Hamstring Muscle Injuries and Hamstring Specific Training in Elite Athletics (Track and Field) Athletes

Baseline clinical and MRI risk factors for hamstring reinjury showing the value of performing baseline MRI and delaying return to play: a multicentre, prospective cohort of 330 acute hamstring injuries

OBJECTIVES

Studies identifying clinical and MRI reinjury risk factors are limited by relatively small sample sizes. This study aimed to examine the association between baseline clinical and MRI findings with the incidence of hamstring reinjuries using a large multicentre dataset.

METHODS

We merged data from four prospective studies (three randomised controlled trials and one ongoing prospective case series) from Qatar and the Netherlands. Inclusion criteria included patients with MRI-confirmed acute hamstring injuries (<7 days). We performed multivariable modified Poisson regression analysis to assess the association of baseline clinical and MRI data with hamstring reinjury incidence within 2 months and 12 months of follow-up.

RESULTS

330 and 308 patients were included in 2 months (31 (9%) reinjuries) and 12 months (52 (17%) reinjuries) analyses, respectively. In the 2-month analysis, the presence of discomfort during the active knee extension test was associated with reinjury risk (adjusted risk ratio (ARR) 3.38; 95% CI 1.19 to 9.64). In the 12 months analysis, the time to return to play (RTP) (ARR 0.99; 95% CI 0.97 to 1.00), straight leg raise angle on the injured leg (ARR 0.98; 95% CI 0.96 to 1.00), the presence of discomfort during active knee extension test (ARR 2.52; 95% CI 1.10 to 5.78), the extent of oedema anteroposterior on MRI (ARR 0.74; 95% CI 0.57 to 0.96) and myotendinous junction (MTJ) involvement on MRI (ARR 3.10; 95% CI 1.39 to 6.93) were independently associated with hamstring reinjury.

CONCLUSIONS

Two clinical findings (the presence of discomfort during active knee extension test, lower straight leg raise angle on the injured leg), two MRI findings (less anteroposterior oedema, MTJ involvement) and shorter time to RTP were independently associated with increased hamstring reinjury risk. These findings may assist the clinician to identify patients at increased reinjury risk following acute hamstring injury.

TRIAL REGISTRATION NUMBERS

NCT01812564; NCT02104258; NL2643; NL55671.018.16.

Athletes who have already experienced an injury are more prone to adhere to an injury risk reduction approach than those who do not: an online survey of 7870 French athletics (track and field) athletes

Objective

To compare the perception towards injury risk reduction approach between athletes who have already experienced an injury and those who have not.

Methods

We conducted a cross-sectional study using a one-time online survey asking athletics athletes licensed at the French Federation of Athletics (http://www.athle.fr) about their perceptions regarding injuries and injury risk reduction behaviours. We statistically compared athletes who already experienced an injury and those who did not.

Results

A total of 7870 athletes were included. 90% of athletes declared having experienced at least one injury. They (1) were proportionally more men than women, (2) had significantly more years of experience in athletics, (3) had a significant difference in disciplines (more hurdles, jumps and combined events and fewer sprint athletes), (4) had a significant difference in competition levels (more national and less departmental levels) and (5) reported significantly higher values or agreements in favour of injury risk reduction approach, compared with uninjured athletes. There were significantly more athletes declaring following injury risk reduction programmes among athletes who experienced at least one injury than those who did not.

Conclusions

Athletes who experienced at least one injury during their lifetime were more prone to adhere to injury risk reduction strategies than athletes who have never experienced an injury. Their entourage (coaches and health professionals) should use this fertile ground to implement injury risk reduction strategies. In addition, their experience should be disseminated to uninjured athletes to help them adhere to injury risk reduction without injury experience.

Effectiveness of Warm-Up Exercises with Tissue Flossing in Increasing Muscle Strength

Tissue flossing is an increasingly popular method in physiotherapy and sports. There is a belief that tissue flossing can improve range of motion and muscle strength, shorten muscle recovery time, and reduce the risk of injury. The aim of this study was to analyse the effectiveness of tissue flossing for immediately improving muscle strength in recreational athletes when it is performed during warm-up. All participants were randomly assigned to either an experimental group (n = 36) or a control group (n = 34) using a random number generator. The experimental group (n = 36) performed an intervention comprising exercises with muscle tissue flossing and exercises without flossing. The control group (n = 30) performed the same protocol without a floss band. Muscle strength was measured for knee flexion end extension at three speeds (60, 120, and 180 °/s) 3 times. Analysed parameters include peak torque, work, and power related to body weight, flexors−extensors ratio, and time to peak torque. There were no significant changes in the muscle strength parameters from before to after the warm-up in either group (p > 0.05). Significantly lower values of peak torque, work, and power were observed in the experimental group during the warm-up with the floss band applied to muscles (p < 0.05). No clinically significant changes in time to peak torque or flexors−extensors ratio were observed. A single application of flossing does not improve muscle strength or power and can even reduce individuals’ maximum muscle strength capabilities.