Hamstring Injury Rates Research Articles

Effect of injury prevention programs that include the Nordic hamstring exercise on hamstring injury rates in soccer players: A systematic review and meta-analysis

Effect of injury prevention programs that include the Nordic hamstring exercise on hamstring injury rates in soccer players: A systematic review and meta-analysis

Hamstring injuries in elite Gaelic football: an 8-year investigation to identify injury rates, time-loss patterns and players at increased risk

BackgroundHamstring injuries occur frequently in field sports, yet longitudinal information to guide prevention programmes is missing.AimInvestigate longitudinal hamstring injury rates and associated time loss in elite Gaelic football, while identifying...

Effect of Injury Prevention Programs that Include the Nordic Hamstring Exercise on Hamstring Injury Rates in Soccer Players: A Systematic Review and Meta-Analysis.

Hamstring injuries are among the most common non-contact injuries in sports. The Nordic hamstring (NH) exercise has been shown to decrease risk by increasing eccentric hamstring strength. The purpose of this systematic review and meta-analysis was to investigate the effectiveness of the injury prevention programs that included the NH exercise on reducing hamstring injury rates while factoring in athlete workload. Two researchers independently searched for eligible studies using the following databases: the Cochrane Central Register of Controlled Trials via OvidSP, AMED (Allied and Complementary Medicine) via OvidSP, EMBASE, PubMed, MEDLINE, SPORTDiscus, Web of Science, CINAHL and AusSportMed, from inception to December 2015. The keyword domains used during the search were Nordic, hamstring, injury prevention programs, sports and variations of these keywords. The initial search resulted in 3242 articles which were filtered to five articles that met the inclusion criteria. The main inclusion criteria were randomized controlled trials or interventional studies on use of an injury prevention program that included the NH exercise while the primary outcome was hamstring injury rate. Extracted data were subjected to meta-analysis using a random effects model. The pooled results based on total injuries per 1000h of exposure showed that programs that included the NH exercise had a statistically significant reduction in hamstring injury risk ratio [IRR] of 0.490 (95% confidence interval [CI] 0.291-0.827, p=0.008). Teams using injury prevention programs that included the NH exercise reduced hamstring injury rates up to 51% in the long term compared with the teams that did not use any injury prevention measures. This systematic review and meta-analysis demonstrates that injury prevention programs that include NH exercises decrease the risk of hamstring injuries among soccer players. A protocol was registered in the International Prospective Register of Systematic Reviews, PROSPERO (CRD42015019912).

Hamstring Injuries in Major and Minor League Baseball

Objectives:The purpose of this study is to test the efficacy of a hamstring injury prevention program designed to address the high incidence of acute and chronic hamstring injuries and re-injuries that occur in the sport of professional baseball.Methods:This was a prospective cluster cohort study assessing the efficacy of an injury prevention intervention designed to address hamstring injury in rookie and professional baseball players participating in Minor and Major League Baseball (N = 213). Each athlete was asked to participate and consented (Johns Hopkins Internal Review Board, Baltimore, Maryland). Those athletes who agreed to participate completed a questionnaire detailing their hamstring injury history. The hamstring injury prevention program was disseminated to each medical staff (team physician, certified athletic trainer and strength and conditioning coach) and they were instructed on how to implement the program. Weekly individual compliance with the program and injury data was collected. At the end of the season, the data were analyzed for program compliance and hamstring (HS) injury rates (both acute and reoccurrence) compared to the control data in the MLB HITS database. All data were stripped of individual and team identifiers prior to analysis.Results:For the major and minor league intervention study, one Major and Minor League organization served as the intervention (INT) team, which encompassed Rookie League, Fall Ball, Class A, AA, AAA and major league rosters (6 total teams). A total of 213 athletes consented to participate: Minor League: N = 173 players and Majors League: N = 40. Weekly compliance, injury incidence and time loss due to injury was compared to the HITS database (age, skill matched control group). The average weighted utilization of the injury prevention program was 25.30 utilizations for the uninjured group compared to 13.53 in the injured group (p=0.09). In the majors, there were 2 HS injuries in the INT vs. 79 in the CON (IR: .025 INT vs .068 CON, p < 0.05); constituting a 25% reduction in HS injury. In the minors, there were 7 HS injuries in the INT vs. 297 in the CON (IR: .039 INT vs. .065 CON, p < 0.05), constituting a 40% reduction in the minor league HS injuries. There was a significant reduction in time loss due to injury for both the major and minor league INT players compared to the CON. For the Major League INT, there were 9 vs. 25.9 days lost in the CON group, resulting in a 65.3% reduction in time loss (p<0.05). The Minor League INT reported a similar finding: 11.63 vs. 21.3 days lost to injury in the CON group, resulting in a 45.3% reduction in time loss (p<0.05).Conclusion:The reduction in hamstring injury in the major and minor league intervention teams is consistent what researchers have reported with respect to the efficacy and value of utilizing a this intervention program in other sports. The intervention is a time and cost efficient means to reduce hamstring injury incidence and time loss in professional baseball players. This study is continuing in a prospective manner for an additional competitive season.

Influence on Strength and Flexibility of a Swing Phase-Specific Hamstring Eccentric Program in Sprinters' General Preparation.

Hamstring injuries are common in sprinters and mainly occur during the terminal swing phase. Eccentric training has been shown to reduce hamstring injury rate by improving several risk factors. The aim of this study was to test the hypothesis that an additional swing phase-specific hamstring eccentric training in well-trained sprinters performed at the commencement of the winter preparation is more efficient to improve strength, ratio, optimum angle, and flexibility than a similar program without hamstring eccentric exercises. Twenty sprinters were randomly allocated to an eccentric (n = 10) or a control group (n = 10). Both groups performed their usual track and field training throughout the study period. Sprinters in the eccentric group performed an additional 6-week hamstring eccentric program, which was specific to the swing phase of the running cycle (eccentric high-load open-chain kinetic movements covering the whole hamstring length-tension relationship preformed at slow to moderate velocity). Isokinetic and flexibility measurements were performed before and after the intervention. The eccentric group increased hamstring peak torques in concentric at 60° · s(-1) by 16% (p < 0.001) and at 240° · s(-1) by 10% (p < 0.01), in eccentric at 30° · s(-1) by 20% (p < 0.001) and at 120° · s(-1) by 22% (p < 0.001), conventional and functional ratios by 12% (p < 0.001), and flexibility by 4° (p < 0.01), whereas the control group increased hamstring peak torques only in eccentric at 30° · s(-1) by 6% (p ≤ 0.05) and at 120° · s(-1) by 6% (p < 0.01). It was concluded that an additional swing phase-specific hamstring eccentric training in sprinters seems to be crucial to address different risk factors for hamstring strain injuries, such as eccentric and concentric strength, hamstring-to-quadriceps ratio ratio, and flexibility.

Hamstring injuries have increased by 4% annually in men's professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study

BackgroundThere are limited data on hamstring injury rates over time in football.AimTo analyse time trends in hamstring injury rates in male professional footballers over 13 consecutive seasons and to distinguish...

Effects of an eccentric training programme on hamstring strain injuries in women football players

Summary Study aim: to test the hypothesis that an eccentric training programme applied on women football players would reduce the hamstring injury rate by improving thigh muscle balance and, particularly, hamstring strength. Material and methods: three football teams were recruited for this randomised controlled trial. They played in the first and second divisions in Spain. Players were randomised within clubs either to the intervention (eccentric exercises, n = 22) or control (control exercises, n = 21) groups, and randomisation was stratified according to previous history of thigh strains. The eccentric programme was divided into 3 phases, and each phase was composed of 7 weeks. Compliance level and all injuries were recorded throughout the season as well as training and game exposure times. Muscle strength and power of the lower extremities and flexibility of the hamstrings and lower back were measured before and after the intervention. Results: the risk for sustaining a hamstring strain (RSHS) was reduced by 81%. However, differences were not significant due to the low number of subjects (relative risk 0.19; 95% coefficient interval 0.02–1.50). The strength of the hamstrings decreased in both groups (p &lt; 0.05), whereas sprint time was improved only in the intervention group (p &lt; 0.05). Conclusion: the present findings suggest that a simple program of eccentric exercise could reduce RSHS.

Evidence-based hamstring injury prevention is not adopted by the majority of Champions League or Norwegian Premier League football teams: the Nordic Hamstring survey

BackgroundThe Nordic hamstring (NH) exercise programme was introduced in 2001 and has been shown to reduce the risk of acute hamstring injuries in football by at least 50%. Despite this,...

Injury Incidence, Risk Factors and Prevention in Australian Rules Football

Along with the enjoyment and the other positive benefits of sport participation, there is also the risk of injury that is elevated in contact sport. This review provides a summary of injury incidence in Australian rules football (ARF), identifies injury risk factors, assesses the efficacy of interventions to reduce injury risk and makes recommendations for future research. The most common injuries were found to be muscle strains, particularly hamstrings; joint ligament sprains, especially ankle; haematomas and concussion. The most severe joint injury was anterior cruciate ligament rupture. Mouthguards are commonly worn and have been shown to reduce orofacial injury. There is evidence that thigh pads can reduce the incidence of thigh haematomas. There is a reluctance to wear padded headgear and an attempt to assess its effectiveness was unsuccessful due to low compliance. The most readily identified risk factor was a history of that injury. There were conflicting findings as to the influence strength imbalances or deficit has on hamstring injury risk in ARF. Static hamstring flexibility was not related to risk but low hip flexor/quadriceps flexibility increased hamstring injury risk. High lower-limb and high hamstring stiffness were associated with an elevated risk of hamstring injury. Since stiffness can be modulated through strength or flexibility training, this provides an area for future intervention studies. Low postural balance ability was related to a greater risk of ankle injury in ARF, players with poor balance should be targeted for balance training. There are preliminary data signifying a link between deficiencies in hip range of motion and hip adductor strength with groin pain or injury. This provides support for future investigation into the effectiveness of an intervention for high-risk players on groin injury rate. Low cross-sectional area of core-region muscle has been associated with more severe injuries and a motor control exercise intervention that increased core muscle size and function resulted in fewer games missed due to injury. A randomized controlled trial of the effectiveness of eccentric hamstring exercise in decreasing hamstring injury rate in ARF players was unsuccessful due to poor compliance from muscle soreness; a progressive eccentric training intervention for ARF should be given future consideration. Jump and landing training reduced injury risk in junior ARF players and it would be advisable to include this component as part of a neuromuscular training intervention. A multifaceted programme of sport-specific drills for hamstring flexibility while fatigued, sport skills that load the hamstrings and high-intensity interval training to mimic match playing conditions showed some success in reducing the incidence of hamstring injuries in ARF. A countermeasure designed to reduce injury risk is more likely to be adopted by coaches and players if it also has the scope to enhance performance.

Risk Factors for Lower Extremity Muscle Injury in Professional Soccer

Background: Muscle injury is the most common injury type in professional soccer players. Despite this, risk factors for common lower extremity injuries remain elusive. Purpose: To evaluate the effects of various player- and match-related risk factors on the occurrence of lower extremity muscle injury in male professional soccer. Study Design: Cohort study; Level of evidence, 2. Methods: Between 2001 and 2010, 26 soccer clubs (1401 players) from 10 European countries participated in the study. Individual player exposure and time loss muscle injuries in the lower extremity were registered prospectively by the club medical staffs during 9 consecutive seasons. Hazard ratios (HRs) were calculated for player-related factors from simple and multiple Cox regression, and odds ratios (ORs) were calculated for match-related variables from simple and multiple logistic regression, presented with 95% confidence intervals (CIs). Results: There were 2123 muscle injuries documented in the major lower extremity muscle groups: adductors (n = 523), hamstrings (n = 900), quadriceps (n = 394), and calf (n = 306). Injuries to the adductors (56%; P = .015) and quadriceps (63%; P< .001) were more frequent in the kicking leg. Multiple analysis indicated that having a previous identical injury in the preceding season increased injury rates significantly for adductor (HR, 1.40; 95% CI, 1.00-1.96), hamstring (HR, 1.40; 95% CI, 1.12-1.75), quadriceps (HR, 3.10; 95% CI, 2.21-4.36), and calf injuries (HR, 2.33; 95% CI, 1.52-3.57). Older players (above mean age) had an almost 2-fold increased rate of calf injury (HR, 1.93; 95% CI, 1.38-2.71), but no association was found in other muscle groups. Goalkeepers had reduced injury rates in all 4 muscle groups. Match play on away ground was associated with reduced rates of adductor (OR, 0.56; 95% CI, 0.43-0.73) and hamstring injuries (OR, 0.76; 95% CI, 0.63-0.92). Quadriceps injuries were more frequent during preseason, whereas adductor, hamstring, and calf injury rates increased during the competitive season. Conclusion: Intrinsic factors found to increase muscle injury rates in professional soccer were previous injury, older age, and kicking leg. Injury rates varied during different parts of the season and also depending on match location.

Preventive Effect of Eccentric Training on Acute Hamstring Injuries in Men’s Soccer

Background: The incidence of acute hamstring injuries is high in several sports, including the different forms of football. Purpose: The authors investigated the preventive effect of eccentric strengthening of the hamstring muscles using the Nordic hamstring exercise compared with no additional hamstring exercise on the rate of acute hamstring injuries in male soccer players. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Fifty Danish male professional and amateur soccer teams (942 players) were allocated to an intervention group (461 players) or a control group (481 players). Players in the intervention group conducted a 10-week progressive eccentric training program followed by a weekly seasonal program, whereas players in the control group followed their usual training program. The main outcome measures were numbers of overall, new, and recurrent acute hamstring injuries during 1 full soccer season. Results: Fifty-two acute hamstring injuries in the control group compared with 15 injuries in the intervention group were registered. Comparing intervention versus the control group, overall acute hamstring injury rates per 100 player seasons were 3.8 versus 13.1 (adjusted rate ratio [RR], 0.293; 95% confidence interval [CI], 0.150-0.572; P < .001). New injury rates per 100 player seasons were 3.1 versus 8.1 (RR, 0.410; 95% CI, 0.180-0.933; P = .034), whereas recurrent injury rates per 100 player seasons were 7.1 versus 45.8 (RR, 0.137; 95% CI, 0.037-0.509; P = .003). Number needed to treat [NNT] to prevent 1 acute hamstring injury (new or recurrent) is 13 (95% CI, 9-23) players. The NNT to prevent 1 new injury is 25 (95% CI, 15-72) players, and NNT to prevent 1 recurrent injury is 3 (95% CI, 2-6) players. Conclusion: In male professional and amateur soccer players, additional eccentric hamstring exercise decreased the rate of overall, new, and recurrent acute hamstring injuries.

A Soccer-Specific Balance Training Program for Hamstring Muscle and Patellar and Achilles Tendon Injuries

Background A soccer-specific balance training has been shown to decrease injury incidence of the anterior cruciate ligament and ankle sprains in randomized controlled trials. However, hamstring injuries and tendinopathy remain significant issues in soccer. Hypothesis Proprioceptive training can reduce the incidence of hamstring muscle injuries and tendinopathy in elite soccer. There is a dose-effect relationship between balance training duration and injury incidence. Study Design Cohort study; Level of evidence, 3. Methods Twenty-four elite female soccer players (body mass index, 21.7 ± 1.2; age, 21 ± 4 years) of a German premier league soccer team were prospectively included. Starting in January 2004, an additional soccer-specific proprioceptive multistation training was initiated over 3 years. Injury data/1000 hours of exposure with documentation of all occurred injuries, detailed training, and match exposure data as well as time loss data were 100% complete. Results At the end of the 3-year proprioceptive balance training intervention, noncontact hamstring injury rates were reduced from 22.4 to 8.2/1000 hours (P = .021), patellar tendinopathy from 3.0 to 1.0/1000 hours (P = .022), and Achilles tendinopathy from 1.5 to 0.0/1000 hours (P = .035). There was no effect of balance training on contact injuries. Mean time loss of all assessed injuries significantly decreased from 14.4 days during the control period to 1.5 days during intervention periods (P = .003). The more minutes of balance training performed, the lower the rate of overall injuries (r = −0.185, P = .001), hamstring injuries (r = −0.267, P = .003), patellar tendinopathy (r = −0.398, P = .02), and gastrocnemius strains (r = −0.342, P = .002). Conclusion Soccer-specific balance training (protective balancing) can reduce noncontact hamstring injuries and patellar and Achilles tendinopathy. A dose-effect relationship between duration of balance training and injury incidence is evident. A proprioceptive training program reduced the rehabilitation time in noncontact injuries, which warrants further investigation.

Prevention of hamstring injuries in footballers

Despite many postulated causes of hamstring injury, the only risk factors that have been prospectively validated by multiple trials are past history and muscle weakness (measured by hamstring/quadriceps (H/Q) strength ratio and/or side-to-side deficits). Hamstring weakness has been associated prospectively with injury by Burkett (1970), Christensen et al. (1972), Bailey et al. (1981), Heiser et al. (1984), Yamamoto (1993) and Orchard et al. (1997) and retrospectively by Jonhagen et al. (1194). Whilst other studies have not shown an association, there is enough evidence to assume that hamstring weakness is a risk factor for hamstring strain. Further study is needed to confirm whether preventive strengthening would lower the hamstring injury rate.