Recommendations for hamstring injury prevention in elite football: translating research into practice

Published on Apr 1, 2019in British Journal of Sports Medicine11.645
· DOI :10.1136/bjsports-2018-099616
Matthew Buckthorpe4
Estimated H-index: 4
Steve Wright2
Estimated H-index: 2
+ 8 AuthorsMo Gimpel4
Estimated H-index: 4
Injuries in football exert negative impacts on team performance1 and club finance.2 Hamstring strain injuries (HSI) are consistently the most prevalent time loss injury in football3 and as such are an important issue in football medicine. Despite an ever-increasing wealth of information emerging on the aetiology of HSIs, their incidence in football is increasing.3 This could be explained by the increased intensity and physical demands of football match play over the last decade4; but practitioners should also question their approach to injury prevention and physical preparation of players, an area where research is lacking.5–8 There is an evidence-based strategy to prevent HSIs, however, there appears to be a large disconnect between this available evidence and its adoption in elite football.5 6 For example, the Nordic hamstring exercise (NHE) programme has been shown to effectively reduce HSIs by 65%–70%.9 10 But recent surveys of elite European Champions League (n=32) and Norwegian Premier League (n=18) teams showed that only 11% of these teams fully adopt the programme.11 Within elite football, there is a large disconnect between evidence-based practice and the actual interventions used by science and medical teams to prevent injuries.12 In line with an emerging body of evidence-based research, we believe that preventing HSIs in elite football requires a holistic approach, which considers multiple risk factors and their inter-relations, implemented effectively.6–8 13 In designing our injury prevention programme, we combine both the theory and the available evidence on HSI risk factors and intervention studies, as well as considering the context surrounding the player when designing our overall injury prevention approach. ### Why do HSIs happen? Risk factor analysis and programme planning To prevent HSIs, it is important to understand why they occur, so that an appropriate intervention can be developed, targeted at the specific risk factors. Importantly, there is not a …
  • References (89)
  • Citations (4)
📖 Papers frequently viewed together
2 Citations
1 Citations
1 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
#1J. Ekstran (Linköping University)H-Index: 58
#2Daniel Lundqvist (Linköping University)H-Index: 4
Last. Anne Marte Pensgaard (Norwegian School of Sport Sciences)H-Index: 9
view all 5 authors...
Objectives We investigated medical staff interpretations and descriptions of internal communication quality in elite football teams to determine whether internal communication was correlated with injuries and/or player availability at training and matches. Methods Medical staff from 36 elite football clubs across 17 European countries produced 77 reports at four postseason meetings to provide their perceptions of internal communications in their teams. They also recorded data on individual playe...
7 CitationsSource
#1Håkan Bengtsson (Linköping University)H-Index: 5
#2J. Ekstran (Linköping University)H-Index: 58
Last. Martin Hägglund (Linköping University)H-Index: 38
view all 4 authors...
Background The association between match congestion and injury rates in professional football has yielded conflicting results. Aim To analyse associations between match congestion on an individual player level and injury rates during professional football matches. Methods Data from a prospective cohort study of professional football with 133 170 match observations were analysed with Poisson regressions. Associations between short-term match congestion, defined as number of days between two match...
12 CitationsSource
#1Aiden J. OakleyH-Index: 1
#2Jacob JenningsH-Index: 1
Last. Chris Bishop (Middlesex University)H-Index: 8
view all 3 authors...
Hamstring strain injuries (HSIs) are the most prevalent in team sports, accounting for 12%–26% of injuries in Australian rules football, American football, football, rugby and track and field.1 The biceps femoris is the most commonly injured muscle with 53%–68% of injuries occurring during sprinting.1 In European football, the incidence and recurrence of HSI has continued to rise, while in Australian rules football, a notable reduction in HSI recurrences has been reported.1 It is possible that e...
5 CitationsSource
#1Joel Presland (ACU: Australian Catholic University)H-Index: 3
#2Ryan G. Timmins (ACU: Australian Catholic University)H-Index: 12
Last. David A. Opar (ACU: Australian Catholic University)H-Index: 19
view all 5 authors...
9 CitationsSource
#1Ayako Higashihara (Japan Society for the Promotion of Science)H-Index: 4
#2Yasuharu Nagano (Japan Women's College of Physical Education)H-Index: 8
Last. Toru Fukubayashi (Waseda University)H-Index: 18
view all 4 authors...
ABSTRACTThis study aimed to investigate activation characteristics of the biceps femoris long head (BFlh) and semitendinosus (ST) muscles during the acceleration and maximum-speed phases of sprinting. Lower-extremity kinematics and electromyographic (EMG) activities of the BFlh and ST muscles were examined during the acceleration sprint and maximum-speed sprint in 13 male sprinters during an overground sprinting. Differences in hamstring activation during each divided phases and in the hip and k...
8 CitationsSource
Hamstring muscle injuries (HMI) are consistently the most prevalent time-loss injury in football and are prone to reoccurrence.1 We note the disconnection between evidence-based recommendations and the HMI prevention programmes adopted in elite clubs.2 For example, only 11% of elite level football teams surveyed fully use the Nordic Hamstring Programme.3 Why don’t elite sports medicine teams adopt evidence-based practices?4 The aim of this editorial is not only to share our experience of HMI pre...
6 CitationsSource
#1Evert VerhagenH-Index: 36
#2Nicol van DykH-Index: 4
Last. Ian Shrier (JGH: Jewish General Hospital)H-Index: 32
view all 4 authors...
Norway’s Professor Roald Bahr recently highlighted that screening does not predict which athlete will sustain an injury.1 Some interpreted this to mean screening is useless for injury prevention. However, screening remains essential in our efforts to protect athletes’ health. To extend what has been a robust discussion, we argue how screening can be important for an individual athlete , and offer potential reasons why and how individual screening tests still lack clinical utility. Previous injur...
6 CitationsSource
#1J. Ekstran (Linköping University)H-Index: 58
#2Daniel Lundqvist (Linköping University)H-Index: 4
Last. Qiuxia ZhangH-Index: 74
view all 6 authors...
Background Do coaches’ leadership styles affect injury rates and the availability of players in professional football? Certain types of leadership behaviour may cause stress and have a negative imp ...
18 CitationsSource
#1Anthony Shield (QUT: Queensland University of Technology)H-Index: 24
#2Matthew N. Bourne (La Trobe University)H-Index: 9
Hamstring strain injuries are endemic in running-based sports. Given the economic and performance implications of these injuries, a significant body of research has emerged in recent years in an attempt to identify risk factors and develop or optimise injury prevention strategies. Surveys of injury prevention practices among medical and conditioning staff in elite sport suggest that many sporting clubs invest significant efforts in eccentric hamstring conditioning and lumbo-pelvic or trunk stabi...
6 CitationsSource
#1Shane Malone (LJMU: Liverpool John Moores University)H-Index: 8
#2Brian Hughes (Institute of Technology, Tallaght)H-Index: 4
Last. Tim J. Gabbett (University of Southern Queensland)H-Index: 56
view all 5 authors...
Abstract Objectives The aim of this study was to investigate potential moderators (i.e. lower body strength, repeated-sprint ability [RSA] and maximal velocity) of injury risk within a team-sport cohort. Design Observational Cohort Study. Methods Forty male amateur hurling players (age: 26.2 ± 4.4 yr, height: 184.2 ± 7.1 cm, mass: 82.6 ± 4.7 kg) were recruited. During a two-year period, workload (session RPE x duration), injury and physical qualities were assessed. Specific physical qualities as...
10 CitationsSource
Cited By4
#1Brady Green (La Trobe University)H-Index: 3
#2Matthew N. BourneH-Index: 9
Last. Tania Pizzari (La Trobe University)H-Index: 21
view all 4 authors...
Objective To systematically review risk factors for hamstring strain injury (HSI). Design Systematic review update. Data sources Database searches: (1) inception to 2011 (original), and (2) 2011 to December 2018 (update). Citation tracking, manual reference and ahead of press searches. Eligibility criteria for selecting studies Studies presenting prospective data evaluating factors associated with the risk of index and/or recurrent HSI. Method Search result screening and risk of bias assessment....
Outcomes following anterior cruciate ligament (ACL) reconstruction need improving, with poor return-to-sport rates and high risk of secondary re-injury. There is a need to improve rehabilitation strategies after ACL reconstruction, if we can support enhanced patient outcomes. This paper discusses how to optimise the mid-stage rehabilitation process after ACL reconstruction. Mid-stage is a difficult and vitally important stage of the functional recovery process and provides the foundation on whic...
#1João Breno Ribeiro-Alvares (UHSA: University of Health Sciences Antigua)H-Index: 1
#2Gabriel dos Santos Oliveira (UHSA: University of Health Sciences Antigua)
Last. Bruno Manfredini Baroni (UHSA: University of Health Sciences Antigua)H-Index: 16
view all 4 authors...
ABSTRACTBoth injury history and eccentric knee flexor strength have been associated with risk of football players sustaining hamstring strain injury (HSI). However, it remains unclear whether footb...
#1George A. Koumantakis (Queen Margaret University)
#2Eleonora Roussou (Queen Margaret University)
Last. Maria Papadopoulou (Queen Margaret University)
view all 9 authors...
Abstract Introduction The effectiveness of novel soft-tissue interventions relative to traditional ones requires further exploration. The purpose of this pilot study was to evaluate the immediate effect of Instrument Assisted Soft Tissue Mobilization (IASTM) compared to vibration massage or light hand massage on hamstrings’ flexibility and knee proprioception. Methods 16 healthy non-injured male participants (mean age 23.7 years, height 1.80 cms and body mass 77.7 kg) were randomly assigned to t...
#1Samuel P. Hills (Leeds Trinity University)H-Index: 2
#2Jon N. Radcliffe (Leeds Trinity University)H-Index: 4
Last. Mark Russell (Leeds Trinity University)H-Index: 18
view all 6 authors...
Despite empirical observations suggesting that practitioners value the use of substitutions during soccer match-play, limited research has sought to substantiate such claims. This study used online surveys to assess the perceptions of practitioners within professional soccer about the use and practices of substitutes. Thirty-three practitioners completed one of two surveys (each requiring both open and closed questions to be answered), depending upon whether their primary role related mostly to ...
1 CitationsSource
#1Diulian Muniz Medeiros (UHSA: University of Health Sciences Antigua)H-Index: 1
#2Mateus Alves Aimi (UFRGS: Universidade Federal do Rio Grande do Sul)
Last. Bruno Manfredini Baroni (UHSA: University of Health Sciences Antigua)H-Index: 16
view all 4 authors...
Abstract Objectives To evaluate the effects of low-level laser therapy (LLLT) on functional rehabilitation following hamstring strain injury (HSI) in amateur athletes treated with an exercise-based rehabilitation program. Design Randomized controlled trial. Methods Male athletes (18–40 years old) who sustained HSI were randomized in LLLT or placebo groups. All patients were engaged in the same exercise-based rehabilitation program until they met specific criteria to return to sport. Hamstring mu...
Resume Introduction Les lesions musculaires des ischiojambiers sont une problematique importante chez les sportifs du fait de leur frequence, de leur taux de recidive et de leur impact. Leur incidence ne cesse de croitre malgre la multiplication des etudes scientifiques sur ce sujet. L’objectif principal de notre etude etait d’evaluer les connaissances et les attitudes des medecins pouvant y etre confrontes. Methodes Nous avons realise une etude observationnelle, descriptive, transversale, decla...
Rationale Hamstring injuries are common in elite sports. Muscle injury classification systems aim to provide a framework for diagnosis. The British Athletics Muscle Injury Classification (BAMIC) describes an MRI classification system with clearly defined, anatomically focused classes based on the site of injury: (a) myofascial, (b) muscle–tendon junction or (c) intratendinous; and the extent of the injury, graded from 0 to 4. However, there are no clinical guidelines that link the specific diagn...
Resume Objectif Determiner et comparer les profils musculaires isocinetiques des cuisses en fonction de la pratique de haut niveau du basketball, du handball, du volleyball, du football, et du cyclisme. Methode Cent dix-neuf sportifs professionnels ont ete inclus. Trente pratiquaient le basketball (10 en Ligue A, 10 en Ligue B et 10 en National Ligue 1), vingt et un pratiquaient le handball (Ligue 1), 13 pratiquaient le volleyball (Ligue A), trente pratiquaient le cyclisme ( Continental Pro Tour...