Dataset Information

Match High-Speed Running Distances Are Often Suppressed After Return From Hamstring Strain Injury in Professional Footballers.

ABSTRACT:

Background

High-speed running is commonly implicated in the genesis of hamstring injury. The success of hamstring injury management is typically quantified by the duration of time loss or reinjury rate. These metrics do not consider any loss in performance after returning to play from hamstring injury. It is not known to what extent high-speed running is altered on return to play after such injury.

Hypothesis

Match high-speed running distance will change after returning from hamstring injury.

Study design

Non-randomized cohort.

Level of evidence

Level 3.

Methods

Match high-speed running distance in highest level professional football (soccer, Rugby League, Rugby Union, and Australian Rules) were examined for a minimum of 5 games prior and subsequent to hamstring strain injury for individual differences using a linear regression models approach. A total of 22 injuries in 15 players were available for analysis.

Results

Preinjury cumulative high-speed running distances were strongly correlated for each individual (r² = 0.92-1.0; P < 0.0001). Pre- and postinjury high-speed running data were available for a median of 15 matches (range, 6-15). Variance from the preinjury high-speed running distance was significantly less (P = 0.0005) than the post injury values suggesting a suppression of high-speed running distance after returning from injury. On return to play, 7 of the 15 players showed a sustained absolute reduction in preinjury high-speed running distance, 7 showed no change, and 1 player (only) showed an increase. Analysis of subsequent (second and third injury) return to play showed no differences to return from the index injury.

Conclusion

Return to play was not associated with return to high-speed running performance for nearly half of the players examined, although the same number showed no difference. Persisting deficits in match high-speed running may exist for many players after hamstring strain injury.

Clinical relevance

Returning to play does not mean returning to (high-speed running) performance for nearly half of the high-level professional football players examined in this study. This suggests that successful return to play metrics should be expanded from simple time taken and recurrence to include performance.

SUBMITTER: Whiteley R

PROVIDER: S-EPMC8079800 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundProximal hamstring complex injury (PHCI) is a common injury among professional athletes, particularly those participating in pivot contact sports. Previous studies have suggested that surgery can be effective in restoring function and allowing athletes to return to sport (RTS), but the factors influencing successful RTS have been less clear.PurposeTo assess RTS capabilities after surgical treatment of PHCI in professional athletes and to identify favorable predictors of RTS.Study designCase series; Level of evidence, 4.MethodsThis study (2002-2022) was conducted on professional athletes who underwent surgical treatment for PHCI at a sports surgery center. The primary outcome of the study was the RTS capability, evaluated based on the rate of athletes' return to their preinjury level of competition, time delay to RTS, and quality of RTS as measured using their level of performance and progression of scores on activity scales such as the Tegner Activity Scale (TAS) and University of California, Los Angeles (UCLA), scale. "Maintained performance" was defined as athletes returning to the same preinjury activity level (per the TAS and UCLA scale) and perceiving themselves to have maintained their performance. Secondary outcomes covered the potential RTS predictors and complication rate. The study distinguished 2 types of PHCI: proximal hamstring tendon avulsion injury (proximal rupture with empty footprint, or having a "positive dropped ice cream sign") and complete proximal hamstring free tendon rupture (PHTR; proximal rupture without empty footprint, or having a "negative dropped ice cream sign").ResultsThe study examined 64 professional athletes (mean age, 27.3 years; 82.8% male) undergoing surgery for PHCI. The RTS rate was 98.4%, with 78.1% of the athletes returning to their preinjury level of competition at 6.2 months (SD, 2.5 months). Twelve (19%) patients had returned to sport at an inferior level of competition, and 2 (3.1%) were unable to continue in their preinjury sport. Subgroup analysis revealed variation in RTS based on sport type, with the highest rate of return to preinjury performance found in athletes in handball and sports with splits (fencing, squash, and escalade; 100%) and soccer (95.2%). In the univariate analysis, male sex (hazard ratio [HR], 4.05; 95% CI, 1.45-11.3; P = .008), higher preinjury TAS score (HR, 1.27; 95% CI, 1.06-1.52; P = .011), injury involving the semimembranosus (HR, 4.84; 95% CI, 2.31-10.2; P < .001) or conjoint tendon (HR, 3.12; 95% CI, 1.55-6.25; P = .001), and PHTR (HR, 7.77; 95% CI, 3.54-17.0; P < .001) were significantly associated with a better postoperative level of competition. Multivariate analysis identified 3 favorable predictors of RTS with HRs of 2.91 (95% CI, 1.01-8.35; P = .047) for male sex, 3.86 (95% CI, 1.78-8.37; P < .001) for isolated semimembranosus injury, and 5.18 (95% CI, 2.24-12.0; P < .001) for PHTR. The complication rate was 4.7%.ConclusionFavorable predictors of early RTS were male sex, isolated semimembranosus injury, and PHTR injuries.RegistrationNCT02906865 (ClinicalTrials.gov identifier).

Project description:A number of studies have used GPS technology to categorise rugby union locomotive demands. However, the utility of the results of these studies is confounded by small sample sizes, sub-elite player status and the global application of absolute speed thresholds to all player positions. Furthermore, many of these studies have used GPS units with low sampling frequencies. The aim of the present study was to compare and contrast the high speed running (HSR) demands of professional rugby union when utilizing micro-technology units sampling at 10 Hz and applying relative or individualised speed zones. The results of this study indicate that application of individualised speed zones results in a significant shift in the interpretation of the HSR demands of both forwards and backs and positional sub-categories therein. When considering the use of an absolute in comparison to an individualised HSR threshold, there was a significant underestimation for forwards of HSR distance (HSRD) (absolute = 269 ± 172.02, individualised = 354.72 ± 99.22, p < 0.001), HSR% (absolute = 5.15 ± 3.18, individualised = 7.06 ± 2.48, p < 0.001) and HSR efforts (HSRE) (absolute = 18.81 ± 12.25; individualised = 24.78 ± 8.30, p < 0.001). In contrast, there was a significant overestimation of the same HSR metrics for backs with the use of an absolute threshold (HSRD absolute = 697.79 ± 198.11, individualised = 570.02 ± 171.14, p < 0.001; HSR% absolute = 10.85 ± 2.82, individualised = 8.95 ± 2.76, p < 0.001; HSRE absolute = 41.55 ± 11.25; individualised = 34.54 ± 9.24, p < 0.001). This under- or overestimation associated with an absolute speed zone applies to varying degrees across the ten positional sub-categories analyzed and also to individuals within the same positional sub-category. The results of the present study indicated that although use of an individulised HSR threshold improves the interpretation of the HSR demands on a positional basis, inter-individual variability in maximum velocity within positional sub-categories means that players need to be considered on an individual basis to accurately gauge the HSR demands of rugby union.