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Predictors of time to return to play and reinjury following hamstring strain injuries with and without tendon involvement in professional football

Scott, McAuley and Dobbin, Nicholas and Peter, Goodwin (2020) Predictors of time to return to play and reinjury following hamstring strain injuries with and without tendon involvement in professional football. In: IOC Word Conference on Prevention of Injury and Illness in Sport, 12 March 2020 - 14 March 2020, Monaco. (Unpublished)

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Abstract

Background: Hamstring strain injury (HSI) is the single most commonly (~12%) sustained injury in professional football. It is suggested HSIs extending into the intramuscular tendon are more prone to reinjury, resulting in greater time-loss and delayed time to return to play (TtRtP). Currently, there is a lack of evidence regarding the effects of HSI with and without intramuscular involvement as well as the impact of factors such as removal of a player and grade. Objectives: 1) Describe the number of HSIs using the British Athletics Muscle Injury Classification (BAMIC); 2) Determine if intramuscular tendon HSI results in extended TtRtP and higher reinjury risk; 3) Determine the predictors of TtRtP and reinjury. Methods: A retrospective study in one English Premier League football club over four seasons. Players included underwent an MRI within 7 days of injury and were graded by a Radiologist using the BAMIC (0a-4). TtRtP and injury recurrence rates were recorded along with information on whether the players were removed from play. Data were analysed using a Kruskal-Wallis test and linear regression. Results: Twenty-nine HSI across 24 players (age = 26.1 ± 3.8 years) were recorded over 4 seasons. There was a significant difference in TtRtP between grades 1a and 2c (P = 0.027). No significant difference was observed in TtRtP between 2b and 2c and no greater risk of reinjury. Grade of HSI (P = < 0.000) and removal of the player (P = 0.001) were significant predictors of TtRtP. An increase in grade of HSI resulted in an additional 4 days TtRtP and removal from the field of play (P = 0.001) resulted in an additional 10 days. Conclusion: HSIs extending into the intramuscular tendon (2b cf. 2c) do not influence TtRtP or reinjury, however TtRtP is affected by the removal of a player and overall grade.

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