Clinical predictors of time to return to competition and of recurrence following hamstring strain in elite Australian footballers

OBJECTIVE: To investigate early clinical predictors of time to return to competition and of recurrence following hamstring strain. DESIGN: Prospective observational study. SETTING: Elite level of Australian football competition. PARTICIPANT: 59 players who suffered a hamstring strain in 2002 season. PREDICTORS: Clinical assessment by a physiotherapist and questionnaire. MAIN OUTCOME MEASURES: Time taken to return to play and recurrence of hamstring injury within 3 weeks. RESULTS: Players taking more than 1 day to walk pain-free were significantly more likely (p=0.018) to take longer than 3 weeks to return to competition (adjusted odds ratio 4.0; 95% CI 1.3 to 12.6). Nine players (15.2%) experienced an injury recurrence, all involving the biceps femoris. Recurrence was more likely in players who reported a hamstring injury in the past 12 months (adjusted odds ratio 19.6; 95% CI 1.5 to 261.0; p=0.025). CONCLUSION: Time to walk pain-free and previous hamstring injury are predictors of time to return to competition and recurrence, respectively, and should be included in a clinical assessment to aid in prognosis.