The Effect of Sports Chiropractic on the Prevention of Hamstring Injuries

Abstract

Hamstring injuries are the most prevalent and recurrent injury in Australian Rules football resulting in the most missed matches. PURPOSE: To determine whether sports chiropractic involving manipulation and supporting soft tissue therapies to the spine, pelvis and lower extremity can prevent the occurrence of hamstring injuries in semi-elite Australian Rules footballers. METHOdS: 59 male subjects (age range 18–27) were drawn from two semi-elite clubs and randomly allocated to an intervention (n=29) or control group (n=30) matched for age, low back pain, Knee Injury and Osteoarthirits Outcome Score and hamstring injury history. Treatment and scheduling for the intervention group was pragmatically determined. The minimum scheduling adhered to was 1 treatment per week for 6 weeks, 1 treatment per fortnight for 3 months and 1 treatment per month for the remainder of the season. Treatment began 6 weeks prior to round 1. The intervention and control group both continued to receive standard club medical management (including medication, surgery, physiotherapy, massage, strength and conditioning and rehabilitation) as directed by club staff. All medical staff were employed by the club and had no limitation in the number of treatments or the type of treatment they could render. This was independently administered without restriction or interference from the study authors. Injury was determined and recorded by club medical staff and denned as that which results in a missed match. Clinical parameters were recorded including mechanism of injury. Two-sample t-tests with 95% confidence intervals were used to assess the efficacy of the treatment with respect to the number of injuries and total amount of playing weeks lost. Survival analysis based on Kaplan-Meier curves and the logrank test were used to compare with respect to injury recurrence. RESULTS: At the end of season (24 matches/24 weeks) there was a significant difference between the intervention and control group for hamstring injury incidence (1 v 5 p<0.05), weeks missed due to hamstring injury (4 v 14 p<0.05), hamstring injury recurrence (0 v 2 p<0.05), total lower-limb muscle strain incidence (1 v 8 p<0.05), weeks missed due to total lower-limb muscle strain (4 v 21 p<0.05), non-contact knee injury incidence (1 v 7 p<0.05) and weeks missed due to non-contact knee injury (1 v 24p<0.05). CONCLUSION: This study demonstrated significant prevention of hamstring injuries severe enough to result in loss of competition match play. Significant reduction in lower-limb muscle strains and non-contact knee injury was also observed. Importantly, no adverse outcomes were noted with treatment during this trial.