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A 4-year study of hamstring injury outcomes in elite track and field using the British Athletics rehabilitation approach
  1. Noel Pollock1,2,
  2. Shane Kelly2,3,
  3. Justin Lee4,
  4. Ben Stone2,
  5. Michael Giakoumis2,
  6. George Polglass2,
  7. James Brown2,
  8. Ben MacDonald5
  1. 1Institute of Sport, Exercise and Health, University College London, London, UK
  2. 2National Performance Institute, British Athletics Science and Medicine Team, Loughborough, UK
  3. 3Ballet Healthcare, The Royal Ballet, London, UK
  4. 4Radiology Department, Fortius Clinic, London, UK
  5. 5Medical Department, British Cycling, Manchester, UK
  1. Correspondence to Dr Noel Pollock, Institute of Sport, Exercise and Health, University College London, London WC1E 6BT, UK; NPollock{at}britishathletics.org.uk

Abstract

Objectives The British Athletics Muscle Injury Classification (BAMIC) correlates with return to play in muscle injury. The aim of this study was to examine hamstring injury diagnoses and outcomes within elite track and field athletes following implementation of the British Athletics hamstring rehabilitation approach.

Methods All hamstring injuries sustained by elite track and field athletes on the British Athletics World Class Programme between December 2015 and November 2019 that underwent an MRI and had British Athletics medical team prescribed rehabilitation were included. Athlete demographics and specific injury details, including mechanism of injury, self-reported gait phase, MRI characteristics and time to return to full training (TRFT) were contemporaneously recorded.

Results 70 hamstring injuries in 46 athletes (24 women and 22 men, 24.6±3.7 years) were included. BAMIC grade and the intratendon c classification correlated with increased TRFT. Mean TRFT was 18.6 days for the entire cohort. Mean TRFT for intratendon classifications was 34±7 days (2c) and 48±17 days (3c). The overall reinjury rate was 2.9% and no reinjuries were sustained in the intratendon classifications. MRI variables of length and cross-sectional (CSA) area of muscle oedema, CSA of tendon injury and loss of tendon tension were associated with TRFT. Longitudinal length of tendon injury, in the intratendon classes, was not associated with TRFT.

Conclusion The application of BAMIC to inform hamstring rehabilitation in British Athletics results in low reinjury rates and favourable TRFT following hamstring injury. The key MRI variables associated with longer recovery are length and CSA of muscle oedema, CSA of tendon injury and loss of tendon tension.

  • hamstring
  • muscle injury
  • exercise rehabilitation
  • rehabilitation
  • elite performance

Data availability statement

Data are available upon reasonable request. Data is available upon reasonable request.

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Data availability statement

Data are available upon reasonable request. Data is available upon reasonable request.

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Footnotes

  • Twitter @drnoelpollock, @shanekellypt, @MickGiakoumis

  • Contributors NP and BM led the study design, data collection and write up. NP, SK, BM, JB, MG and GP contributed to data collection. JL reported the imaging and wrote the imaging sections of the manuscript. BS led the data analysis. All authors contributed to drafting.

  • 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 and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

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

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