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Acute First-Time Hamstring Strains During High-Speed Running

A Longitudinal Study Including Clinical and Magnetic Resonance Imaging Findings

Carl M. Askling, PT^,,*, Magnus Tengvar, MD, Tönu Saartok, MD, PhD and Alf Thorstensson, PhD

From the Swedish School of Sport and Health Sciences, Stockholm, Sweden, the Department of Radiology, Sophiahemmet Hospital, Stockholm, Sweden, and the Section of Orthopaedics and Sports Medicine, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

^* Address correspondence to Carl M. Askling, Karolinska Institutet, Box 5626, 114 86 Stockholm, Sweden (e-mail: carl.askling{at}ihs.se).

Background: Hamstring muscle strain is one of the most common injuries in sports. Still, knowledge is limited about the progression of clinical and magnetic resonance imaging characteristics and their association with recovery time in athletes.

Hypothesis: Knowing the anatomical location and extent of an acute first-time hamstring strain in athletes is critical for the prognosis of recovery time.

Study Design: Case series (prognosis); Level of evidence, 2.

Methods: Eighteen elite sprinters with acute first-time hamstring strains were prospectively included in the study. All subjects were examined, clinically and with magnetic resonance imaging, on 4 occasions after injury: at day 2 to 4, 10, 21, and 42. The clinical follow-up period was 2 years.

Results: All sprinters were injured during competitive sprinting, and the primary injuries were all located in the long head of the biceps femoris muscle. There was an association between the time to return to pre-injury level (median, 16; range, 6–50 weeks) and the extent of the injury, as indicated by the magnetic resonance imaging parameters. Involvement of the proximal free tendon, as estimated by MRI, and proximity to the ischial tuberosity, as estimated both by palpation and magnetic resonance imaging, were associated with longer time to return to pre-injury level.

Conclusion: Careful palpation during the first 3 weeks after injury and magnetic resonance imaging investigation performed during the first 6 weeks after injury provide valuable information that can be used to predict the time to return to pre-injury level of performance in elite sprinting.

Key Words: magnetic resonance imaging • palpation • recovery • rehabilitation

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				C. M. Askling, M. Tengvar, T. Saartok, and A. Thorstensson Proximal Hamstring Strains of Stretching Type in Different Sports: Injury Situations, Clinical and Magnetic Resonance Imaging Characteristics, and Return to Sport Am. J. Sports Med., September 1, 2008; 36(9): 1799 - 1804. [Abstract] [Full Text] [PDF]

				C. M. Askling, M. Tengvar, T. Saartok, and A. Thorstensson Acute First-Time Hamstring Strains During Slow-Speed Stretching: Clinical, Magnetic Resonance Imaging, and Recovery Characteristics Am. J. Sports Med., October 1, 2007; 35(10): 1716 - 1724. [Abstract] [Full Text] [PDF]