Rehabilitation Following a Distal Semitendinosus Excision in a Collegiate American Football Player: A Resident's Case Report.

One participant. The authors state that a case report cannot establish cause and effect, so nothing here shows the surgery or this rehabilitation programme works. Several treatments were given at once (the tendon excision, a platelet-rich plasma injection, blood flow restriction training, and a GPS-guided running progression), so the contribution of any one of them cannot be separated. Follow-up after return to sport lasted only a few months because of the college season, so long-term outcomes are unknown, including whether the knee flexion weakness persists. No minimal clinically important difference has been established for the FASH, so the size of the change in that score cannot be judged against a known threshold of meaningfulness. The college season limited how much reconditioning and testing could be done, and the authors say compensation strategies may have influenced the return-to-sport testing, which limits how well that battery shows true readiness. The findings are not applicable to other patients having this operation; this was one elite 20-year-old athlete and the authors state the design does not establish cause and effect.

The authors state they have no conflict of interest to disclose. No funding source is stated in the article. Several commercial devices and systems are named as part of the protocol (VALD dynamometry and NordBord, Delfi blood flow restriction, Catapult GPS), but the paper does not say who paid for the work or whether any of these companies were involved.

Do not take this as evidence that excising a torn distal semitendinosus tendon, or this 12-week programme, gets athletes back to play. It is a single athlete with no comparison group, the authors say the design cannot establish cause and effect, and he also received a platelet-rich plasma injection and worked with a full sports medicine and coaching team. Note too that he was cleared while eccentric hamstring strength was still 34.8% below his own pre-injury maximum, and was kept off special teams afterwards, so passing the return-to-sport battery did not mean full recovery.