Red Bull Athlete Performance Centre, Thalgau, Austria.
Wolverhampton Wanderers Football Club, Wolverhampton, UK.
Scand J Med Sci Sports. 2022 Jul;32(7):1109-1118. doi: 10.1111/sms.14160. Epub 2022 Mar 31.
Rectus femoris (RF) injuries are common in sports requiring maximal acceleration and sprinting. The British Athletics Muscle Injury Classification (BAMIC) describes acute muscle injury based on the anatomical site of injury and has been associated with return to play in hamstring and calf muscle injury. The aim of this study was to describe and compare the time to return to full training (TRFT) and injury recurrence for BAMIC-classified RF injuries sustained by elite track and field (T&F) athletes over a 9-year period. All rectus femoris injuries sustained by elite T&F athletes on the British Athletics World Class Program between September 2010 and September 2019 that were investigated with an MRI within 7 days of acute onset anterior thigh pain were included. Injuries were graded from the MRI by a specialist musculoskeletal radiologist using the BAMIC, and TRFT and injury recurrence were determined by evaluation of the Electronic Medical Record. Athlete demographics and World Athletics event discipline were recorded. Specific injury details including mechanism, location of injury, and whether surgical or rehabilitation management was undertaken were recorded. There were 38 RF injuries in 27 athletes (24.7 ± 2.3 years; 10 male, 17 female). Average TRFT for rehabilitation managed cases was 20.4 ± 14.8 days. Grade 1 injuries had significantly shorter TRFT compared with grades 2 (p = 0.04) and 3 (p = 0.01). Intratendinous (c) and surgically managed RF injuries each had significantly longer TRFT compared with other injury classes (p < 0.001). Myofascial (a) injuries had reduced repeat injury rates compared with b or c classes (p = 0.048). Grade 3 injuries had an increased repeat injury rate compared with other grades (p = 0.02). There were 4 complete (4c) proximal free tendon injuries sustained during sprinting and all in female athletes. The average TRFT for RF injuries in elite T&F is similar to that previously identified in elite football and Australian Rules. Similar to previous research in hamstring and calf injury, RF injuries extending into the tendon (BAMIC class c) had delayed TRFT which may reflect the longer duration required for tendon healing and adaptation. Grade 3 injuries had in increased repeat injury rate compared with grades 1 and 2. The BAMIC diagnostic framework may provide useful information for clinicians managing rectus femoris injuries in T&F.
股直肌(RF)损伤在需要最大加速度和冲刺的运动中很常见。英国田径肌肉损伤分类(BAMIC)根据损伤的解剖部位描述急性肌肉损伤,并且与腘绳肌和小腿肌肉损伤的重返赛场有关。本研究的目的是描述和比较 9 年间精英田径运动员(T&F)中 BAMIC 分类的 RF 损伤的完全训练恢复时间(TRFT)和损伤复发情况。2010 年 9 月至 2019 年 9 月期间,在英国田径世界一流计划中接受 MRI 检查的精英 T&F 运动员中,出现急性前大腿疼痛的股直肌损伤均包括在内。由专门的肌肉骨骼放射科医生根据 BAMIC 对 MRI 进行分级,通过电子病历评估确定 TRFT 和损伤复发情况。记录运动员的人口统计学和世界田径赛事学科。记录了具体的损伤细节,包括损伤机制、损伤位置以及是否进行手术或康复管理。在 27 名运动员中有 38 例 RF 损伤(24.7±2.3 岁;10 名男性,17 名女性)。康复管理病例的平均 TRFT 为 20.4±14.8 天。与 2 级(p=0.04)和 3 级(p=0.01)相比,1 级损伤的 TRFT 明显更短。腱内(c)和手术管理的 RF 损伤的 TRFT 均明显长于其他损伤类别(p<0.001)。筋膜(a)损伤的重复损伤率低于 b 或 c 类(p=0.048)。与其他等级相比,3 级损伤的重复损伤率更高(p=0.02)。在短跑过程中,有 4 例完全(4c)近端游离肌腱损伤,均发生在女性运动员身上。在 T&F 的精英中,RF 损伤的平均 TRFT 与之前在精英足球和澳大利亚规则中确定的平均 TRFT 相似。与之前对腘绳肌和小腿损伤的研究类似,延伸到肌腱的 RF 损伤(BAMIC 分级 c)的 TRFT 延迟,这可能反映了肌腱愈合和适应所需的时间更长。与 1 级和 2 级相比,3 级损伤的重复损伤率更高。BAMIC 诊断框架可能为管理 T&F 中的股直肌损伤的临床医生提供有用的信息。