School of Public Health, University of Sydney Medical School, Sydney, New South Wales, Australia
School of Public Health, University of Sydney Medical School, Sydney, New South Wales, Australia.
Br J Sports Med. 2020 Sep;54(18):1103-1107. doi: 10.1136/bjsports-2019-100755. Epub 2020 Feb 5.
To determine the rates of muscle strain injury recurrence over time after return to play in Australian football and to quantify risk factors.
We analysed Australian Football League player data from 1992 to 2014 for rates of the four major muscle strain injury types (hamstring, quadriceps, calf and groin) diagnosed by team health professionals. Covariates for analysis were: recent history (≤8 weeks) of each of the four muscle strains; non-recent history (>8 weeks) of each; history of hip, knee anterior cruciate ligament, knee cartilage, ankle sprain, concussion or lumbar injury; age; indigenous race; match level and whether a substitute rule was in place.
3647 (1932 hamstring, 418 quadriceps, 458 calf and 839 groin) muscle strain injuries occurred in 272 759 player matches. For all muscle strains combined, the risk of injury recurrence gradually reduced, with recurrence risks of 9% (hamstring), 5% (quadriceps), 2% (calf) and 6% (groin) in the first match back and remaining elevated for 15 weeks after return to play. The strongest risk factor for each muscle injury type was a recent history of the same injury (hamstring: adjusted OR 13.1, 95% CI 11.5 to 14.9; calf OR 13.3, 95% CI 9.6 to 18.4; quadriceps: OR 25.2, 95% CI 18.8 to 33.8; groin OR 20.6, 95% CI 17.0 to 25.0), followed by non-recent history of the same injury (hamstring: adjusted OR 3.5, 95% CI 3.2 to 3.9; calf OR 4.4, 95% CI 3.6 to 5.4; quadriceps OR 5.2, 95% CI 4.2 to 6.4; groin OR 3.5, 95% CI 3.0 to 4.0). Age was an independent risk factor for calf muscle strains (adjusted OR 1.6, 95% CI 1.3 to 2.0). Recent hamstring injury increased the risk of subsequent quadriceps (adjusted OR 1.8, 95% CI 1.2 to 2.7) and calf strains (OR 1.8, 95% CI 1.2 to 2.6). During the 'substitute rule' era (2011-2014), hamstring (adjusted OR 0.76, 95% CI 0.67 to 0.86), groin (OR 0.78, 95% CI 0.65 to 0.93) and quadriceps (OR 0.70, 95% CI 0.53 to 0.92) strains were less likely than outside of that era but calf (OR 1.6, 95% CI 1.3 to 1.9) strains were more likely than before the substitute rule era.
Recent injury is the greatest risk factor for the four major muscle strains, with increased risk persisting for 15 weeks after return to play.
确定澳大利亚足球运动员重返赛场后肌肉拉伤复发的比率，并量化风险因素。
我们分析了 1992 年至 2014 年澳大利亚足球联赛（AFL）球员的数据，以了解由队医诊断的四种主要肌肉拉伤类型（腿筋、股四头肌、小腿和腹股沟）的复发率。分析的协变量包括：最近（≤8 周）的四种肌肉拉伤中的每一种；非最近（>8 周）的每一种；髋关节、膝关节前交叉韧带、膝关节软骨、踝关节扭伤、脑震荡或腰椎损伤的病史；年龄；土著种族；比赛级别以及是否有替补规则。
在 272759 名球员的比赛中，3647 名（1932 例腿筋、418 例股四头肌、458 例小腿和 839 例腹股沟）肌肉拉伤。对于所有肌肉拉伤的综合来看，受伤复发的风险逐渐降低，首次复出时的复发风险为 9%（腿筋）、5%（股四头肌）、2%（小腿）和 6%（腹股沟），在回归赛场后的 15 周内仍处于高位。每种肌肉损伤类型的最强风险因素是同一损伤的近期病史（腿筋：调整后的 OR 13.1，95%CI 11.5 至 14.9；小腿：调整后的 OR 13.3，95%CI 9.6 至 18.4；股四头肌：调整后的 OR 25.2，95%CI 18.8 至 33.8；腹股沟：调整后的 OR 20.6，95%CI 17.0 至 25.0），其次是同一损伤的非近期病史（腿筋：调整后的 OR 3.5，95%CI 3.2 至 3.9；小腿：调整后的 OR 4.4，95%CI 3.6 至 5.4；股四头肌：调整后的 OR 5.2，95%CI 4.2 至 6.4；腹股沟：调整后的 OR 3.5，95%CI 3.0 至 4.0）。年龄是小腿肌肉拉伤的独立风险因素（调整后的 OR 1.6，95%CI 1.3 至 2.0）。近期腿筋拉伤增加了随后股四头肌（调整后的 OR 1.8，95%CI 1.2 至 2.7）和小腿（OR 1.8，95%CI 1.2 至 2.6）拉伤的风险。在“替补规则”时代（2011-2014 年），与该时代以外的时期相比，腿筋（调整后的 OR 0.76，95%CI 0.67 至 0.86）、腹股沟（OR 0.78，95%CI 0.65 至 0.93）和股四头肌（OR 0.70，95%CI 0.53 至 0.92）拉伤的可能性更小，但与该时代之前相比，小腿（OR 1.6，95%CI 1.3 至 1.9）拉伤的可能性更大。
近期损伤是四种主要肌肉拉伤的最大风险因素，回归赛场后 15 周内风险持续增加。
