The course of a hamstring injury in an elite athlete: Patient perception, functionality tests and actual status of the injury observed using MRI and DTI

Injuries are a frequent occurrence among professional football players. As the
aforementioned trauma is known for its high prevalence of recurrence, it begs
the question whether there is an overall premature *return-to-play*. Especially
as regeneration and remodeling may occur up to 9 months following the injury 1.
In addition, studies regarding potential prognostic markers predicting *return
to play* following the said injury are scarce.
In light of the current medical literature, efficiently predicting the
convalescent period of an athlete remains difficult. Our interest lies in
particular with acute hamstring injuries occurring during sudden explosive
movements (such as jumping, shooting, twisting, turning and change of
direction), sprinting or high intensity running.
Diffusion Tensor Imaging (DTI) is a Magnetic Resonance Imaging (MRI) technique
that is able to characterize muscle and nerve fiber architecture as well as to
provide insights in local histopathological status of nerve and muscle tissue 2*
6.

The main research question of this explorative study is:
What is the association between the patient*s perception of the severity of the
injury, clinical tests and parameters found using DTI and MRI during the
rehabilitation process.

We hypothesize that the DTI findings will provide insights regarding muscle
repair and the convalescent period, which will not entirely correlate with
current used patient self-perception and clinical tests. Thus return-to-play
will not concur with complete normalization of DTI and MRI parameters.

The main objective of this study is to explore the correlation between the
patient*s perception of the injury, clinical tests and parameters found using
DTI and MRI during the rehabilitation process.

Observational prospective study

Patients have no benefit by participating in this study.
Risks for the subjects undergoing a MRI examination are minimal, provided
precautions have been made to prevent examining individuals with
contraindications. For this purpose, the routine MRI contra indications form of
the AMC will be used. Findings in this study will not be used for management. A
group-related benefit of this diagnostic study is that DTI potentially has
clinical utility in the assessment of therapeutic intervention if proven a
suitable method to illustrate and predict the convalescent period. This is now
based on hypothetically less reproducible strength measurements.