Objectives This study tested the hypothesis that radial extracorporeal shock wave therapy combined with a specific rehabilitation program (rESWT + RP) is more effective than sham rESWT + RP in athletes with acute hamstring muscle complex (HMC) injury type 3b.

Methods This was a prospective, randomized, sham-controlled, single center trial with published protocol, concealed allocation, blinded patients and blinded assessors. A total of 36 semi-professional athletes (soccer, field hockey and rugby players) receiving fees or university scholarships with acute HMC injury type 3b were randomly allocated to rESWT + RP for up to 5 weeks (n=18) or sham rESWT + RP (n=18). The primary outcome was the individual time to return to sport. Secondary outcomes were the individual patient’s satisfaction and presence or absence of re-injury during 6 months post-inclusion into this trial.

Results No serious adverse events occurred during the trial. The median / mean time to return to sport was 25.5 / 25.4 ± 3.5 (mean ± SD) days after rESWT + RP (n=18) and 27.5 / 28.3 ± 4.5 days after sham rESWT + RP (n=18) (p=0.037). The mean patient’s satisfaction was not significantly different between the groups. Only one patient in each group experienced a re-injury during 6 months post-inclusion into this trial.

Conclusion In rehabilitation of athletes with acute HMC injury type 3b, rESWT + RP is more effective than sham rESWT + RP.

Christoph Schmitz served until 12/2017 and serves since 07/2024 as consultant for Electro Medical Systems (Nyon, Switzerland), the inventor, manufacturer and distributor of the rESWT device Swiss DolorClast that was used in this study. However, Electro Medical Systems did not have any role in data collection and analysis, interpretation of the data, decision to publish and writing the manuscript. The other authors declare no conflict of interest.

NCT03473899

https://josr-online.biomedcentral.com/articles/10.1186/s13018-019-1283-x

This study was funded in part by thesportgroup (Mainz, Germany) and Pro profil Gesellschaft fuer individuelles Karrieremanagement mbH (Dortmund, Germany) (no grant numbers).

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Ethics committee of the Universidad Abierta Interamericana (Buenos Aires, Argentina) gave ethical approval for this work

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