This 28 year-old elite football player presents with pain in both thighs after a single sliding tackle. As he was making the tackle he reports flexing his right knee while at the same time fully extending the left one. As he was doing this he felt sharp pain in the middle of the right quadriceps and in the left hamstrings muscle. He describes experiencing a stabbing pain in both legs. He had difficulty walking for the next seven to ten days.
MRI images show increased signal within the right rectus femoris and left biceps femoris. These findings are consistent with muscle strain injuries of the right rectus femoris muscle and left hamstrings strain (biceps femoris).
The injury was treated with a period of rehabilitation involving time away from football, a progressive strengthening programme and a graded return to football. This patient also had a PRP injection in an effort to expedite his recovery. He was able to return to play four weeks after the injury.
Muscle injuries, including rectus femoris and hamstring injuries, occur frequently in athletes. These two muscle groups are especially at risk of injury as they are bipennate (they cross two joints). Muscle strain injuries are especially common in athletes who participate in sports that require sprinting, sudden changes of direction and kicking. Rehabilitation involves altered loading, progressive strengthening and a gradual reintroduction of running and other football activities. For the last few years PRP is comonnly used in some treatment centres. While this is an increasingly common treatment, there is very limited evidence to support its efficacy. Surgery is most often performed for tendon avulsion injuries with significant displacement.
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