Longitudinal Study Comparing Sonographic and MRI Assessments of Acute and Healing Hamstring Injuries

Context:Predicting when an athlete can return to sport after muscle injury is a major concern.Objective: To determine whether combining objective clinical and ultrasound findings at presentation accurately predicted time to sport resumption in athletes with muscle injuries.Design: Cohort study. Setting: Sports medicine clinic. Patients or Other Participants: A total of 93 consecutive patients, 87 male and 6 female, were seen over a 1-year period for sudden-onset muscle pain while engaging in a sporting activity within the last 5 days and inability to continue the training session or game. Intervention(s): Standardized physical examination and sonogram.Main Outcome Measure(s): Statistical associations between clinical and sonographic features at presentation and time to sport resumption (<40 days or ≥40 days) were evaluated using multivariate models. Correlations between time to sport resumption predicted by a sports medicine specialist and actual time to sport resumption were evaluated using the Spearman rank correlation coefficient.Results: The 93 patients had 95 injuries, caused by muscle contraction in 86 cases and impact in 9 cases. Only 7 injuries had normal sonogram findings. Late sport resumption was associated with 4 clinical criteria (bruising, tenderness to palpation, range-of-motion limitation compared with the other limb, and increased pain with isometric contraction during passive limb straightening) and 4 sonographic criteria (disorganized fibrous tissue, intramuscular hematoma, intermuscular hematoma, and power Doppler signal). The Spearman rank correlation coefficient between predicted and actual times was 0.669 (P < .0001) for mild exercise resumption and 0.804 (P < .0001) for full sport resumption.Conclusion: A combination of physical and sonographic data collected during the acute phase of sport-related muscle injury was effective in predicting time to sport resumption.Key Words: diagnostic imaging, contusions, strains, sports, return to sport Key Points• Sonography was useful for diagnosing acute sport-related muscle injuries, monitoring the course of the injuries, and guiding the drainage of fluid if needed.• In combination with the objective physical findings, sonographic findings were beneficial in predicting injury severity and time to resumption of sport.

show abstract

“…Among them, a prospective study 14 showed that sonography was as useful as MRI for assessing acute hamstring injury (48 injuries in our study).…”

Section: Discussionmentioning

confidence: 69%

Value of Sonography Combined With Clinical Assessment to Evaluate Muscle Injury Severity in Athletes

Guillodo

Bouttier

Saraux

2011

Journal of Athletic Training

View full text Add to dashboard Cite

show abstract

“…Whereas musculoskeletal ultrasound has been demonstrated to be an effective tool for assessing acute HSIs, no evidence is available to support its use in making RTP decisions. 75 Although the ATs did not place a high level of importance on bilateral isokinetic testing, it is an RTP component of clinical commentaries, and most of the available evidence supports its use. Some researchers have demonstrated bilateral deficits (peak torque, angle of peak torque) in participants with previous HSIs or have shown increased risk for future reinjury due to bilateral asymmetries 55,76,77 ; however, some investigators have refuted these findings.…”

Section: Importance Of Rtp Methodsmentioning

confidence: 99%

Clinical Practice Patterns and Beliefs in the Management of Hamstrings Strain Injuries

Lobacz¹,

Glutting

Kaminski³

2016

Journal of Athletic Training

View full text Add to dashboard Cite

Context: Hamstrings strain injuries (HSIs) are among the most commonly occurring injuries in sport and are top causes of missed playing time. Lingering symptoms, prolonged recovery, and a high reinjury rate (12%-34%) make HSI management a frustrating and challenging process for the athletic trainer (AT). The clinical practice patterns and opinions of ATs regarding HSI treatment and rehabilitation are unknown.Objective: To examine the frequency of method use and opinions about current HSI management among ATs.Design: Cross-sectional study. Setting: Survey administered to registrants at the 2013 National Athletic Trainers' Association Clinical Symposia and AT Expo.Patients or Other Participants: A total of 1356 certified ATs (691 men, 665 women; age ¼ 35.4 6 10.5 years, time certified ¼ 11.92 6 9.75 years).Data Collection and Analysis: A survey was distributed electronically to 7272 registrants and on paper to another 700 attendees. Validity and reliability were established before distribution. Participants reported demographic information and rated their frequency of treatment and rehabilitation method use and agreement with questions assessing confidence, satisfaction, and desire for better clinical practice guidelines. Exploratory factor analysis and principal axis factor analysis were used. We also calculated descriptive statistics and v 2 tests to assess practice patterns.Results: The response rate was 17% (n ¼ 1356). A 2-factor solution was accepted for factor analysis (r ¼ 0.76, r ¼ 0.70), indicating that ATs follow either a contemporary or traditional management style. Various practice patterns were evident across employment settings and years of clinical experience. Satisfaction with the current HSI management plan was high (73.6%), whereas confidence in returning an athlete to play was lower (62.0%). Rates of use were associated with belief in effectiveness for all methods assessed (P , .001). Higher confidence levels were associated with high use of several methods; we observed increased satisfaction (v 2 2 ¼ 22.5, P ¼ .002) but not increased confidence levels in more experienced ATs.Conclusions: Our study demonstrated the lack of consensus in HSI treatment and rehabilitation and the ATs' desire for better clinical practice guidelines. Future research in which multimodal strategies, including both traditional and contemporary methods, are studied is warranted for effective management of HSI.Key Words: muscle, athletic trainer, reinjury Key PointsConsensus on the management of hamstrings strain injuries among athletic trainers was lacking. Confidence in returning an athlete to play after injury was low. Evidence-based treatment and rehabilitation methods are needed to drive clinical practice.H amstrings strain injury (HSI) is one of the most commonly occurring soft tissue injuries in sport and recreational participants.1-3 Authors of epidemiologic studies across various sports leagues have indicated that HSI is one of the highest ranked causes of missed playing time in both practice and competition, with...

show abstract

“…In the event edema and hemorrhage occur in the injured area, these two imaging methods make it possible to make a diagnosis [24]. Magnetic resonance imaging is considered preferable when damage is found inside the muscle tissue, or for example, when mild local edema exists or when an old scar is present as a result of a previous injury [12,13,25].…”

Section: Diagnostic Imaging Methodsmentioning

confidence: 99%

Hamstring Strain in Soccer Players: Things the Trainer Must Know

Tsur¹

2015

JESO

View full text Add to dashboard Cite

Longitudinal Study Comparing Sonographic and MRI Assessments of Acute and Healing Hamstring Injuries

Cited by 398 publications

References 18 publications

Value of Sonography Combined With Clinical Assessment to Evaluate Muscle Injury Severity in Athletes

Value of Sonography Combined With Clinical Assessment to Evaluate Muscle Injury Severity in Athletes

Clinical Practice Patterns and Beliefs in the Management of Hamstrings Strain Injuries

Hamstring Strain in Soccer Players: Things the Trainer Must Know

Contact Info

Product

Resources

About