• muscle injury
• tendon

There​ ​has​ ​been​ ​a​n​ ​upsurge​ ​of​ ​interest,​ ​and​ ​some​ ​confusion, about​ ​the​ ​role​ ​of​ ​the ​connective​ ​tissue​ ​condensations within​ ​the​​ ​lower​ ​limb​ ​muscles, notably​​ ​biceps​ ​femoris,​ ​rectus femoris, ​gastrocnemius​ ​and​ ​soleus.​ ​These​ ​bands​ ​are​​ ​variably referred​ ​to​ ​in the​ ​literature​ ​as ​intramuscular​ ​tendon, connective tissue, central tendon​ ​or​ ​aponeurosis, and can have a variable appearance (aponeurotic, cord-like) and vary between individuals.1​ ​

These intramuscular tendons (​IMTs) act as​ central​ ​supporting​ ​struts​ ​to​ ​which​ ​the​ ​muscle fibres​ ​attach​, and they smooth and amalgamate asynchronous motor unit contribution. ​ ​ ​Muscle strain may tear the myofibrillar attachments​​ ​from​ ​the​ intramuscular​ ​tendon, ​​ with resultant​ bleeding and oedema. Occasionally​, ​the​ ​damage​ ​may also involve a partial or complete tear of ​the​ ​ intramuscular​ ​tendon itself.

When​ ​the​ ​ intramuscular​ ​tendon ​is​ ​damaged, ​ ​the​ ​injury​ ​is​ ​regarded​ ​as​ a ​more severe strain. ​ Damage to​ ​the​ intramuscular​ ​tendon ​of​ ​the hamstring group ​ has been associated with a prolonged ​​return​ ​to​ ​play​​,2 3 although van​ ​der​ ​Made​ ​et​ ​al 4 reported​ ​only​ ​a​ modest increase in return to play duration. ​​​ Differences in the sporting demands of these cohorts may contribute to the …