Does lumbo-pelvic dysfunction predispose to hamstring strain in professional soccer players?

Abstract

Abstract Purpose : It has been reported that hamstring strain in athletes is commonly followed by subsequent hamstring strains (Am. J. Sports Med. 30(2) (2002) 199). The current management of these injuries is oftentimes unsuccessful and may plague the athlete throughout their sporting career. The aim of this study was to test the hypothesis that hamstring strain can be a symptom secondary to dysfunction in other parts of the same biomechanical chain. For reasons explained below, the functionality of the lumbo-pelvic mechanism was selected for assessment in a retrospective double-blinded randomized controlled experimental design. A by-product of the research methodology was the discrimination of predictive value between manual and machine assessment techniques. Methods : Five professional soccer teams sent 20 players with and without histories of hamstring injury for assessment of their lumbo-pelvic mechanisms (subjects=20, of which 15 were Hamstring group and 5 were controls, i.e. one control from each club). Each player followed the same procedure; first, their lumbo-pelvic mechanics were manually assessed using a standardized evaluation by the same blinded manual therapist; second, each player was assessed on a Cybex Norm dynamometer for trunk flexion–extension values. The data were analysed, and subsequently, the medical histories of the players were revealed. Results : Manual assessment revealed higher levels of lumbo-pelvic dysfunction in the hamstring group—particularly in players with recurrent strains (though not statistically significant). Cybex assessment appeared to be less sensitive than manual assessment. However, for subjects who had a greater time period out of competitive play, the dynamometry was more sensitive; indicating its use in assessing deconditioning syndromes. There was no statistical correlation between manual and dynamometer assessment results. Statistical evaluation proved insignificant, but was hampered by low subject number, and more importantly by lack of normative data and contamination of the control group. Conclusion : Further research is required to provide statistical validity for this clinically acceptable and highly evidenced hypothesis: hamstring strain can be associated with lumbo-pelvic dysfunction .