly half of the high-level professional football players examined in this study. This suggests that successful return to play metrics should be expanded from simple time taken and recurrence to include performance.

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Return to Play and Career Length After Anterior Cruciate Ligament Reconstruction Among Canadian Professional Football Players

The American Journal of Sports Medicine ◽

10.1177/0363546520918224 ◽

2020 ◽

Vol 48 (7) ◽

pp. 1682-1688

Author(s):

Robert Longstaffe ◽

Jeff Leiter ◽

Tanner Gurney-Dunlop ◽

Robert McCormack ◽

Peter MacDonald

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Return To Play ◽

Football Players ◽

Professional Football ◽

Collateral Ligament ◽

Career Length ◽

Anterior Cruciate ◽

Negative Predictor

Background: For many athletes, a tear of the anterior cruciate ligament (ACL) represents a significant injury that requires a prolonged period away from the sport with substantial rehabilitation. Hypothesis: There will be no difference in return to play (RTP) and career length after hamstring tendon (HT) ACL reconstruction in a group of Canadian Football League professional players as compared with what has been already been reported in the literature among professional football players. Study Design: Case-control study; Level of evidence, 3. Methods: Data on athletes who sustained an ACL injury were collected by team physicians and head athletic trainers from 2002 to 2017 from 2 Canadian Football League teams. Patient details included age at the time of injury, initial injury date, position, practice versus game injury, and primary versus rerupture with injury-specific data, such as affected limb, concomitant injuries, graft choice, and procedure performed. RTP rates and career length data were collected through publically available internet sources. Comparisons between the non-RTP and RTP groups were made with independent-sample t tests. Binomial logistic regression was performed to determine variables (ie, games preinjury, graft type, meniscal injury, collateral ligament injury) that contributed to players not being able to RTP. Results: A total of 44 ACL reconstructions were performed over the study period (HT, n = 32 [72.7%]; bone–patellar tendon–bone [BPTB], n = 8 [18.2%]; allograft, n = 4 [9.1%]). Overall, 69.8% (n = 30) were able to RTP in at least 1 game, while 30.2% (n = 13) did not return. Mean time to return was 316.1 days (range, 220-427 days), or 10.4 months. For those players who did RTP, mean career length after ACL reconstruction was 2.8 seasons, or 34.4 games. The majority (56.8%) of injuries occurred early in the season. Breakdown by graft type demonstrated RTP rates among HT, BPTB, and allograft of 64.5% (n = 20), 87.5% (n = 7), and 75% (n = 3), respectively. Career length among HT, BPTB, and allograft was 2.9, 2.4, and 3 seasons. Logistic regression analysis found only concomitant medial collateral ligament (MCL) injuries to be a negative predictor for RTP. Meniscal injuries were associated with a decreased RTP rate and career length, but this was not statistically significant. Conclusion: The RTP rates after ACL reconstruction in this study are similar to those reported in National Football League players. A concomitant injury to the MCL injury was a negative predictor of RTP. Meniscal injuries demonstrated a trend for decreased RTP rate and career length, but this was not a significant predictor. A large portion of injuries occur early in the season, and further study should be done to examine potential preventative strategies to reduce ACL injuries.

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