Determinants of Return to Play After the Nonoperative Management of Hamstring Injuries in Athletes

Fournier-Farley, Camille; Lamontagne, Martin; Gendron, Patrick; Gagnon, Dany H.

doi:10.1177/0363546515617472

Cited by 47 publications

(44 citation statements)

References 28 publications

(192 reference statements)

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“…However, it has been demonstrated that both MRI and US provide detailed information about the HMC with respect to localization and characterization of injury [12][13][14]. Furthermore, clinical, MRI and US determinants were established in the literature that have an effect on the time to return to play after HMC injury in athletes [16]. On the other hand, it is important to realize that for an individual HMC injury none of these MRI and US determinants show a direct correlation with the time to return to play [14,15].…”

Section: Discussionmentioning

confidence: 99%

“…Both MRI and US provide detailed information about the HMC with respect to localization and characterization of injury [13]. In a recent systematic review [16] several clinical, MRI and US determinants were determined that are associated with a longer recovery time in nonoperative management of acute HMC injury (summarized in Table 1). However, it is important to realize that for an individual HMC injury none of these MRI and US determinants show a direct correlation with the time to return to play [14,15].…”

Section: Introductionmentioning

confidence: 99%

“…Accordingly, the prognosis of HMC injuries should not be guided by imaging findings alone [14]. Table 1 Determinants having an effect on the time to return to play after hamstring muscle complex injury in athletes (according to [16] According to [1] muscle injuries in sports (including acute HMC injuries) can be classified as shown in Table 2. This classification has important implications for treatment and prognosis (i.e., time to return to play).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Is Radial Extracorporeal Shock Wave Therapy Combined with a Specific Rehabilitation Program (rESWT + RP) More Effective than Sham-rESWT + RP for Acute Hamstring Muscle Complex Injury Type 3b in Athletes? Study Protocol for a Prospective, Randomized, Double-Blind, Sham-Controlled Single Centre Trial

Crupnik¹,

Silveti²,

Wajnstein³

et al. 2019

Preprint

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Background: Acute injuries of the hamstring muscle complex (HMC) Type 3b (interfascicle / bundle-tear) are frequently observed in various sports disciplines both in elite and recreational sport. The treatment of choice of acute HMC injuries Type 3b is a progressive physiotherapeutic exercise program. Besides this, there is currently only insufficient scientific evidence to support other treatment methods, including local infiltrations and injections of platelet-rich-plasma. Very recently it was demonstrated that extracorporeal shock wave therapy (ESWT) may accelerate regeneration after acute skeletal muscle injury. The aim of the present study is to test the hypothesis that the combination of radial ESWT (rESWT) and a specific rehabilitation program (RP) is effective and safe in treatment of acute HMC injury Type 3b in athletes, and is statistically significantly more effective than the combination of sham-rESWT and RP. Methods/Design: We will perform a double blind, randomized, sham-controlled clinical trial at the clinic KinEf Kinesiología Deportiva, Ciudad Autónoma de Buenos Aires, Argentina. Fourty patients with acute HMC injury Type 3b will be randomly allocated to receive either rESWT (nine rESWT sessions; three sessions per week; 2500 radial extracorporeal shock waves (rESWs) per session; energy density depending on what the patient tolerates) or sham-rESWT. In addition, all patients will receive a specific rehabilitation program that will last for eight weeks. The primary outcome measure will be the individual time (days) necessary to return to play. Secondary outcomes will include the presence or absence of reinjury during a time period of six months after inclusion into the study. Discussion: Because of the lack of adequate treatment options for acute HMC injury Type 3b in athletes and particularly the high reinjury rate, we hypothesize that the results of this trial will be of importance and have impact on clinical practice. Trial registration: ClinicalTrials.gov ID NCT03473899. Registered March 22, 2018.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is Radial Extracorporeal Shock Wave Therapy Combined with a Specific Rehabilitation Program (rESWT + RP) More Effective than Sham-rESWT + RP for Acute Hamstring Muscle Complex Injury Type 3b in Athletes? Study Protocol for a Prospective, Randomized, Double-Blind, Sham-Controlled Single Centre Trial

Crupnik¹,

Silveti²,

Wajnstein³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…The hamstrings represent the most often injured muscle group in athletes. 90,91 No established clinical criteria as yet predict a safe return to play. 92 The MSK radiologist therefore plays a crucial role in determining the extent of the injury and advising athletes on their expected duration of inactivity.…”

Section: Imaging and Return To Playmentioning

confidence: 99%

Role of Musculoskeletal Radiology in Modern Sports Medicine

Hynes

Walsh

Farrell

et al. 2018

Semin Musculoskelet Radiol

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Musculoskeletal radiology's role in the recent and continued evolution of sports medicine is an exciting and expanding one. In this article we explore a variety of the ways that musculoskeletal radiology contributes to current practices in modern sports medicine, discussing advances across a variety of imaging modalities in the care of both elite athletes and so-called weekend warriors. We describe the technical and ethical factors pertaining to image-guided therapeutic intervention in athletes and speculate on the potential for future developments in the role of imaging in deciding when an athlete may return to participation. We also explore the recent shift to the delivery of imaging facilities at sporting events and in stadiums.

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“…13,53 Specifically, limitations in active knee extension with the hip flexed at 90 degrees compared with the contralateral extremity may be particularly useful as both a diagnostic and prognostic tool, with limited active knee extension suggesting both the presence of injury and prolonged return to play. 63,64 Provocative tests, which may be useful to diagnose mild strains or proximal hamstring tendinopathy, include the Puranen-Orava test, the bent knee stretch test, and the modified bent knee stretch test. 65 The Puranen-Orava test involves actively stretching the hamstring muscle in the standing position with the hip flexed to approximately 90 degrees and the knee fully extended with the foot supported on a chair or examination table.…”

Section: Physical Exammentioning

confidence: 99%

Proximal Hamstring Injuries: Review of Operative and Nonoperative Management

2018

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While uncommon, proximal hamstring injuries can result in significant pain and dysfunction, while also posing considerable treatment dilemmas due to the spectrum of injury that exists. Recent literature suggests that outcomes are improved with acute surgical repair of complete proximal hamstring avulsions, highlighting the importance of timely management of these unique injuries. While chronic repair or reconstruction can result in predictable improvements in pain and function postoperatively, the results are less predictable than acute surgical repair. Nonoperative management should be considered as the initial treatment strategy for patients with proximal hamstring tendinopathy or partial tears, as delayed surgical intervention in this setting has not been shown to significantly affect outcomes. Although current evidence is limited, evolving therapeutic techniques, including biologic injections and endoscopic repair techniques, need to be carefully evaluated to determine their role moving forward. This review aims to provide updated information on the relevant anatomy, mechanism of injury, diagnosis, and management of proximal hamstring injuries, with a specific focus on surgical indications, techniques, and outcomes.

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Determinants of Return to Play After the Nonoperative Management of Hamstring Injuries in Athletes

Abstract: Numerous determinants have an effect on return to play after a hamstring injury in athletes. It is important for sports professionals to be aware of those determinants to guide athletes through the rehabilitation process and refine return-to-play strategies.

Cited by 47 publications

References 28 publications

Is Radial Extracorporeal Shock Wave Therapy Combined with a Specific Rehabilitation Program (rESWT + RP) More Effective than Sham-rESWT + RP for Acute Hamstring Muscle Complex Injury Type 3b in Athletes? Study Protocol for a Prospective, Randomized, Double-Blind, Sham-Controlled Single Centre Trial

Is Radial Extracorporeal Shock Wave Therapy Combined with a Specific Rehabilitation Program (rESWT + RP) More Effective than Sham-rESWT + RP for Acute Hamstring Muscle Complex Injury Type 3b in Athletes? Study Protocol for a Prospective, Randomized, Double-Blind, Sham-Controlled Single Centre Trial

Role of Musculoskeletal Radiology in Modern Sports Medicine

Proximal Hamstring Injuries: Review of Operative and Nonoperative Management

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