Original paperAssessment of player performance following return to sport after hamstring muscle strain injury
Introduction
Hamstring muscle strain injuries are common in many sports, including the various football codes.1, 2 In Australian football, hamstring injuries are responsible for the greatest quantity of competition time lost due to injury2 and have a high recurrence rate.2, 3 Athletes in professional sports are aware of the troublesome nature and high recurrence rate of hamstring injuries.4 Despite this there is often an expectation from the team, coach and the athletes themselves to return to active competition as soon as practical following this injury. Although no data have been presented about player performance after return to sport from hamstring injury, evidence from magnetic resonance imaging (MRI) studies,5 laboratory studies of muscle stretch injury6, 7 and the observed high recurrence rate3 suggests that the injury in many cases has not fully resolved at the time of return to sport. Accordingly, the aim of this study was to determine if athlete performance is poorer following return to sport after recovery from hamstring injury.
Section snippets
Method
All athletes were male and played professional Australian football for an elite level team consisting of first and reserve grade teams. The study was conducted over two full playing seasons with the team playing weekly for 25 competition matches in each season.
Hamstring muscle strain injury was noted when a player developed pain localised to the posterior thigh during the course of playing or training and subsequent MRI scan detected focal intramuscular hyperintensity within the hamstring
Results
Across the two seasons, a total of 20 hamstring injuries were recorded. Thirteen of these injuries had relevant player ratings and were therefore included in the analyses. Seven athletes were excluded (three had insufficient pre-injury ratings, four had insufficient post-injury ratings). Three of the 13 returned to play in the reserve grade and played one match there, before being promoted to the first grade team, whereas the other 10 played in the first grade team for their return from injury
Discussion
This study demonstrates that player performance in Australian football is reduced in the immediate return to play period following hamstring injury. This is consistent with the hypothesis that athletes often return to sport prior to complete resolution, with respect to muscle healing, of injury.3 As obtaining direct histological evidence is difficult in the study of athletic hamstring injuries, indirect evidence, such as player performance or persistent MRI abnormalities may provide support for
Conclusions
This study demonstrates that player performance as assessed by the team coach is reduced following return to play after hamstring injury. This is consistent with the proposition from other studies that some athletes may return to sport prior to complete resolution of injury.
Practical implications
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Player performance is reduced following return to play after hamstring injury.
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Some athletes return to play prior to complete resolution of the hamstring injury.
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Coaches, players and the medical team should be aware for the potential for player performance to be impaired when making decisions on the timing of return to play for hamstring injured athletes.
Acknowledgements
The authors wish to thank Dr. Adrian Esterman for his statistical analysis. The coach of the Norwood football club, Mr. Peter Rhode is also thanked.
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