Hamstring Strain Grade on MRI and Return to Play in Elite Australian Cricket Players
Thomas Cooney, Ashton Reeve, Anna E. Saw, Alex Kountouris, John W. Orchard, James LinklaterObjective:
The aims of this study were to (1) examine the relationship between magnetic resonance imaging (MRI)-confirmed hamstring strain grade and time to return to play; (2) examine this relationship specifically in pace bowlers; and (3) describe the incidence, prevalence, and grade of MRI-confirmed hamstring strains in elite Australian cricket players.
Design:
This is a retrospective cohort study.
Setting:
Elite Australian cricket teams over 13.5 seasons were analyzed.
Participants:
Four hundred seventy-eight male and 365 female contracted Australian cricketers participated in this study.
Independent variable:
British Athletics Muscle Injury Classification system grading of hamstring strains, which had received MRI scan, was the independent variable.
Main outcome measure:
The main outcome was time to return to play (days).
Results:
One hundred forty-one hamstring strain injuries with available MRI imaging scans were recorded during the study period (average 3.2 per 100 players per season: male 4.5, female 1.2). The most commonly injured muscle was biceps femoris (63%, 95% confidence interval: 56%-71%) and the most frequent category of injury was grade 2C (27%, 20%-35%). Across all injury grades, players were unavailable for full participation for a median of 22 (interquartile range: 15-38) days and missed 3 (1-6) matches. The number of days unavailable were higher for injuries that were graded 2 or 3, compared with grade 1 injuries (
Conclusions:
This study provides evidence that higher grade injuries and those involving the intramuscular tendon are associated with a more prolonged return to play. This finding should be viewed in context of the study limitation that MRI findings may have informed management.