Prophylaxis and management of hamstring muscle injuries in intercollegiate football players

Abstract

Hamstring muscle strains were responsible for the loss of playing time of a significant number of football players at the University of Nebraska in the early 1970s. After the acquisition of a Cybex II isokinetic dynamometer, the number of injuries was noted to decrease. A retro spective study was performed over the period 1973 to 1982. Players in Group I, from 1973 to 1977, underwent a training program consisting of a supervised winter run ning program and self-designed year-long stretching, running, and weight lifting. Hamstring injuries were managed with rest, ice, and elevation initially and, by the third day, mild running was instituted. On the av erage, by the 14th day the athlete had demonstrated adequate speed and agility and was allowed to return to action. Group II consisted of players from the 1978 to 1982 period. These players received supervised winter running programs and staff-designed year-long stretching, running, and weight lifting programs. In ad dition, all athletes had baseline testing of hamstrings and quadriceps. Deficits were corrected to a desired ratio of 0.60. Injured players in Group II were treated with rest, ice, and elevation initially. High speed isoki netic workouts were begun on the third day with testing on the fifth day. They were allowed to begin jogging when the peak torque of hamstrings equaled 70% of baseline. Players returned to action when peak-torque reached a level of 95% of the baseline score or a hamstrings:quadriceps ratio of 0.55 or greater. Average time out of action was 2 weeks. Group I consisted of 534 player-years. There were 41 primary hamstring injuries with 13 recurrences. Group II consisted of 564 player-years. There were six primary hamstring injuries with no recurrences. It is concluded that isokinetic testing and rehabilita tion of muscle imbalances can prevent hamstring strains. Also, isokinetic testing of hamstring muscle injuries can prevent recurrences by ensuring the athlete has regained near-normal muscle strength before re turning to action. Isokinetic rehabilitation of injured mus cle can stimulate it to heal with higher tensile strength during the critical healing period resulting in less like lihood of recurrence.