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Journal Article

Citation

Sanfilippo J, Silder A, Sherry MA, Tuite MJ, Heiderscheit BC. Med. Sci. Sports Exerc. 2013; 45(3): 448-454.

Affiliation

1Departments of Biomedical Engineering and Athletics, University of Wisconsin-Madison, Madison, WI 2Departments of Bioengineering and Orthopaedic Surgery, Stanford University, Stanford, CA 3Sports Rehabilitation, University of Wisconsin Health Sports Medicine, Madison, WI 4Department of Radiology, University of Wisconsin-Madison, Madison, WI 5Departments of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI.

Copyright

(Copyright © 2013, Lippincott Williams and Wilkins)

DOI

10.1249/MSS.0b013e3182776eff

PMID

23059864

Abstract

Hamstring strain re-injury rates can reach 30% within the initial two weeks following return to sport (RTS). Incomplete recovery of strength may be a contributing factor. However, relative strength of the injured and unaffected limbs at RTS is currently unknown. PURPOSE: Characterize hamstring strength and morphology at the time of RTS and six months later. METHODS: Twenty-five athletes that experienced an acute hamstring strain injury participated, following completion of a controlled rehabilitation program. Bilateral isokinetic strength testing and magnetic resonance imaging (MRI) were performed at RTS and 6-months later. Strength (knee flexion peak torque, work, angle of peak torque) and MRI (muscle and tendon volumes) measures were compared between limbs and over time using repeated measures ANOVA. RESULTS: The injured limb showed a peak torque deficit of 9.6% compared to the uninjured limb at RTS (60°/s, p<0.001), but not 6-months following. The knee flexion angle of peak torque decreased over time for both limbs (60°/s, p<0.001). MRI revealed that 20.4% of the muscle cross-sectional area showed signs of edema at RTS with full resolution by the 6-month follow-up. Tendon volume of the injured limb tended to increase over time (p=0.108), while muscle volume decreased 4-5% in both limbs (p<0.001). CONCLUSIONS: Residual edema and deficits in isokinetic knee flexion strength were present at RTS, but resolved during the subsequent six months. This occurred despite MRI evidence of scar tissue formation (increased tendon volume) and muscle atrophy, suggesting that neuromuscular factors may contribute to the return of strength.


Language: en

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