Return to play after a hamstring strain injury: it is time to consider natural healing

Review written by Dr Jarred Boyd info

Key Points

  1. Muscle regeneration and scar tissue maturation are often processes which extend beyond the demonstration of meeting functional criteria capacities, which are potential variables in the re-injury equation of hamstrings.
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BACKGROUND & OBJECTIVE

Hamstring strain injuries, specifically the rate of re-injury, continue to plague athletes, particularly those involved in rapid eccentric muscle actions such as, sprinting, kicking and dancing. Whether the impetus is a result of instantaneous capacity exceeding stress-strain loads or repetitive accretion of said loads remains questionable (1).

Two potential variables proclaimed as the primary instigators of hamstring strain injury (HSI) recurrence include unsatisfactory reconditioning tactics and/or a precipitous return to sport as a result of inadequately established criteria (2). A majority, approximately 30%, of hamstring re-injuries transpire within the same season, particularly during the first two weeks after return (2).

Often, throughout the reconditioning process there is a binary approach of either attending specifically to a biological timeline or subscribing solely to a criterion-based approach. Perhaps, however, a more effective perspective is the integration of both time and criteria. Thus, the main purpose of this paper was to discern whether it is prudent to include biological healing times within the determination of returning to play post HSI.

Hamstring strain injuries, specifically the rate of re-injury, continue to plague athletes, particularly those involved in rapid eccentric muscle actions such as sprinting, kicking and dancing.
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The inclusion of biological muscle healing serves as a moderator to re-injury by re-establishing mature tissue capable of tolerating the mechanical forces incurred in sport.

METHODS

This paper was a review article with a search strategy prioritizing return to play post HSI and the biological healing process of muscle. By including review articles and consensus statements, the authors aimed to determine whether a timeframe of biological

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