802 EP008 – Do we need an MRI to prevent hamstring injury recurrence?

Background Up to 63% of athletes with acute hamstring injuries will re-injure. Generic treatment for hamstring injuries does not consider the type of injured tissue. However, hamstring injuries with tendinous involvement have longer rehabilitation times and are more prone to recurrence. Exercise choice and loading progression should be tailored based on the healing processes and functional properties of the injured tissue (British Athletics Muscle Injury Classification: A – myofascial, B – musculotendinous, C – intratendinous). The impact of MRI-guided rehabilitation on acute hamstring strain injuries has not been studied yet. Objective To explore the added value of MRI to differentiate the rehabilitation approach according to injured tissue type in acute hamstring injuries. Evaluation of re-injury rate and return to sport time between two groups. Design Randomised controlled trial Setting Academic sports rehabilitation centre Patients 30 competitive athletes (M/F, 18–35y) with an acute onset of a hamstring injury (no previous treatment). No concomitant musculoskeletal disorders. Intervention Eligible participants undergo a clinical examination and an MRI to define their injury type (A, B or C) within 7 days after injury. After randomisation they receive a rehabilitation prescription with (MRI group) guidelines based on MRI-findings versus (control group) guidelines based on general rehabilitation principles. Main outcome measures Re-injury rate (percentage) Time to return to sport (days) Results Ongoing study. 11 participants finished the full study. 1 re-injury was recorded in the control group. Mean RTS time was 25(B) and 77(C) days in the MRI-group and 28(A), 35(B), 39(C) days in the control group. Conclusion A trend towards longer rehabilitation is seen in intratendinous injuries, but only in the MRI group. Additional research is required in order to detect whether MRI differentiation of the exact injury type can help in the prevention of re-injuries.