Clinically driven recovery from a biceps femoris T-junction injury: a case report

This case report describes the management of a distal biceps femoris (type 2 T-junction) injury in a footballer, guided solely by clinical examination findings. An ultrasound examination was performed 76 hours post-injury; however, the imaging outcomes were not disclosed to either the physiotherapist managing the injury or the player prior to return to play (RTP). A 25-year-old midfielder sustained the injury during a competitive match and was substituted. Pain length and intensity during contraction and mobility tests progressively improved over the first month and return to full training was permitted at 39 days post-injury. Rehabilitation consisted of a gym-based programme followed by on-field progression, with return to play achieved at 70 days. Post-RTP maximal strength testing showed 252 N in the Nordic Exercise and 352 N in the 90º-90º isometric posterior chain test. The athlete remained free from injury and maintained full participation with the team for the remainder of the season.