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Return to Play After a Muscle Lesion

  • Gian Nicola BisciottiEmail author

Abstract

The return to sports after muscle injury is a very delicate and problematic moment of the entire rehabilitation program. In fact, in general, this decision relies on a few objective data that can facilitate and properly address the choice. On the other hand, the policy to be maintained as part of the sports medicine is to try to recover the athlete in the least time as possible while minimizing, in the same time, the risk of recurrence. However, if in a sedentary person, or at least for a person who has low functional demands, the end of the rehabilitative after muscle injury may coincide with the anatomical healing of the lesion site. For an athlete, this may not be the case.

Athletes, especially professional athletes, have extremely high functional requirements, and the rehabilitative process may not be considered concluded until there is optimal recovery of muscular function. For all of these reasons it is clear that the decision of an athlete’s return to the field after muscle injury should try to rest, as much as possible, on objective data that will help the medical staff in this difficult choice.

In this work we will present, although schematically, the guidelines on which to make the decision of return to the field and, at the same time, their scientific rationale of use.

Keywords

Muscle injury Recurrence Functional tests Return to play Risk factors 

References

  1. 1.
    Sewar H, Orchard J, Hazard H, Collinson D (1993) Football injuries in Australia at the elite level. M J Aust 159(5):298–301Google Scholar
  2. 2.
    Drezner J (2003) Practical management of hamstring injuries. Clin J Sport Med 13:48–52CrossRefPubMedGoogle Scholar
  3. 3.
    Askling C, Karlsson J, Thorstensson A (2003) Hamstring injury occurrence in elite soccer players after preseason strength training with eccentric overload. Scand J Med Sci Sports 13:244–250CrossRefPubMedGoogle Scholar
  4. 4.
    Dvorak J, Junge A, Chomiak J, Graf-Baumann T, Peterson L, Rösch D, Hodgson R (2000) Risk factor analysis for injuries in football players. Possibilities for a prevention program. Am Ortho Soc Sports Med 28(5):69–74CrossRefGoogle Scholar
  5. 5.
    Hawkins RD, Hulse MA, Wilkinson C, Hodson A, Gibson M (2001) The association football medical research programme. An audit of injuries in professional football. British J Sport Med 35:43–47CrossRefGoogle Scholar
  6. 6.
    Woods C, Hawkins RD, Maltby S, Hulse M, Thomas A, Hodson A (2004) The football association medical research programme: an audit on injuries in professional football analysis of hamstring injuries. British J Sport Med 38:36–41CrossRefGoogle Scholar
  7. 7.
    Devlin L (2000) Recurrent posterior thigh symptoms detrimental to performance in rugby union. Predisposing factor. Sport Med 29(4):273–287CrossRefGoogle Scholar
  8. 8.
    Orchard J, Best T (2002) The management of muscle strain injuries: an early return versus the risk of recurrence. Clin J Sport Med 12:3–5CrossRefPubMedGoogle Scholar
  9. 9.
    Orchard J, Seward H (2000) Epidemiology of injuries in the Australian Football League, seasons 1997–2000. Br J Sports Med 36:39–45CrossRefGoogle Scholar
  10. 10.
    Orchard J, Seward H (2004) AFL injury report 2003. J Sci Med Sport 7:264–265CrossRefGoogle Scholar
  11. 11.
    Heiderscheit BC, Sherry MA, Silder A, Chumanov ES, Thelen DG (2010) Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention. J Orthop Sports Phys Ther 40(2):67–81CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Upton PA, Noakes TD, Jurits JM (1996) Thermal pants may reduce the risk of recurrent hamstring injuries in rugby players. British J Sport Med 30:57–60CrossRefGoogle Scholar
  13. 13.
    Arnason A, Sigurdsson SB, Gudmundsson A, Holme I, Engebretsen L, Bahr R (2004) Risk factors for injuries in football. Am J Sports Med 32:5S–16SCrossRefPubMedGoogle Scholar
  14. 14.
    Connell D, Schneider-Kolsky M, Hoving J (2004) Longitudinal study comparing sonographic and MRI assessments of acute and healing hamstring injuries. AJR Am J Roentgenol 183:975–984CrossRefPubMedGoogle Scholar
  15. 15.
    Pomeranz SJ, Heidt RS Jr (1993) MR imaging in the prognostication of hamstring injury: work in progress. Radiology 189:897–900CrossRefPubMedGoogle Scholar
  16. 16.
    Slavotinek J, Verrall G, Fon G (2002) Hamstring injury in athletes: using MR imaging measurements to compare extent of muscle injury with amount of time lost from competition. AJR Am J Roentgenol 179:1621–1628CrossRefPubMedGoogle Scholar
  17. 17.
    Gibbs N, Cross T, Cameron M (2004) The accuracy of MRI in predicting recovery and recurrence of acute grade one hamstring muscle strains within the same season in Australian Rules football players. J Sci Med Sport 7:248–258CrossRefPubMedGoogle Scholar
  18. 18.
    Burkett LN (1970) Causative factors in hamstring strains. Med Sci Sports Exerc 2:39–42CrossRefGoogle Scholar
  19. 19.
    Heiser TM, Weber J, Sullivan G et al (1984) Prophylaxis and management of hamstring muscle injuries in intercollegiate football players. Am J Sports Med 12:368–370CrossRefPubMedGoogle Scholar
  20. 20.
    Yamamoto T (1993) Relationship between hamstring strains and leg muscle strength: a follow-up study of collegiate track and field athletes. J Sports Med Phys Fitness 33:194–199PubMedGoogle Scholar
  21. 21.
    Jonhagen S, Nemeth G, Eriksson E (1994) Hamstring injuries in sprinters: the role of concentric and eccentric hamstring muscle strength and flexibility. Am J Sports Med 22:262–266CrossRefPubMedGoogle Scholar
  22. 22.
    Orchard J, Marsden J, Lord S (1997) Preseason hamstring muscle weakness associated with hamstring muscle injury in Australian footballers. Am J Sports Med 25:81–85CrossRefPubMedGoogle Scholar
  23. 23.
    Croisier J, Forthomme B, Namurois M (2002) Hamstring muscle strain recurrence and strength performance disorders. Am J Sports Med 30:199–203PubMedGoogle Scholar
  24. 24.
    Lv F, Tang J, Luo Y, Ban Y, Wu R, Tian J, Yu T, Xie X, Li T (2012) Muscle crush injury of extremity: quantitative elastography with supersonic shear imaging. Ultrasound Med Biol 38(5):795–802CrossRefPubMedGoogle Scholar
  25. 25.
    Bisciotti GN (2000) Per ritrovare la funzionalità. Sport e medicina 6:43–47Google Scholar
  26. 26.
    Brockett C, Morgan D, Proske U (2001) Human hamstrings adapt to eccentric exercise by changing optimum length. Med Sci Sports Exerc 33:783–790CrossRefPubMedGoogle Scholar
  27. 27.
    Brockett C, Morgan D, Proske U (2004) Predicting hamstring strain injury in elite athletes. Med Sci Sports Exerc 36:379–387CrossRefPubMedGoogle Scholar
  28. 28.
    Bisciotti GN. (2003). A avaliação funcional dos atletas. Faculty of Sport Sciences and Physical Therapy, University Estacio de Sa de Puerto Alegre (BR). October 15th 2003. Lecture notes, Estacio de Sa (Ed). Vol 3, p 35Google Scholar
  29. 29.
    Sherry M, Best T (2004) A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains. J Orthop Sports Phys Ther 34:116–125CrossRefPubMedGoogle Scholar
  30. 30.
    Orchard J, Farhart P, Leopold C (2004) Lumbar spine region pathology and hamstring and calf injuries in athletes: is there a connection? Br J Sports Med 38:502–504CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Orchard J, Best TM, Verral GM (2005) Return to play following muscle strain. Clin J Sport Med 15:436–441CrossRefPubMedGoogle Scholar
  32. 32.
    Chomiak J, Junge A, Peterson L, Dvorak J (2000) Severe injuries in football players. Influencing factors. Am J Sports Med 28(5 Suppl):S58–S68CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.FIFA Center of ExcellenceQatar Orthopaedic and Sports Medicine HospitalDohaQatar
  2. 2.Kinemove Rehabilitation CentersPontremoliItaly

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