Rehabiltation and return to play post hamstring strain
Current rehabilitation and return to play (RTP) practices, such as timeframes for physiological muscle healing and subjective measures of pain may be inadequate to address risk factors for recurrent hamstring injury. More objective criteria such as the Askling H-test, ROM testing and handheld or isokinetic dynamometer strength testing may improve the balance of RTP times and rates of re-injury after hamstring strains.
9 studies with rehabilitation and RTP criteria for hamstring strain were included in this systematic review. The main finding is that progression of hamstring rehabilitation is largely based on the injured individual's pain-free limits. RTP is based around perception of pain during performance tests, as well as clinical tests such as manual muscle strength testing. Studies implementing the Askling H-test had the lowest rates of re-injury (1.3-3.6%), but prolonged RTP times and studies using isokinetic muscle testing had faster mean RTP times (12-25 days) and lower rates of re-injury.
RTP times and re-injury rates following hamstring strain are influenced by a multitude of factors, such as injury type/ severity and mode of rehabilitation. This review provides data that more objective individualised rehabilitation progressions and RTP criteria may improve the balance of RTP time and re-injury rates and reduce the ambiguity involved in rehabilitation and RTP decision making.
> From: Hickey et al., Sports Med 47 (2017-11-21 06:03:26) 1375-1387. All rights reserved to Springer International Publishing Switzerland. Click here for the online summary.