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Randomized Controlled Trial
. 2022 Jul;56(14):792-800.
doi: 10.1136/bjsports-2020-103405. Epub 2022 Mar 25.

Early versus delayed lengthening exercises for acute hamstring injury in male athletes: a randomised controlled clinical trial

Robin Vermeulen  1   2 , Rod Whiteley  3 , Anne D van der Made  4   2   5   6 , Nicol van Dyk  4   3   7   8 , Emad Almusa  9 , Celeste Geertsema  10 , Stephen Targett  10 , Abdulaziz Farooq  4 , Roald Bahr  11   12 , Johannes L Tol  2   10 , Arnlaug Wangensteen  4   3   11
Affiliations
Randomized Controlled Trial

Early versus delayed lengthening exercises for acute hamstring injury in male athletes: a randomised controlled clinical trial

Robin Vermeulen et al. Br J Sports Med. 2022 Jul.

Abstract

Background: To evaluate the efficacy of early versus delayed introduction of lengthening (ie, eccentric strengthening) exercises in addition to an established rehabilitation programme on return to sport duration for acute hamstring injuries in a randomised controlled superiority trial.

Methods: 90 male participants (age: 18-36 years, median 26 years) with an MRI-confirmed acute hamstring injury were randomised into an early lengthening (at day 1 of rehabilitation) group or a delayed lengthening (after being able to run at 70% of maximal speed) group. Both groups received an established rehabilitation programme. The primary outcome was time to return to sport (ie, time from injury to full unrestricted training and/or match play). The secondary outcome was reinjury rate within 12 months after return to sport. Other outcomes at return to sport included the Askling H-test, hamstring strength, clinical examination and readiness questions.

Results: The return to sport in the early lengthening group was 23 (IQR 16-35) days and 33 (IQR 23-40) days in the delayed lengthening group. For return to sport (in days), the adjusted HR for the early lengthening group compared with the delayed lengthening group was 0.95 (95% CI 0.56 to 1.60, p=0.84). There was no significant difference between groups for reinjury rates within 2 months (OR=0.94, 95% CI 0.18 to 5.0, p=0.94), from 2 to 6 months (OR=2.00, 95% CI 0.17 to 23.3, p=0.58), and 6 to 12 months (OR=0.57, 95% CI 0.05 to 6.6, p=0.66).

Conclusion: Accelerating the introduction of lengthening exercises in the rehabilitation of hamstring injury in male athletes did not improve the time to return to sport nor the risk of reinjury.

Keywords: exercise therapy; hamstring muscles; randomized controlled trial; rehabilitation; wounds and Injuries.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
The lengthening exercises (in order from left to right; the extender, the diver and the slider).
Figure 2
Figure 2
Participant flow chart.
Figure 3
Figure 3
Cumulative probability of return to sport (in days) of the two treatment groups. We found no difference between the groups (HR 1.15, 95% CI 0.72 to 1.84, p=0.57).
See this image and copyright information in PMC

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