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PubMed1990

The relationship between peak torque and work of the quadriceps and hamstrings after knee injury.

The purpose of the present study was to assess the relationship between the isometric and isokinetic peak torques (speed of movement 0, 60, 180 deg/sec) and the total work output of multiple contractions (180 deg/sec) of the quadriceps and hamstrings in 68 patients having seven years earlier a hemarthrotic knee injury. At every test speed the Pearson product moment (r) and the Spearman rank (rs) correlation coefficients between the peak torque and the total work were highly significant (p less than 0.001) for the quadriceps and hamstrings in the uninjured (r = 0.74-0.92, rs = 0.75-0.93) as well as in the injured (r = 0.83-0.93, rs = 0.84-0.92) knees. All correlation coefficients were higher at the highest speed (180 deg/sec) of the isokinetic test (r = 0.90-0.93, rs = 0.91-0.93) than at the other speeds (0 and 60 deg/sec) (r = 0.74-0.88, rs = 0.75-0.89) obviously since the total work was registered at that speed. In conclusion, in injured or healthy knees the isokinetic total work analysis offers little additional information to that attained by more simple measurements, the peak torque recordings.

Adolescent↗
PubMed2002

Epidemiology of injuries in the Australian Football League, seasons 1997-2000.

OBJECTIVE: To describe the epidemiology of injuries in the Australian Football League (AFL) over four seasons. METHODS: An injury was defined as "any physical or medical condition that caused a player to miss a match in the regular season." The rationale for this definition was to eliminate a previously noted tendency of team recorders to interpret injury definitions subjectively. Administrative records of injury payments to players who did not play matches determined the occurrence of an injury. RESULTS: The seasonal incidence of new injuries was 39 per club (of 40 players) per season (of 22 matches). The match injury incidence for AFL games was 25.7 injuries per 1000 player hours. The injury prevalence (percentage of players missing through injury in an average week) was 16%. The recurrence rate of injuries was 17%. The most common and prevalent injury was hamstring strain (six injuries per club per season, resulting in 21 missed matches per club per season), followed in prevalence by anterior cruciate ligament and groin injuries. CONCLUSIONS: The injury definition of this study does not produce incidence rates that are complete for all minor injuries. However, the determination of an injury is made by a single entity in exactly the same manner for all teams, which overcomes a significant methodological flaw present in other multiteam injury surveillance systems.

Athletic Injuries↗
PubMedDate not supplied

Hamstring muscle strain recurrence and strength performance disorders.

We determined the frequency of strength disorders in 26 athletes with a history of hamstring muscle injury and recurrent strains and discomfort. We also assessed the effectiveness of rehabilitation to correct muscle performance. After concentric and eccentric isokinetic assessment, 18 athletes were found to have strength deficits, as determined by statistically selected cutoffs of peak torque, bilateral differences, and the flexors/quadriceps ratio. The discriminating character of the eccentric trial was demonstrated, combining a preferential eccentric peak torque deficit and a significant reduction of the mixed eccentric flexors/concentric quadriceps ratio. The athletes with muscle imbalances followed a rehabilitation program individually adapted from their strength profile. Treatment length was from 10 to 30 sessions and resulted in isokinetic parameter normalization in 17 of 18 subjects. Isokinetically corrected subjects were observed for 12 months after return to athletics. None sustained a clinically diagnosed hamstring muscle reinjury. Subjective intensity of pain and discomfort were significantly reduced, and they all returned to their prior level of competition. These results demonstrate that persistent muscle strength abnormalities may give rise to recurrent hamstring injuries and discomfort. An individualized rehabilitation program emphasizing eccentric training based on specific deficits contributes to a decrease in symptoms on return to sports.

Adult↗
PubMed2006

Complete semimembranosus rupture following therapeutic stretching after a traumatic brain injury.

Acute hamstring rupture is an uncommon event often occurring during high impact sports. Such events have not been previously reported during neurological rehabilitation. This case report describes a 30 year-old Chinese male presenting in a minimally responsive state 5 years after a severe traumatic brain injury. He was tetraplegic and bed-bound with spasticity involving all four limbs and flexion contracture of the right knee. During an episode of inpatient rehabilitation, he developed acute swelling and bruising of the posterior proximal thigh region associated with fever, tachycardia and diaphoresis. MRI showed a large soft tissue rim-enhancing mass in the right proximal hamstring muscle. During surgical exploration, complete rupture of the right semi-membranosus muscle was found without evidence of pus. The possible causative factors of hamstring rupture in this subject and a brief literature review are discussed. To the authors' knowledge, this is the first such reported case.

Acute Disease↗
PubMed2002

Injuries in Australian cricket at first class level 1995/1996 to 2000/2001.

OBJECTIVE: To describe and analyse injuries and illness occurring in Australian cricket at first class level. METHODS: Injuries occurring to the state and national teams were surveyed prospectively between the seasons 1998/1999 and 2000/2001, and the three preceding seasons were surveyed retrospectively. The definition of an injury was detailed and generally required the player to miss playing time in a major match. RESULTS: Average injury match incidence in the seasons studied prospectively varied from a low of 19.0 injuries per 10 000 player hours in first class domestic matches to a high of 38.5 injuries per 10 000 player hours in one day internationals. The average seasonal incidence was 19.2 injuries per squad (25 players) per season (20 matches). Injury prevalence (the percentage of players missing through injury at any given time) was 14% for pace bowlers, 4% for spin bowlers, 4% for batsmen, and 2% for wicket keepers. The most common injuries were hamstring strains, side strains, groin injuries, wrist and hand injuries, and lumbar soft tissue injuries. Bowlers who had bowled more than 20 match overs in the week leading up to a match had an increased risk of sustaining a bowling injury (risk ratio 1.91, 95% confidence interval (CI) 1.28 to 2.85). A further risk for bowling injury is bowling second in a match-that is, batting first (risk ratio 1.62, 95% CI 1.04 to 2.50). A risk factor for injury in fielding is colliding with the boundary fence. CONCLUSIONS: Further study is required to determine ways to minimise the risk of injury in fast bowlers. Cricket grounds should mark a boundary line on the playing field to prevent players colliding with fences in the field.

Athletic Injuries↗
PubMed2006

Incidence of injury in elite Gaelic footballers.

The purpose of this study was to undertake a comprehensive prospective epidemiological study of injuries sustained by elite Gaelic Football players over one season. The pattern of injury is strikingly similar across all teams with 47% of all injuries occurring in the final quarter of games and training. Injuries to the lower limb, particularly the hamstrings muscles accounted for the majority of injuries. 65% of players were unable to participate fully in Gaelic Football activity for between one and three weeks as a result of injury. The high incidence of injury especially hamstrings injuries in the latter stages of training and games warrants further investigation.

Adolescent↗
PubMed2002

The effects of ACL injury on quadriceps and hamstring torque, work and power.

The aim of this study was to assess isokinetic torque, work and power between non-injured, ACL (anterior cruciate ligament)-deficient and ACL-reconstructed individuals. Ten healthy, non-injured individuals, seven unilateral ACL-deficient individuals and six unilateral ACL-reconstructed individuals were assessed for isokinetic quadriceps and hamstring strength at 1.05 and 3.14 rad.s-1. Peak torque, total work, average power and the ratio of peak torque to body mass were computed for both velocities. Peak torque was also corrected for body mass, using allometric modelling. The non-injured individuals showed significantly greater quadriceps peak torque to body mass ratios than the ACL-deficient and ACL-reconstructed individuals at both velocities, and greater hamstring peak torque to body mass ratios than the ACL-deficient group at 3.14 rad.s-1 (P < 0.05). The ACL-deficient individuals displayed greater quadriceps and hamstring peak torque, total work and average power than the non-injured individuals at 1.05 rad.s-1 (P < 0.05). The ACL-deficient individuals also displayed significantly greater peak torque, total work and average power than the ACL-reconstructed individuals for the quadriceps at both velocities (P < 0.05). The ACL-deficient individuals demonstrated greater hamstring peak torque and total work than the non-injured individuals at both velocities (P < 0.05). The allometrically modelled peak torques at both isokinetic velocities demonstrated that the quadriceps muscle values were significantly higher in the non-involved than the involved limb. The hamstring peak torques corrected for body mass were significantly higher in the non-involved than the involved limb only at 1.05 rad.s-1. The main finding from the present study is that isokinetic measures in ratio-scaled or absolute units yield a different outcome and, hence, interpretation compared with the allometric approach.

Adult↗
PubMedDate not supplied

Diagnostic and prognostic value of clinical findings in 83 athletes with posterior thigh injury: comparison of clinical findings with magnetic resonance imaging documentation of hamstring muscle strain.

BACKGROUND: Little is known about the clinical features of posterior thigh injuries and their contribution to accurate diagnosis and prognostic assessment of hamstring muscle strain injury. HYPOTHESES: The clinical features of posterior thigh injury can be used to diagnose hamstring muscle strain and to predict duration of absence from competition. STUDY DESIGN: Prospective clinical study. METHODS: For two playing seasons, the clinical features of posterior thigh injury, timing of injury, and playing days lost were recorded for Australian Rules football players. Magnetic resonance imaging was used to confirm hamstring muscle injury. RESULTS: Posterior thigh injuries associated with pain and tenderness were recorded for 83 players, with magnetic resonance imaging confirming hamstring injury in 68 (82%). Most of the hamstring injuries were sudden onset (62; 91%) and occurred after a significant warm-up period (57; 84%). Of the patients whose injuries were sudden onset and occurred after the warm-up period (N = 59), 57 (97%) had hamstring muscle strain detected on magnetic resonance imaging. Hamstring muscle injury confirmed by magnetic resonance imaging was associated with a longer absence from competition (mean, 27 days) than injuries where no hamstring injury was detected (mean, 16 days). CONCLUSIONS: The clinical features of hamstring injury typically include sudden onset, pain, and tenderness, although exceptions do occur. Muscle fatigue may be important in the pathogenesis of hamstring injury.

Adult↗
PubMedDate not supplied

Sports injuries in the game of hurling. A one-year prospective study.

A prospective study of hurling injuries was conducted over the 8 months of one season on 74 players. These athletes averaged 4.30 +/- 2.58 hours per week of training and 1.15 +/- 0.21 hours per week of matches. Mean time of injury was 1.20 +/- 2.53 days in the hospital, 20.34 +/- 19.25 days off sport, and 13.34 +/- 17.25 days of restricted activity. Together this injury time amounts to 14.3% of the season. There were 92 match- and 43 training-related injuries, giving 342.47 injuries per 10,000 hours of matches and 43.83 injuries per 10,000 hours of training. Overall, there were 369.9 days of injury per 1000 hours of participation. The most common type of injury was muscle strain (24.4% of the 135 total injuries). The hamstrings was the most common site of strain, accounting for 41% of these injuries. Contusions comprised 16.3% of the injuries and sprains comprised 15.6%. The most frequently injured sites were the finger (13%), hamstrings (12%), back (11%), head (9%), and knee and ankle (9%). Forty-one percent of the injuries were attributed to foul play. The results of the study suggest that the incidence of injuries in hurling is high and may be attributed to poor conditioning, poor protection, and lack of enforcement of the rules.

Absenteeism↗
PubMedDate not supplied

Increasing hamstring flexibility decreases lower extremity overuse injuries in military basic trainees.

The purpose of this intervention study was to prove that increasing flexibility of the hamstring musculotendinous unit would decrease the number of lower extremity overuse injuries that occur in military infantry basic trainees. Two different companies going through basic training at the same time were used. Hamstring flexibility was checked at the beginning and at the end of the 13-week infantry basic training course. The control company (N = 148) proceeded through normal basic training. The intervention company (N = 150) followed the same program but added three hamstring stretching sessions to their already scheduled fitness program. All subsequent lower extremity overuse injuries were recorded through the troop medical clinic. Hamstring flexibility increased significantly in the intervention group compared with the control group. The number of injuries was also significantly lower in the intervention group. Forty-three injuries occurred in the control group for an incidence rate of 29.1%, compared with 25 injuries in the intervention group for an incidence rate of 16.7%. Thus, in this study, the number of lower extremity overuse injuries was significantly lower infantry basic trainees with increased hamstring flexibility.

Adult↗
PubMed1999

Hamstring extensibility and transverse plane knee control relationship in athletic women.

Athletic women are at particular risk for sustaining a non-contact anterior cruciate ligament (ACL) injury. The hamstrings are vital to providing dynamic knee motion control in the sagittal and transverse planes during running stance, and some have suggested this function is enhanced when they are less extensible. This study attempted to determine the correlational relationships between hamstring extensibility and transverse plane knee kinematics and from these data to describe the dynamic transverse plane knee motion control capabilities of the hamstrings. Twenty normal athletic women (mean +/- SD; aged 21 +/- 1.6 years; height 163.3 +/- 5.7 cm; weight 60.1 +/- 3.6 kg) were evaluated for active hamstring extensibility and transverse plane knee kinematic relationships during crossover-cut stance phase. Following crossover-cut training (3 weeks) using the left (preferred) lower extremity as the stance limb, hamstring extensibility was measured. Following this, subjects were fitted with 9 retroreflective markers denoting the local segmental coordinate systems (3 markers each) of the left foot, leg and thigh. Kinematic (3-dimensional, four phase-locked cameras, 200 Hz) knee and ankle data were sampled and analyzed. Descriptive statistics and Pearson correlations between hamstring extensibility and knee and ankle kinematic variables were calculated. Statistical significance was set at P < or = 0.05 with Bonferroni adjustments. Hamstring extensibility (12 degrees +/- 8 degrees terminal extension) revealed low but significant positive correlations with tibial external rotation (6 degrees +/- 10.7 degrees) at heelstrike (19.3 degrees +/- 8.5 degrees knee flexion) (r = 0.62, P = 0.004) and tibial internal rotation (-13 degrees +/- 8.4 degrees) at peak knee flexion (57.8 degrees +/- 9.3 degrees) following heelstrike (r = 0.47, P = 0.01). Increased hamstring extensibility resulted in increased tibial external rotation at heelstrike and decreased tibial internal rotation at peak knee flexion. Increased hamstring extensibility may improve knee extensor efficiency at heelstrike by enabling greater tibial external rotation and protect the ACL at peak knee flexion by decreasing the tibial internal rotation magnitude.

Adult↗
PubMed1996

The incidence of injury in surfboat rowers.

A questionnaire was completed by 202 surfboat rowers. The questionnaire investigated injuries that occurred over the preceding two years. The injuries were classified according to the nature of onset of the injury, the anatomical location of the injury, and the age of the rower. Eighty percent of surfboat rowers reported some type of injury during the two years prior to completing the questionnaire. Eighty one percent of injuries were classified as chronic insidious onset injuries. The mean time lost from employment due to chronic insidious onset injuries was 10.4 days, Low back pain accounted for 60% of all injuries. Sixty percent of the acute injuries were hamstring or calf tears that were incurred during sprint running training. No relationship between age or surfboat rowing experience and incidence of injury was identified. The present study suggests that there is a high incidence of injury in surfboat rowing, and that most injuries are chronic injuries and are of an insidious onset.

Absenteeism↗
PubMedDate not supplied

Hamstring muscle complex: an imaging review.

Increasing activity in the general population and the high demands placed on athletes have resulted in injuries to the hamstring muscle complex (HMC) being commonplace in sports. Imaging of HMC injuries can form a considerable part of a sports medicine practice, with a wide spectrum of such injuries being reflected in their varied imaging appearances. Magnetic resonance (MR) imaging and ultrasonography (US) are the imaging modalities of choice in this setting. Both MR imaging and US provide exquisitely detailed information about the HMC with respect to localization and characterization of injury. Optimization of MR imaging involves the use of a surface coil and high-resolution techniques, allowing the musculoskeletal radiologist not only to diagnose injury and assess severity but also to provide the clinician with useful clues with respect to prognosis. The portability and availability of US make it an attractive modality for the diagnosis of acute hamstring injuries, although its effectiveness is dependent on operator experience. A thorough knowledge of the HMC anatomy and of the spectrum of imaging findings in HMC injury is crucial for providing optimal patient care and will enable the musculoskeletal radiologist to make an accurate and useful contribution to the treatment of athletes at all levels of participation.

Athletic Injuries↗
PubMed2003

Management of muscle and tendon injuries in footballers.

BACKGROUND: Muscle and tendon injuries are among the commonest football injuries and can be very frustrating to treat because of the high risk of recurrence. OBJECTIVE: This article aims to highlight the optimal management of, and risk factor for re-injury of, the common soft tissue injuries in football players. DISCUSSION: The high risk of recurrence of soft tissue injuries is because most football players return to play before complete healing of the injury. For hamstring and quadriceps strains and thigh haematomas, early return is often a sensible strategy. Calf strains in older players and tendinopathies (Achilles, patellar tendon and chronic groin injuries) generally require a more conservative approach as the risk of prolonged missed playing time is greater. The rupture of tendons that have nearby agonists can often be managed conservatively, but rupture of isolated prime mover tendons, such as the Achilles and patellar tendons, should be managed surgically.

Anterior Cruciate Ligament Injuries↗