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Hamstring rehabilitation in elite track and field athletes: applying the British Athletics Muscle Injury Classification in clinical practice
  1. Ben Macdonald1,
  2. Stephen McAleer1,
  3. Shane Kelly1,
  4. Robin Chakraverty2,
  5. Michael Johnston1,3,
  6. Noel Pollock1,4
  1. 1 National Performance Institute, British Athletics, Loughborough, UK
  2. 2 St George's Park, Football Association, Burton, UK
  3. 3 A-STEM, Swansea University, Swansea, UK
  4. 4 Institute of Sport, Exercise and Health, University College London, London, UK
  1. Correspondence to Ben Macdonald, British Cycling, National Cycling Centre, Manchester, UK; benmacdonald{at}


Rationale Hamstring injuries are common in elite sports. Muscle injury classification systems aim to provide a framework for diagnosis. The British Athletics Muscle Injury Classification (BAMIC) describes an MRI classification system with clearly defined, anatomically focused classes based on the site of injury: (a) myofascial, (b) muscle–tendon junction or (c) intratendinous; and the extent of the injury, graded from 0 to 4. However, there are no clinical guidelines that link the specific diagnosis (as above) with a focused rehabilitation plan.

Objective We present an overview of the general principles of, and rationale for, exercise-based hamstring injury rehabilitation in British Athletics. We describe how British Athletics clinicians use the BAMIC to help manage elite track and field athletes with hamstring injury. Within each class of injury, we discuss four topics: clinical presentation, healing physiology, how we prescribe and progress rehabilitation and how we make the shared decision to return to full training. We recommend a structured and targeted diagnostic and rehabilitation approach to improve outcomes after hamstring injury.

  • hamstring
  • rehabilitation
  • muscle injury
  • sprinting

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  • Correction notice This article has been corrected since it published Online First. The second author's name has been corrected.

  • Contributors BM, NP, SM, RC, SK and MJ all contributed to the initial drafting and editing of the manuscript. RC led the design of the infographic.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.