Objectives To determine the rates of muscle strain injury recurrence over time after return to play in Australian football and to quantify risk factors. Methods We analysed Australian Football League player data from 1992 to 2014 for rates of the four major muscle strain injury types (hamstring, quadriceps, calf and groin) diagnosed by team health professionals. Covariates for analysis were: recent history (≤8 weeks) of each of the four muscle strains; non-recent history (>8 weeks) of each; history of hip, knee anterior cruciate ligament, knee cartilage, ankle sprain, concussion or lumbar injury; age; indigenous race; match level and whether a substitute rule was in place. Results 3647 (1932 hamstring, 418 quadriceps, 458 calf and 839 groin) muscle strain injuries occurred in 272 759 player matches. For all muscle strains combined, the risk of injury recurrence gradually reduced, with recurrence risks of 9% (hamstring), 5% (quadriceps), 2% (calf) and 6% (groin) in the first match back and remaining elevated for 15 weeks after return to play. The strongest risk factor for each muscle injury type was a recent history of the same injury (hamstring: adjusted OR 13.1, 95% CI 11.5 to 14.9; calf OR 13.3, 95% CI 9.6 to 18.4; quadriceps: OR 25.2, 95% CI 18.8 to 33.8; groin OR 20.6, 95% CI 17.0 to 25.0), followed by non-recent history of the same injury (hamstring: adjusted OR 3.5, 95% CI 3.2 to 3.9; calf OR 4.4, 95% CI 3.6 to 5.4; quadriceps OR 5.2, 95% CI 4.2 to 6.4; groin OR 3.5, 95% CI 3.0 to 4.0). Age was an independent risk factor for calf muscle strains (adjusted OR 1.6, 95% CI 1.3 to 2.0). Recent hamstring injury increased the risk of subsequent quadriceps (adjusted OR 1.8, 95% CI 1.2 to 2.7) and calf strains (OR 1.8, 95% CI 1.2 to 2.6). During the ‘substitute rule’ era (2011–2014), hamstring (adjusted OR 0.76, 95% CI 0.67 to 0.86), groin (OR 0.78, 95% CI 0.65 to 0.93) and quadriceps (OR 0.70, 95% CI 0.53 to 0.92) strains were less likely than outside of that era but calf (OR 1.6, 95% CI 1.3 to 1.9) strains were more likely than before the substitute rule era. Conclusion Recent injury is the greatest risk factor for the four major muscle strains, with increased risk persisting for 15 weeks after return to play.

中文翻译：

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足球中复发性肌肉拉伤的 15 周窗口：23 年职业澳式足球中 3600 名肌肉拉伤的前瞻性队列

目的 确定重返澳大利亚足球赛后肌肉拉伤的复发率，并量化风险因素。方法 我们分析了 1992 年至 2014 年澳大利亚橄榄球联盟球员的数据，了解球队健康专家诊断出的四种主要肌肉拉伤类型（腿筋、股四头肌、小腿和腹股沟）的发生率。用于分析的协变量是：四种肌肉拉伤的近期病史（≤8 周）；每个人的非近期病史（> 8 周）；髋关节、膝关节前交叉韧带、膝关节软骨、踝关节扭伤、脑震荡或腰椎损伤病史；年龄; 原住民种族；匹配级别以及替换规则是否到位。结果 272 759 名球员比赛中发生 3 647 例（1932 例腿筋、418 例股四头肌、458 例小腿和 839 例腹股沟）肌肉拉伤。对于所有的肌肉拉伤，伤病复发风险逐渐降低，复出首场比赛复发风险分别为 9%（腿筋）、5%（股四头肌）、2%（小腿）和 6%（腹股沟），并在重返赛场后持续升高 15 周. 每种肌肉损伤类型的最强风险因素是近期同一损伤史（腿筋：调整后 OR 13.1，95% CI 11.5 至 14.9；小腿 OR 13.3，95% CI 9.6 至 18.4；股四头肌：OR 25.2，95% CI 18.8 至 33.8；腹股沟 OR 20.6，95% CI 17.0 至 25.0），其次是同一损伤的非近期病史（腿筋：调整后 OR 3.5，95% CI 3.2 至 3.9；小腿 OR 4.4，95% CI 3.6 至 5.4 ；股四头肌 OR 5.2，95% CI 4.2 至 6.4；腹股沟 OR 3.5，95% CI 3.0 至 4.0）。年龄是小腿肌肉拉伤的独立危险因素（调整后的 OR 1.6，95% CI 1.3 至 2.0）。最近的腿筋损伤增加了随后股四头肌的风险（调整后的 OR 1.8，95% CI 1.2 至 2.7）和小牛应变（OR 1.8，95% CI 1.2 至 2.6）。在“替代规则”时代（2011-2014），腘绳肌（调整后 OR 0.76，95% CI 0.67 至 0.86），腹股沟（OR 0.78，95% CI 0.65 至 0.93）和股四头肌（OR 0.70，95% CI 0.53 至0.92）菌株比那个时代以外的可能性更小，但小牛（OR 1.6，95% CI 1.3 至 1.9）菌株比替代规则时代之前更有可能。结论 近期受伤是四种主要肌肉拉伤的最大风险因素，恢复比赛后 15 周内风险持续增加。95% CI 1.3 至 1.9）菌株比替代规则时代之前更有可能。结论 近期受伤是四种主要肌肉拉伤的最大风险因素，恢复比赛后 15 周内风险持续增加。95% CI 1.3 至 1.9）菌株比替代规则时代之前更有可能。结论 近期受伤是四种主要肌肉拉伤的最大风险因素，恢复比赛后 15 周内风险持续增加。