Hamstring Injuries in Professional Football Players

Autor: Peter F. DeLuca, Jay J. Irrgang, Jeffrey D. Towers, Steven B. Cohen, Junaid A. Makda, James P. Bradley, Adam C. Zoga
Rok vydání: 2011
Předmět:
Zdroj: Sports Health: A Multidisciplinary Approach. 3:423-430
ISSN: 1941-0921
1941-7381
Popis: Hamstring injuries are common in many sports, including football.1,8 Strain is the typical pattern of injury, and it results from excessive stretching of the myotendinous unit, often during sprinting or jumping.6,13 In the elite athlete, hamstring injuries cause prolonged absence from competition and have a high recurrence rate.9 Given the financial and competitive concerns associated with professional athletes, the time to return to activity is of particular importance to the athlete and the team. Thus, there is pressure on the medical staff and athletic trainers to return an athlete to competition as soon as possible. Failing to properly rehabilitate or returning to competition prematurely can result in further injury and/or a chronic strain and, thus, prolonged return to play.15 Although the diagnosis is made clinically, advanced radiologic evaluation is frequently used with professional athletes to assess the severity and extent of injury. Ultrasound and magnetic resonance imaging (MRI) are equally sensitive in assessing hamstring injury; however, MRI offers a more detailed analysis of the injury and is not user dependent.10 The added cost of MRI is not a precluding factor for professional organizations and is the preferred imaging modality for elite athletes, in an effort to prevent recurrent injury for those who may return to competition prematurely.6,7 The mainstay of treatment consists of conservative management and gradual return to competition. Cases of proximal or distal avulsion of the hamstring tendons do, however, warrant consideration of surgical management.4,5 MRI allows for detailed evaluation of hamstring injuries. Not only can MRI confirm the clinical diagnosis of strain, but it provides information about the location, cross-sectional area, and extent of tear. It also allows the radiologist to grade the injury on the basis of radiologic strain grade.11 Although this additional information is helpful, there is no clinical classification system that allows for prediction of return to activity based on the extent of injury seen on MRI. Slavotinek et al14 published a prospective study evaluating 37 Australian Rules football players after hamstring injuries, comparing the extent of injury on MRI with time lost from competition. They found that the percentage of abnormal muscle area and volume of muscle injury were related to return to sports. However, no classification system was used to predict specific amount of time missed from sports. Ideally, a classification or scoring system would guide treatment to provide enough time for complete healing, avoid premature return to activity, and decrease risk of reinjury. The purpose of this study is to correlate the time for return to play in professional football players with the MRI findings after acute hamstring strains as well as to develop a scoring system that more easily allows for prediction of time missed.
Databáze: OpenAIRE
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