The purpose of this study is to correlate the time for return to play in professional football players with the MRI findings after acute hamstring strains as well as to develop a scoring system that more easily allows for prediction of time missed. Ideally, a classification or scoring system would guide treatment to provide enough time for complete healing, avoid premature return to activity, and decrease risk of reinjury. However, no classification system was used to predict specific amount of time missed from sports. They found that the percentage of abnormal muscle area and volume of muscle injury were related to return to sports. Slavotinek et al 14 published a prospective study evaluating 37 Australian Rules football players after hamstring injuries, comparing the extent of injury on MRI with time lost from competition. 11 Although this additional information is helpful, there is no clinical classification system that allows for prediction of return to activity based on the extent of injury seen on MRI. It also allows the radiologist to grade the injury on the basis of radiologic strain grade. Not only can MRI confirm the clinical diagnosis of strain, but it provides information about the location, cross-sectional area, and extent of tear. MRI allows for detailed evaluation of hamstring injuries. Cases of proximal or distal avulsion of the hamstring tendons do, however, warrant consideration of surgical management. 6, 7 The mainstay of treatment consists of conservative management and gradual return to competition. 10 The added cost of MRI is not a precluding factor for professional organizations and is the preferred imaging modality for elite athletes, in an effort to prevent recurrent injury for those who may return to competition prematurely. Ultrasound and magnetic resonance imaging (MRI) are equally sensitive in assessing hamstring injury however, MRI offers a more detailed analysis of the injury and is not user dependent. 15Īlthough the diagnosis is made clinically, advanced radiologic evaluation is frequently used with professional athletes to assess the severity and extent of injury. Failing to properly rehabilitate or returning to competition prematurely can result in further injury and/or a chronic strain and, thus, prolonged return to play. Thus, there is pressure on the medical staff and athletic trainers to return an athlete to competition as soon as possible. 9 Given the financial and competitive concerns associated with professional athletes, the time to return to activity is of particular importance to the athlete and the team. In the elite athlete, hamstring injuries cause prolonged absence from competition and have a high recurrence rate. 1, 8 Strain is the typical pattern of injury, and it results from excessive stretching of the myotendinous unit, often during sprinting or jumping. Hamstring injuries are common in many sports, including football.
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