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

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Abstract

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.

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Most cited references 39

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The Football Association Medical Research Programme: an audit of injuries in professional football--analysis of hamstring injuries.

C. WOODS (2004)

To conduct a detailed analysis of hamstring injuries sustained in English professional football over two competitive seasons. Club medical staff at 91 professional football clubs annotated player injuries over two seasons. A specific injury audit questionnaire was used together with a weekly form that documented each clubs' current injury status. Completed injury records for the two competitive seasons were obtained from 87% and 76% of the participating clubs respectively. Hamstring strains accounted for 12% of the total injuries over the two seasons with nearly half (53%) involving the biceps femoris. An average of five hamstring strains per club per season was observed. A total of 13 116 days and 2029 matches were missed because of hamstring strains, giving an average of 90 days and 15 matches missed per club per season. In 57% of cases, the injury occurred during running. Hamstring strains were most often observed during matches (62%) with an increase at the end of each half (p<0.01). Groups of players sustaining higher than expected rates of hamstring injury were Premiership (p<0.01) and outfield players (p<0.01), players of black ethnic origin (p<0.05), and players in the older age groups (p<0.01). Only 5% of hamstring strains underwent some form of diagnostic investigation. The reinjury rate for hamstring injury was 12%. Hamstring strains are common in football. In trying to reduce the number of initial and recurrent hamstring strains in football, prevention of initial injury is paramount. If injury does occur, the importance of differential diagnosis followed by the management of all causes of posterior thigh pain is emphasised. Clinical reasoning with treatment based on best available evidence is recommended.

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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.

Jan Ekstrand, Markus Waldén, Martin Hägglund (2016)

There are limited data on hamstring injury rates over time in football.

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Hamstring strain injuries: factors that lead to injury and re-injury.

J. Shield, David Opar, Joseph D. Williams (2012)

Hamstring strain injuries (HSIs) are common in a number of sports and incidence rates have not declined in recent times. Additionally, the high rate of recurrent injuries suggests that our current understanding of HSI and re-injury risk is incomplete. Whilst the multifactoral nature of HSIs is agreed upon by many, often individual risk factors and/or causes of injury are examined in isolation. This review aims to bring together the causes, risk factors and interventions associated with HSIs to better understand why HSIs are so prevalent. Running is often identified as the primary activity type for HSIs and given the high eccentric forces and moderate muscle strain placed on the hamstrings during running these factors are considered to be part of the aetiology of HSIs. However, the exact causes of HSIs remain unknown and whilst eccentric contraction and muscle strain purportedly play a role, accumulated muscle damage and/or a single injurious event may also contribute. Potentially, all of these factors interact to varying degrees depending on the injurious activity type (i.e. running, kicking). Furthermore, anatomical factors, such as the biarticular organization, the dual innervations of biceps femoris (BF), fibre type distribution, muscle architecture and the degree of anterior pelvic tilt, have all been implicated. Each of these variables impact upon HSI risk via a number of different mechanisms that include increasing hamstring muscle strain and altering the susceptibility of the hamstrings to muscle damage. Reported risk factors for HSIs include age, previous injury, ethnicity, strength imbalances, flexibility and fatigue. Of these, little is known, definitively, about why previous injury increases the risk of future HSIs. Nevertheless, interventions put in place to reduce the incidence of HSIs by addressing modifiable risk factors have focused primarily on increasing eccentric strength, correcting strength imbalances and improving flexibility. The response to these intervention programmes has been mixed with varied levels of success reported. A conceptual framework is presented suggesting that neuromuscular inhibition following HSIs may impede the rehabilitation process and subsequently lead to maladaptation of hamstring muscle structure and function, including preferentially eccentric weakness, atrophy of the previously injured muscles and alterations in the angle of peak knee flexor torque. This remains an area for future research and practitioners need to remain aware of the multifactoral nature of HSIs if injury rates are to decline.

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Journal

Journal ID (iso-abbrev): Sports Med

Title: Sports medicine (Auckland, N.Z.)

Publisher: Springer Nature

ISSN (Electronic): 1179-2035

ISSN (Print): 0112-1642

Publication date (Electronic): May 2017

Volume: 47

Issue: 5

Affiliations

[1 ] Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, NSW, 2141, Australia. wala3431@uni.sydney.edu.au.

[2 ] Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, 2141, Australia. wala3431@uni.sydney.edu.au.

[3 ] Department of Physiotherapy and Rehabilitation Sciences, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, 24382, Saudi Arabia. wala3431@uni.sydney.edu.au.

[4 ] Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, NSW, 2141, Australia.

[5 ] Rural Health Mildura, Faculty of Medicine, Nursing and Health Sciences, Monash University, Mildura, VIC, 3500, Australia.

[6 ] Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, 2141, Australia.

Article

Publisher Item ID: 10.1007/s40279-016-0638-2

DOI: 10.1007/s40279-016-0638-2

PubMed ID: 27752982

SO-VID: cba4d5d1-c853-431e-93d4-58541c80606f

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

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Special issue: Social Pedagogy in the Nordic Countries

Most cited references 39

The Football Association Medical Research Programme: an audit of injuries in professional football--analysis of hamstring injuries.

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.

Hamstring strain injuries: factors that lead to injury and re-injury.

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