Does a bounding exercise program prevent hamstring injuries in adult male soccer players? - A cluster-RCT.

Peter Alexander Van De Hoef,Frank J G Backx,Maarten Van Smeden,Bionka M A Huisstede,Niels De Vries,Vincent Gouttebarge,Michel S Brink,Edwin A Goedhart

doi:10.1111/sms.13353

Abstract

BackgroundAlthough the Nordic Hamstring Exercise (NHE) prevents hamstring injury in soccer players effectively, the annual incidence of these injuries still increases. This may be because of poor long‐term compliance with the program. Furthermore, the timing and amplitude of gluteal and core muscle activation seem to play an important role in hamstring injury prevention, the NHE program was not designed to improve activation of these muscles. Therefore, we propose plyometric training as an alternative to reduce hamstring injuries in soccer players.PurposeTo determine the preventive effect of the Bounding Exercise Program (BEP) on hamstring injury incidence and severity in adult male amateur soccer players.Study designA cluster‐Randomized Controlled Trial.MethodsThirty‐two soccer teams competing in the first‐class amateur league were cluster‐randomized into the intervention or control group. Both groups were instructed to perform their regular training program, and the intervention group additionally performed BEP. Information about player characteristics was gathered at baseline and exposure, hamstring injuries and BEP compliance were weekly registered during one season (2016‐2017).ResultsThe data of 400 players were analyzed. In total, 57 players sustained 65 hamstring injuries. The injury incidence was 1.12/1000 hours in the intervention group and 1.39/1000 hours in the control group. There were no statistically significant differences in hamstring injury incidence (OR = 0.89, 95% CI 0.46‐1.75) or severity between the groups (P > 0.48).ConclusionIn this large cluster‐randomized controlled trial, no evidence was found for plyometric training in its current form to reduce hamstring injuries in amateur soccer players.

Highlights

A final explanation is that the Bounding Exercise Program as we developed it does not sufficiently load the hamstring or the lumbo‐pelvic region sufficiently to gain a preventive effect
This large cluster‐randomized controlled trial found no evidence that a new functional injury prevention exercise program prevented hamstring injuries in adult male amateur soccer players
Effective hamstring injury prevention programs did not accomplish an annual decrease of hamstring injuries in male amateur soccer players

Summary

Introduction

Hamstring injuries are the most common muscle injuries in amateur soccer and account for 15% of all injuries in adult male soccer players.[1,2] The high incidence rate (0.7/1000 soccer hours), together with a high recurrence rate (12%‐30%) and long rehabilitation (mean >28 days), makes this injury a major problem in soccer.[1,3,4] Hamstring injuries can be classified as sprint‐type injuries and stretching‐type injuries, with sprint‐ type hamstring injuries being the most common in soccer.[1,5] The sprint‐type hamstring injury occurs mostly in the late swing phase, when the hamstring undergoes a stretch‐shortening cycle.[6,7] In this phase, the hamstring eccentrically contracts to decelerate hip flexion and knee extension. Methods: Thirty‐two soccer teams competing in the first‐class amateur league were cluster‐randomized into the intervention or control group Both groups were instructed to perform their regular training program, and the intervention group performed BEP. Information about player characteristics was gathered at baseline and exposure, hamstring injuries and BEP compliance were weekly registered during one season (2016‐2017)

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