Abstract Information 
Abstract ID
20260133
Category
Sports Medicine: Sports Physiotherapy
Preferable Presentation
Both
Title
SPIKE MAGNITUDE AS A DETERMINANT OF REHABILITATION DURATION: PREDICTING RETURN-TO-PLAY IN GRADE I HAMSTRING INJURIES
Author
  • Full Name: PUWAPONG NIMKINGRATANA
  • Affiliation/Institution: Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Country: Thailand
  • Full Name: GAN GITILUE
  • Affiliation/Institution: Medical Department, Lamphun Warrior Football Club, Lamphun, Thailand
  • Country: Thailand
  • Full Name: WORRAWAT THANANCHAI
  • Affiliation/Institution: Medical Department, Lamphun Warrior Football Club, Lamphun, Thailand
  • Country: Thailand
  • Full Name: NONTAPAT KHAMPIN
  • Affiliation/Institution: Medical Department, Lamphun Warrior Football Club, Lamphun, Thailand
  • Country: Thailand
  • Full Name: NUTTASIT CHAISANG
  • Affiliation/Institution: Medical Department, Lamphun Warrior Football Club, Lamphun, Thailand
  • Country: Thailand
  • Full Name: NATTAPONG PONGNIKORN
  • Affiliation/Institution: Medical Department, Lamphun Warrior Football Club, Lamphun, Thailand
  • Country: Thailand
  • Full Name: TANACHOTE CHUMCHUEN
  • Affiliation/Institution: Medical Department, Lamphun Warrior Football Club, Lamphun, Thailand
  • Country: Thailand
  • Full Name: NUTTAYA PATTAMAPASPONG
  • Affiliation/Institution: Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Country: Thailand
  • Full Name: THANAT KANTHAWANG
  • Affiliation/Institution: Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Country: Thailand
  • Full Name: PICHITCHAI ATTHAKOMOL
  • Affiliation/Institution: Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Country: Thailand
Presenter
GAN GITILUE
Abstract
Background: Clinical grading via imaging is the gold standard for hamstring strain injury (HSI) prognosis, yet significant variance in return-to-play (RTP) timelines exists within the same grade. While the Acute:Chronic Workload Ratio (ACWR) is a known injury trigger, its capacity to predict the duration of the subsequent rehabilitation process remains unexplored.

Objectives: To investigate if the "Spike Magnitude" (ACWR on the day of injury) serves as a reliable prognostic marker for RTP duration in elite athletes, specifically differentiating its impact across clinical injury grades.

Study Design & Methods: A retrospective analysis was conducted on 28 professional athletes with confirmed HSIs (Grade I: n=15; Grade II: n=13). GPS-derived workload data were analyzed for the session in which the injury occurred to calculate the Spike Magnitude (ACWR). RTP was recorded as the number of weeks until full clearance for team training. Statistical significance was determined using Pearson correlation coefficients and independent t-tests.

Results: For Grade I injuries, a statistically significant, strong positive correlation was identified between Spike Magnitude and RTP duration (r = 0.64, p = 0.034). In these minor strains, the magnitude of the loading error explained approximately 41% of the variance in recovery time. Conversely, no significant relationship was found for Grade II injuries (r = 0.47, p = 0.29), where structural tissue failure appeared to be the primary limiting factor. Additionally, Grade I injuries were preceded by a significantly higher frequency of spikes (>1.3 ACWR) in the 3-day lead-up compared to Grade II injuries (30.3% vs 14.3%).

Conclusions: Spike Magnitude is a statistically significant predictor of rehabilitation duration for Grade I hamstring injuries. These results suggest that for minor "tweaks," the severity of the workload mismanagement dictates the healing requirement. Practitioners can utilize injury-day GPS data to provide immediate, data-driven RTP prognostications for Grade I injuries, whereas Grade II injuries require a more traditional pathology-led approach.
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