Association of the British Athletic Muscle Injury Classification and anatomic location with return to full training and reinjury following hamstring injury in elite football
Association of the British Athletic Muscle Injury Classification and anatomic location with return to full training and reinjury following hamstring injury in elite football
Reference
Shamji R, James SLJ, Botchu R, et al. Association of the British Athletic Muscle Injury Classification and anatomic location with return to full training and reinjury following hamstring injury in elite football. BMJ Open Sport & Exercise Medicine 2021;7:e001010. doi: 10.1136/bmjsem-2020-001010
Background
The relationship between hamstring muscle injuries (HMIs) that involve the intramuscular tendon and prolonged recovery time and increased reinjury rate remains unclear in elite footballers. The objective was to determine the association of time to return to full training (TRFT) and reinjury of HMIs using the British Athletic Muscle Injury Classification (BAMIC) and specific anatomical injury location in elite-level football players.
Methodology
The electronic medical records of all players at an English Premier League club were reviewed over eight consecutive seasons. 61 acute HMIs were included. Two experienced musculoskeletal radiologists independently graded each muscle using the BAMIC, categorised each injury location area (proximal vs middle vs distal third and proximal vs distal tendon) and reported second muscle involvement. TRFT and reinjury were recorded.
Conclusion
Hamstring muscle injuries (HMIs) extending into the intramuscular tendon, categorised as British Athletic muscle injury ‘c’ on MRI, are associated with longer TFRT (36 v 24 days) and increased reinjury rate (38.5% v 12.5%) in elite-level players. Most of the HMIs to the biceps femoris with reinjury were seen at the distal musculotendinous ‘T’ junction (DMTJ) involving both the long and short heads on MRI. Clinicians managing elite-level players should consider HMI patterns, beyond intramuscular tendon involvement, such as location and second muscle injury.
Summarised by:
Dr Ricky Shamji
Head of Medical Services, Aston Villa FC
Consultant in SEM at Royal Orthopaedic Hospital, Birmingham
