This month we are going to mix it up a little and focus on one topic: hamstring strain injury (HSI) in sports and private practice settings.
Hamstring injuries have been consistently common in many sports and exercise settings around the world, particularly in fast-paced running sports1.
This is a topic that physiotherapists should regularly review as our understanding of the risk factors, injury mechanisms, rehabilitation, and prevention evolves over time.
Below is a list of resources as of September 2020 to help in different aspects of the assessment, management, and prevention of HSI.
Recalibrating the risk of hamstring strain injury (HSI): A 2020 systematic review and meta-analysis of risk factors for index and recurrent hamstring strain injury in sport1
This systematic review looks into the evidence of what factors influence the risk of HSI, from a person’s age, injury history (hamstring, calf, ACL), to also performance indicators for risk of injury, such as hamstring muscle strength, running strength, and capacity.
Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes2
This review looks at the statistical effect across the literature that the Nordic hamstring exercise has on injury prevention.
A Multifactorial, Criteria-based Progressive Algorithm for Hamstring Injury Treatment3
A great study by Mendiguchia et al. looking at the effectiveness of an individualised and multifactorial criteria-based algorithm on hamstring injury rehabilitation compared to a general rehabilitation protocol.
Sprint versus isolated eccentric training: Comparative effects on hamstring architecture and performance in soccer players4
Another nice study by Mendiguchia and team comparing the effect of eccentric hamstring strength training versus sprint training as a part of regular football practice, on subsequent sprint performance and hamstring muscle architecture.
Tenderness to palpation predicts return to sport following acute hamstring strain5
– Reviewed by Dr. Teddy Willsey
This is a nice example of the great review work at Physio Network. This article looks at the predictive value of hamstring muscle tenderness to palpation on return to play after acute hamstring injury.
In this Physio Edge episode David Pope chats with Jack Hickey about how an accelerated hamstring rehab program can be implemented in your clinical practice.
Feel free to share these hamstring injury resources with any physio friends that would find these helpful.
1. Green B, Bourne MN, van Dyk N, et al. Recalibrating the risk of hamstring strain injury (HSI): A 2020 systematic review and meta-analysis of risk factors for index and recurrent hamstring strain injury in sport. British Journal of Sports Medicine 2020;54:1081-1088. [link]
2. van Dyk N, Behan FP, Whiteley R. Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes. British Journal of Sports Medicine 2019;53:1362-1370. [link]
3. Mendiguchia, Jurdan; Martinez-Ruiz, Enrique; Edouard, Pascal; Morin, Jean-Benoît; Martinez-Martinez, Francisco; Idoate, Fernando; Mendez-Villanueva, Alberto. A Multifactorial, Criteria-based Progressive Algorithm for Hamstring Injury Treatment, Medicine & Science in Sports & Exercise: July 2017 – Volume 49 – Issue 7 – p 1482-1492. doi: 10.1249/MSS.0000000000001241. [link]
4. Mendiguchia J, Conceição F, Edouard P, Fonseca M, Pereira R, Lopes H, et al. (2020) Sprint versus isolated eccentric training: Comparative effects on hamstring architecture and performance in soccer players. PLoS ONE 15(2): e0228283. (https://creativecommons.org/licenses/by/4.0/) – [link]
5. Blog post – Tenderness to palpation predicts return to sport following acute hamstring strain. Review by Dr. Teddy Willsey. [link]