Fifteen-week window for recurrent muscle strains in football: a prospective cohort of 3600 muscle strains over 23 years in professional Australian rules football

Abstract

ObjectivesTo determine the rates of muscle strain injury recurrence over time after return to play in Australian football and to quantify risk factors.MethodsWe analysed Australian Football League player data from 1992 to 2014 for rates of the four major muscle strain injury types (hamstring, quadriceps, calf and groin) diagnosed by team health professionals. Covariates for analysis were: recent history (≤8 weeks) of each of the four muscle strains; non-recent history (>8 weeks) of each; history of hip, knee anterior cruciate ligament, knee cartilage, ankle sprain, concussion or lumbar injury; age; indigenous race; match level and whether a substitute rule was in place.Results3647 (1932 hamstring, 418 quadriceps, 458 calf and 839 groin) muscle strain injuries occurred in 272 759 player matches. For all muscle strains combined, the risk of injury recurrence gradually reduced, with recurrence risks of 9% (hamstring), 5% (quadriceps), 2% (calf) and 6% (groin) in the first match back and remaining elevated for 15 weeks after return to play. The strongest risk factor for each muscle injury type was a recent history of the same injury (hamstring: adjusted OR 13.1, 95% CI 11.5 to 14.9; calf OR 13.3, 95% CI 9.6 to 18.4; quadriceps: OR 25.2, 95% CI 18.8 to 33.8; groin OR 20.6, 95% CI 17.0 to 25.0), followed by non-recent history of the same injury (hamstring: adjusted OR 3.5, 95% CI 3.2 to 3.9; calf OR 4.4, 95% CI 3.6 to 5.4; quadriceps OR 5.2, 95% CI 4.2 to 6.4; groin OR 3.5, 95% CI 3.0 to 4.0). Age was an independent risk factor for calf muscle strains (adjusted OR 1.6, 95% CI 1.3 to 2.0). Recent hamstring injury increased the risk of subsequent quadriceps (adjusted OR 1.8, 95% CI 1.2 to 2.7) and calf strains (OR 1.8, 95% CI 1.2 to 2.6). During the ‘substitute rule’ era (2011–2014), hamstring (adjusted OR 0.76, 95% CI 0.67 to 0.86), groin (OR 0.78, 95% CI 0.65 to 0.93) and quadriceps (OR 0.70, 95% CI 0.53 to 0.92) strains were less likely than outside of that era but calf (OR 1.6, 95% CI 1.3 to 1.9) strains were more likely than before the substitute rule era.ConclusionRecent injury is the greatest risk factor for the four major muscle strains, with increased risk persisting for 15 weeks after return to play.

The Comparison of Different Stretching Intensities on the Range of Motion and Muscle Stiffness of the Quadriceps Muscles

“…One of the most frequent sports injuries and the third most common in a survey of injuries occurring during the Olympic Games in Rio de Janeiro is muscle strain, after sprain/ligament rupture and contusion/hematoma/bruise (Soligard et al, 2017). Regarding incidence of muscle strain, the hamstrings, quadriceps, and triceps muscles are the most frequently involved (Garrett, 1996;Orchard et al, 2020). In a study, which used MRI, the rectus femoris (RF) muscle was the reported preferred muscle strain site of the quadriceps muscle (Cross et al, 2004).…”

Return to Play and Recurrence After Calf Muscle Strain Injuries in Elite Australian Football Players

“…Clinical data about the athlete’s age and injury history (early recurrence: previous ankle injury; overall: previous CMSI) were associated with a greater risk of recurrent CMSI. Recent studies similarly found older age and history of CMSI to be risk factors for CMSI, 19,39 and clinical data provide better information than MRI findings about the risk of recurrent hamstring muscle strain injuries. 12 A previous muscle strain injury can result in persistent strength deficits, 6,17,38 atrophy, 6,25,38,49 and noncontractile tissue infiltration, 20,38 as well as neurophysiological changes (eg, inhibition).…”

“…Soleus intramuscular aponeurosis injuries with AD had a slower functional progression when compared with injuries at the same location with no AD (Table 2). Patients with myofascial injuries had the shortest time on average to achieve pain-free [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]. There was no difference in time to RTP between CMSI with no AD versus mild AD (r = 0.22; P = .06), or mild AD versus severe AD (r = 0.15; P = .30).…”

High-Intensity Static Stretching in Quadriceps Is Affected More by Its Intensity Than Its Duration

“…Muscle strain is a frequent sports injury and occurs most often in hamstrings, quadriceps [especially the rectus femoris (RF)], and gastrocnemius ( Schuermans et al, 2016 ; Soligard et al, 2017 ; Orchard et al, 2020 ). To prevent muscle strain, it is important to decrease the muscle-tendon unit stiffness ( Watsford et al, 2010 ; Pickering Rodriguez et al, 2017 ).…”