Conservative management of 3c biceps femoris intramuscular tendon injury: A case report of an elite-level inter-county Gaelic football player.
DOI:
https://doi.org/10.64255/5ce3qk51Keywords:
Biceps femoris, Intramuscular tendon injury, Isometric loading, Hamstring injuryAbstract
Introduction: Hamstring injuries are one of the most common injuries across many field-sports, including Gaelic football. Hamstring injuries involving the intramuscular tendon (IMT) are becoming increasingly common, and are associated with longer return-to-play times and greater recurrence. Rehabilitation guidelines for IMT hamstring injuries are not well-documented. The aim of this study was to detail the return-to-play (RTP) process of a Gaelic football player after intramuscular tendon (IMT) hamstring injury.
Methods: This case report involves a male, inter-county level, Gaelic football player, who sustained a type 3c biceps femoris injury during a competitive match. Rehabilitation involved the implementation of an early isometric loading programme using a unique hamstring isometric assessment device (HRIG) which replicates the late swing/early stance phase of running gait in an isometric position. In this unique rehabilitation approach, specific hamstring rehabilitation consisted of progressions in isometric loading alongside running progressions, as opposed to traditional programming involving hamstring-specific isotonic exercise.
Results: The player achieved a return-to-running (RTR) on day 19, return-to-training (RTT) on day
38, and RTP on day 48. Isometric hamstring force from the involved limb increased from 0.9 Nm/kg on clinical presentation, 2.13Nm/kg on RTR, 2.52Nm/kg on RTT, to 2.51Nm/kg on RTP. Additionally, isometric hamstring inter-limb asymmetry improved from 66% on clinical presentation (day 2), 20% on RTR, 4% on RTT, to 13% on RTP.
Conclusion: An early isometric loading programme restored isometric hamstring force and resulted in shorter a RTP time then typically reported for type 3c hamstring injuries.
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