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MR observations of long-term musculotendon remodeling following a hamstring strain injury

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Abstract

Objective

The objective of this study was to use magnetic resonance (MR) imaging to investigate long-term changes in muscle and tendon morphology following a hamstring strain injury.

Materials and methods

MR images were obtained from 14 athletes who sustained a clinically diagnosed grade I–II hamstring strain injury between 5 and 23 months prior as well as five healthy controls. Qualitative bilateral comparisons were used to assess the presence of fatty infiltration and changes in morphology that may have arisen as a result of the previous injury. Hamstring muscle and tendon–scar volumes were quantified in both limbs for the biceps femoris long head (BFLH), biceps femoris short head (BFSH), the proximal semimembranosus tendon, and the proximal conjoint biceps femoris and semitendinosus tendon. Differences in muscle and tendon volume between limbs were statistically compared between the previously injured and healthy control subjects.

Results

Increased low-intensity signal was present along the musculotendon junction adjacent to the site of presumed prior injury for 11 of the 14 subjects, suggestive of persistent scar tissue. The 13 subjects with biceps femoris injuries displayed a significant decrease in BFLH volume (p < 0.01), often accompanied by an increase in BFSH volume. Two of these subjects also presented with fatty infiltration within the previously injured BFLH.

Conclusion

The results of this study provide evidence of long-term musculotendon remodeling following a hamstring strain injury. Additionally, many athletes are likely returning to sport with residual atrophy of the BFLH and/or hypertrophy of the BFSH. It is possible that long-term changes in musculotendon structure following injury alters contraction mechanics during functional movement, such as running and may contribute to reinjury risk.

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Acknowledgment of funding sources

National Football League Medical Charities, National Institutes of Health Grant Number R01 AR56201, National Science Foundation predoctoral fellowship (A.S.)

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Author notes

  1. Michael J. Tuite

    Present address: , Box 3252, Clinical Science Center-E3, 600 Highland Ave., Madison, WI, 53792, USA

Authors and Affiliations

  1. Department of Biomedical Engineering, University of Wisconsin—Madison, Madison, WI, USA

    Amy Silder, Bryan C. Heiderscheit & Darryl G. Thelen

  2. Department of Orthopedics and Rehabilitation, University of Wisconsin—Madison, Madison, WI, USA

    Bryan C. Heiderscheit & Darryl G. Thelen

  3. Department of Mechanical Engineering, University of Wisconsin—Madison, Madison, WI, USA

    Darryl G. Thelen

  4. Department of Radiology, University of Wisconsin—Madison, Madison, WI, USA

    Timothy Enright & Michael J. Tuite

Authors
  1. Amy Silder
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  2. Bryan C. Heiderscheit
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  3. Darryl G. Thelen
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  4. Timothy Enright
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  5. Michael J. Tuite
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Correspondence to Michael J. Tuite.

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Silder, A., Heiderscheit, B.C., Thelen, D.G. et al. MR observations of long-term musculotendon remodeling following a hamstring strain injury. Skeletal Radiol 37, 1101–1109 (2008). https://doi.org/10.1007/s00256-008-0546-0

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  • DOI: https://doi.org/10.1007/s00256-008-0546-0

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