Acute First-Time Hamstring Strains during Slow-Speed Stretching

  • Carl M. Askling
    Swedish School of Sport and Health Sciences, Stockholm, Sweden
  • Magnus Tengvar
    Department of Radiology, Sophiahemmet Hospital, Stockholm, Sweden
  • Tönu Saartok
    Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden
  • Alf Thorstensson
    Swedish School of Sport and Health Sciences, Stockholm, Sweden

書誌事項

タイトル別名
  • Clinical, Magnetic Resonance Imaging, and Recovery Characteristics

抄録

<jats:sec><jats:title>Background</jats:title><jats:p> Hamstring strains can be of 2 types with different injury mechanisms, 1 occurring during high-speed running and the other during stretching exercises. </jats:p></jats:sec><jats:sec><jats:title>Hypothesis</jats:title><jats:p> A stretching type of injury to the proximal rear thigh may involve specific muscle-tendon structures that could affect recovery time. </jats:p></jats:sec><jats:sec><jats:title>Study Design</jats:title><jats:p> Case series (prognosis); Level of evidence, 2. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> Fifteen professional dancers 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. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> All dancers were injured during slow hip-flexion movements with extended knee and experienced relatively mild acute symptoms. All injuries were located proximally in the posterior thigh close to the ischial tuberosity. The injury involved the semimembranosus (87%), quadratus femoris (87%), and adductor magnus (33%). All injuries to the semimembranosus involved its proximal free tendon. There were no significant correlations between clinical or magnetic resonance imaging parameters and the time to return to preinjury level (median, 50 weeks; range, 30-76 weeks). </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> Stretching exercises can give rise to a specific type of strain injury to the posterior thigh. A precise history and careful palpation provide the clinician enough information to predict a prolonged time until return to preinjury level. One factor underlying prolonged recovery time could be the involvement of the free tendon of the semimembranosus muscle. </jats:p></jats:sec>

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