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Clinical predictors of time to return to competition following hamstring injuries.

OBJECTIVES: hamstring strain injuries are the most common sports-related muscle injuries and one of the main causes of missed sporting events.

HYPOTHESIS: clinical findings reflecting hamstring injury severity at presentation predict time to sports resumption.

DESIGN: cohort study (prognosis); Level of evidence, 2.

METHODS: five sports medicine specialists at four sports medicine centers prospectively evaluated 120 athletes within 5 days of acute hamstring injury. Patients were interviewed and asked to evaluate their worst pain on a visual analog scale (VAS). Four physical criteria were assessed at baseline: bruising, tenderness to palpation, pain upon isometric contraction, and pain upon passive straightening. The same standardized rehabilitation protocol was used in all patients. A standardized telephone interview was conducted 45 days after the injury to determine the time to-full recovery (≤40 days or >40 days).

RESULTS: by univariate analysis, clinical criteria associated with a full recovery time >40 days were VAS pain score greater than 6, popping sound injury, pain during everyday activities for more than 3 days, bruising, and greater than 15° motion-range limitation. By multivariate analysis, only VAS pain score and pain during everyday activities were significantly associated with time to recovery >40 days (53% sensitivity, 95% specificity).

CONCLUSION: the initial examination provides valuable information that can be used to predict the time to full recovery after acute hamstring injuries in athletes.

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