Application of the British Athletics Muscle Injury Classification in Collegiate Football Athletes: A Retrospective, Observational Study.

Abstract

Background: Lower extremity muscle tears are common sports injuries. The British Athletics Muscle Injury Classification (BAMIC) may provide clinical guidance for tears although its value in American football and college athletes is unknown.

Hypothesis: Clinical outcomes, specifically time to return to play (RTP) (TRTP), in college American football athletes with activity-related hamstring (HS) and quadriceps (QD) tears will be associated with BAMIC.

Study design: Retrospective cohort study.

Level of evidence: Level 3.

Methods: American football college athletes who sustained a HS or QD tear and underwent magnetic resonance imaging within 7 days at 1 institution during the 2023 season were included. TRTP and reinjury rate (RIR) for HS and QD tears classified by BAMIC and injury characteristics were evaluated.

Results: Of the 24 HS and 10 QD tears in 21 (17.3%) of 121 athletes (20 ± 1.2 years; 100.0% male), most (60.0%) were BAMIC 2a-3b. Most (89.3%) injuries occurred before the season, and all occurred in practice. Overall median TRTP was 26 days (interquartile range, 17.8-33.0), translating to about 4 weeks missed play. The RIR was 19.0% (4/21). Most (75.0%) reinjuries occurred before RTP. There was no significant relationship between BAMIC and TRTP, although TRTP was less for grade 0 injuries and greater TRTP for injury site "c," albeit with small effect sizes.

Conclusion: Activity-related HS and QD tears are common in American football college athletes, particularly in preseason and practice. Injured athletes missed about 3 to 4 games, regardless of BAMIC, with 1 in 5 athletes suffering a reinjury. There was no relationship between BAMIC or muscle group and TRTP.

Clinical relevance: This appraisal of BAMIC in college and American football athletes highlights the prevalence of muscle tears and the need for prevention. Although BAMIC lacked value in this study, larger studies are needed to evaluate BAMIC in this population.