Hamstring injuries in elite Track and Field athletes

                 Hamstring injuries in elite  Track and Field athletes :

 In the current presentation  we will present our experience treating ttrack and field athletes with hamstring  injuries based  on objective clinical measurements (knee range of motion) and ultrasound (US) imaging findings with time to return to athletic activities.A new  clinical classification scheme for hamstring  injuries” will presented.

Material-Methods: All the athletes with an acute hamstring injury and no history of previous pathology in the posterior thigh or sciatica, were evaluated by measuring the knee active ROM (AROM) deficit compared to the uninjured side, 48 hours after their injury, by two examiners. An age matched group of controls was also examined. An US scan identified the muscle lesion (if present) and measurements (width and length of lesion expressed in cm) in the longitudinal view were performed. All athletes were managed nonoperatively with the same principals and rehabilitation protocol. The “full rehabilitation time” (time interval from the injury to full athletic activities) was recorded.  

Results: AROM measurements achieved substantial agreement between theexaminers. US scans showed that biceps femoris was injured in 75% of athletes. Values of width and length of the muscle lesions, measured by US scan, were significantly different  comparing mean values between different injury grades. About 45% of the athletes will have returned to full activities within 10 days after their injury and another 35% within 20 days (grades I and II), whereas 16% (grade III) will return after a month and 4% (grade IV) after two months.

Conclusion: Addition to history and clinical examination knee AROM deficit is an objective, reproducible and accurate measurement of the severity of  hamstring  injuries  in athletes. AROM deficit 48 hours after the injury was also predictive of the length of FRT. US imaging we think that is not necessary for I degree injuries following our clinical classification but it is  useful for high grade(III-IV) hamstring  injuries .

Βιβλιογραφία- References

Malliaropoulos, N., S. Papalexandris, A. Papalada, E. Papacostas. The role of stretching in rehabilitation of hamstring injuries : 80 athletes follow-up. Med Sci Sports Exerc. 36(5):756-759, 2004.

MalliaropoulosN,Akritidou N, Clinical applications for musculoskeletal injuries in accordance of the healing process   Galenus 49, 3: 245-254 ,.2007

Malliaropoulos N,  MScThessis Academic Department of Sports Medicine QMUL 1999

Malliaropoulos N.Tsaklis P,Isokinetic  rehabilitation of hamstring injuries Hellenic Physiotherapy Journal 8:26-28,1994

Van Holsbeeck M, Introcasco J. Musculoskeletal ultrasound, 2nd ed. St Louis Mosby 2001

Jarvinen TA, Jarvinen TL, KaariainenM, et al. Muscle injuries: biology and treatment. Am J Sports Med 2005;33:745–64.

Hamstring Strains: Expediting Return to PlayThomas M. Best, MD, PhD; William E. Garrett Jr, MD, PhD THE PHYSICIAN AND SPORTS MEDICINE - VOL 24 - NO. 8 - AUGUST 96

American Academyof Orthopaedic Surgeons. Joint motion. Method of measuring and recording.Chicago: author; 1985.

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33:1:59-74.

Mason DL, Dickens V, Vail A. Rehabilitation for hamstring injuries. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD004575.

Sherry MA, Best TM. A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains. Journal of Orthopaedic & Sports Physical Therapy 2004;34(3):116–25.

Recent Announcements

Monday, 20 Feb 2017

5th Congress of ECOSEP & 2nd UAE FA Football Medicine Update 25th-27th November 2017 Dubai

read more

Monday, 05 Sep 2016


read more

Recent Articles

Platelet Rich Plasma (PRP)

An innovative treatment, for  Musculoskeletal Pathologies , PRP uses your own blood for healing muscle, tendon and ligament injuries. 

A common form of healing is scarring which affects function . Most of the Current therapies  treating sports Injuries  do not change the intrinsically poor healing properties. Given this situation, biologically based strategies involving the stimulation of cell activities through the delivery of Growth Factors have attracted considerable interest. 

Platelet Rich Plasma is derived by placing a small amount of your blood in a filtration system which separates red blood cells from platelets. The high concentration of platelets (containing a high level of Growth Factor) is then injected into the injured tissue which initiates the body’s natural healing response.

read more

Extra Shockwave Therapy & Treatment

At European SportsCare, Extracorporeal Shockwave Therapy (ECSWT) is available for the treatment of musculoskeletal softtissue pathology such as Tendon, Ligament, Muscle and bone. Shockwave Therapy is a non-invasive treatment provided by fully trained Consultants providing this treatment for more than 15 years. It is available as an out-patient treatment in one of our comfortable consultation rooms at 68 Harley Street.

read more

Acute Lateral Ankle Sprains In Track & Field Athletes: A Proposal Of An Expanded Classification

We present a longitudinal observational study on classification of acute lateral ankle ligament injuries in track & field athletes, based on objective criteria. These very common and sometimes troublesome sports injuries are treated functionally but there is a lack in international literature in predicting the time needed for full recovery.

read more

Ten year follow-up study comparing conservative versus operative treatment of anterior cruciate ligament ruptures. A matched-pair analysis of high level athletes

Objective: To compare long term outcome of highly active patients with anterior cruciate ligament ruptures treated operatively versus non-operatively.

Design: We reviewed high level athletes with an anterior cruciate ligament rupture on either MRI or arthroscopic evaluation more than 10 years previously, who were treated conservatively. They were pair-matched with patients who had had an anterior cruciate ligament reconstruction with bone-patella-tendon-bone, with respect to age, gender and Tegner activity score before injury.Participants: In total 50 patients were pair-matched.

Results: We found no statistical difference between the patients treated conservatively or operatively with respect to osteoarthritis or meniscal lesions of the knee, as well as activity level, objective and subjective functional outcome. The patients who were treated operatively had a significantly better stability of the knee at examination.

Conclusion: We conclude that the instability repair using

a bone-patella-tendon-bone anterior cruciate ligament reconstruction is a good knee stabilising operation. Both treatment options however show similar patient outcome at 10 year follow up.

read more

ACL injuries. Diagnosis, treatment and rehabilitation

The ability to recognize the ACL deficient knee is lacking, even among orthopaedic surgeons. The history of an acute ACL tear is remarkably constant, because the injury is often non contact, and patients usually report a twist on the flexed knee, turning to the same side as the injured knee, although hyperextension or direct injury is the cause in some sports. Patients often remember a loud pop, but, because there are no nociceptors in the ACL, pain is not an immediate feature in the isolated lesion. Players may attempt to continue to play, but they usually stop because the knee feels insecure. Pain ensues in association with a hemarthrosis: 70% of acute hemarthroses of the knee are associated with a tear of the ACL. The diagnosis must be confirmed before treatment is offered.

read more