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Review

Hamstring muscle injuries in athletics

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Pages 103-114 | Received 24 Oct 2022, Accepted 24 Feb 2023, Published online: 13 Mar 2023

References

  • Edouard P, Branco P, Alonso J-M. Muscle injuries and hamstring muscle injuries during the international athletics championships between 2007 and 2015. Ann Phys Rehabil Med. 2016;59:e22.
  • Ekstrand J, Bengtsson H, Waldén M, et al. Hamstring injury rates have increased during recent seasons and now constitute 24% of all injuries in men’s professional football: the UEFA elite club injury study from 2001/02 to 2021/22. Br J Sports Med. 2022;57(5): bjsports-2021. 105407.
  • Mueller-Wohlfahrt HW, Haensel L, Mithoefer K, et al. Terminology and classification of muscle injuries in sport: the Munich consensus statement. Br J Sports Med. 2013;47(6):342–350.
  • Wangensteen A, Guermazi A, Tol JL, et al. New MRI muscle classification systems and associations with return to sport after acute hamstring injuries: a prospective study. Eur Radiol. 2018;28(8):3532–3541.
  • Pollock N, James SLJ, Lee JC, et al. British athletics muscle injury classification: a new grading system. Br J Sports Med. 2014;48(18):1347–1351.
  • Valle X, Alentorn-Geli E, Tol JL, et al. Muscle injuries in sports: a new evidence-informed and expert consensus-based classification with clinical application. Sports Med. 2017;47(7):1241–1253.
  • Vermeulen R, Whiteley R, van der Made AD, et al. Early versus delayed lengthening exercises for acute hamstring injury in male athletes: a randomised controlled clinical trial. Br J Sports Med. 2022;56:103405.
  • Pollock N, Kelly S, Lee J, et al. A 4-year study of hamstring injury outcomes in elite track and field using the British Athletics rehabilitation approach. Br J Sports Med. Published Online First: 2021;56(5):257–263.
  • MacDonald B, McAleer S, Kelly S, et al. Hamstring rehabilitation in elite track and field athletes: applying the British Athletics Muscle Injury Classification in clinical practice. Br J Sports Med. 2019;53(23):1464–1473.
  • Stępień K, Śmigielski R, Mouton C, et al. Anatomy of proximal attachment, course, and innervation of hamstring muscles: a pictorial essay. Knee Surg Sports Traumatol Arthrosc. 2019;27(3):673–684.
  • Kellis E. Intra- and inter-muscular variations in hamstring architecture and mechanics and their implications for injury: a narrative review. Sports Med. 2018;48(10):2271–2283.
  • Edouard P, Navarro L, Branco P, et al. Injury frequency and characteristics (location, type, cause and severity) differed significantly among athletics (‘ track and field’) disciplines during 14 international championships (2007–2018): implications for medical service planning. Br J Sports Med. 2020;54:159–167.
  • Chumanov ES, Heiderscheit BC, Thelen DG. The effect of speed and influence of individual muscles on hamstring mechanics during the swing phase of sprinting. J Biomech. 2007;40(16):3555–3562.
  • Kenneally-Dabrowski CJB, Brown NAT, Lai AKM, et al. Late swing or early stance? A narrative review of hamstring injury mechanisms during high-speed running. Scand J Med Sci Sports. 2019;29(8):1083–1091.
  • Morin JB, Gimenez P, Edouard P, et al. Sprint acceleration mechanics: the major role of hamstrings in horizontal force production. Front Physiol. 2015;6:6.
  • Schache AG, Blanch PD, Dorn TW, et al. Effect of running speed on lower limb joint kinetics. Med Sci Sports Exerc. 2011;43:1260–1271.
  • Alt T, Komnik I, Severin J, et al. Swing phase mechanics of maximal velocity sprints-does isokinetic lower-limb muscle strength matter? Int J Sports Physiol Perform. 2021;16:974–984. DOI:10.1123/ijspp.2020-0423.
  • Nuell S, Illera-Domínguez V, Carmona G, et al. Hamstring muscle volume as an indicator of sprint performance. J Strength Cond Res. 2021;35:902–909.
  • Larruskain J, Lekue JA, Diaz N, et al. A comparison of injuries in elite male and female football players: a five‐season prospective study. Scand J Med Sci Sports. 2018;28(1):237–245.
  • Mack CD, Kent RW, Coughlin MJ, et al. Incidence of lower extremity injury in the national football league: 2015 to 2018. Am J Sports Med. 2020;48(9):2287–2294.
  • Tondelli E, Boerio C, Andreu M, et al. Impact, incidence and prevalence of musculoskeletal injuries in senior amateur male rugby: epidemiological study. Phys Sportsmed. 2021;50:1–7.
  • Askling CM, Tengvar M, Tarassova O, et al. Acute hamstring injuries in Swedish elite sprinters and jumpers: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br J Sports Med. 2014;48(7):532–539.
  • Askling CM, Tengvar M, Thorstensson A. Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br J Sports Med. 2013;47(15):953–959.
  • Fournier-Farley C, Lamontagne M, Gendron P, et al. Determinants of return to play after the nonoperative management of hamstring injuries in athletes. Am J Sports Med. 2016;44(8):2166–2172.
  • Kerin F, Farrell G, Tierney P, et al. Its not all about sprinting: mechanisms of acute hamstring strain injuries in professional male rugby union—a systematic visual video analysis. Br J Sports Med. 2022;56(11):608–615.
  • Martínez-Silván D, Wik EH, Alonso JM, et al. Injury characteristics in male youth athletics: a five-season prospective study in a full-time sports academy. Br J Sports Med. 2021;55(17):954–960.
  • Jacobsson J, Timpka T, Kowalski J, et al. Injury patterns in Swedish elite athletics: annual incidence, injury types and risk factors. Br J Sports Med. 2013;47(15):941–952.
  • Hader K, Mendez-Villanueva A, Ahmaidi S, et al. Changes of direction during high-intensity intermittent runs: neuromuscular and metabolic responses. BMC Sports Sci Med Rehabil. 2014;6(1):2.
  • Huygaerts S, Cos F, Cohen DD, et al. Mechanisms of hamstring strain injury: interactions between fatigue, muscle activation and function. Sports. 2020;8(5):65.
  • Ekstrand J, Hägglund M, Waldén M. Epidemiology of muscle injuries in professional football (Soccer). Am J Sports Med. 2011;39(6):1226–1232.
  • Opar DA, Drezner J, Shield A, et al. Acute hamstring strain injury in track-and-field athletes: a 3-year observational study at the Penn Relay Carnival. Scand J Med Sci Sports. 2014;24(4):e254–9.
  • van Hooren B, Bosch F. Is there really an eccentric action of the hamstrings during the swing phase of high-speed running? Part II: implications for exercise. J Sports Sci. 2017;35(23):2322–2333.
  • Alt T, Heinrich K, Funken J, et al. Lower extremity kinematics of athletics curve sprinting. J Sports Sci. 2015;33(6):552–560.
  • Pietraszewski P, Gołaś A, Krzysztofik M. Comparison of muscle activity during 200 m indoor curve and straight sprinting in elite female sprinters. J Hum Kinet. 2021;80:309–316.
  • Kelly S, Pollock N, Polglass G, et al. Injury and illness in elite athletics: a prospective cohort study over three seasons. Int J Sports Phys Ther. Published Online First 2022 Apr 1;17(3). DOI:10.26603/001c.32589.
  • Viljoen CT, Janse van Rensburg DC, Verhagen E, et al. Epidemiology of injury and illness among trail runners: a systematic review. Sports Med. 2021;51(5):917–943.
  • Bahr R, Clarsen B, Ekstrand J. Why we should focus on the burden of injuries and illnesses, not just their incidence. Br J Sports Med. 2018;52(16):1018–1021.
  • Gronwald T, Klein C, Hoenig T, et al. Infographic. Video analysis of match hamstring injury patterns in professional male football (soccer) teaches us about the need for demand-specific multicomponent exercise-based risk reduction programmes. Br J Sports Med. 2022;56:1194–1195.
  • Hamilton B, Valle X, Rodas G, et al. Classification and grading of muscle injuries: a narrative review. British Journal of Sports Medicine. Published Online First: 2015;49(5):306.
  • Grassi A, Quaglia A, Canata G, et al. An update on the grading of muscle injuries: a narrative review from clinical to comprehensive systems. Joints. 2016;04:039–46.
  • Takebayashi S, Takasawa H, Banzai Y, et al. Sonographic findings in muscle strain injury: clinical and MR imaging correlation. J Ultrasound Med. 1995;14(12):899–905.
  • Peetrons P. Ultrasound of muscles. Eur Radiol. 2002;12(1):35–43.
  • Lee JC, Healy J. Sonography of lower limb muscle injury. Am J Roentgenol. 2004;182(2):341–351.
  • Chan O, Del Buono A, Best TM, et al. Acute muscle strain injuries: a proposed new classification system. Knee Surg Sports Traumatol Arthrosc. 2012;20(11):2356–2362.
  • Blankenbaker DG, de Smet AA. MR imaging of muscle injuries. Appl Radiol. 2004;14–26. DOI:10.37549/AR1235
  • Ekstrand J, Healy JC, Waldén M, et al. Hamstring muscle injuries in professional football: the correlation of MRI findings with return to play. Br J Sports Med. 2012;46(2):112–117.
  • Ekstrand J, Askling C, Magnusson H, et al. Return to play after thigh muscle injury in elite football players: implementation and validation of the Munich muscle injury classification. Br J Sports Med. 2013;47(12):769–774.
  • Meek WM, Kucharik MP, Eberlin CT, et al. Calf strain in athletes. JBJS Rev. 2022;10:10.
  • Lempainen L, Mechó S, Valle X, et al. Management of anterior thigh injuries in soccer players: practical guide. BMC Sports Sci Med Rehabil. 2022;14(1):41.
  • Tol JL, Hamilton B, Best TM. Palpating muscles, massaging the evidence? An editorial relating to ‘Terminology and classification of muscle injuries in sport: the Munich consensus statement.’ Br J Sports Med. 2013;47(6):340–341.
  • Patel A, Chakraverty J, Pollock N, et al. British athletics muscle injury classification: a reliability study for a new grading system. Clin Radiol. 2015;70(12):1414–1420.
  • Pollock N, Patel A, Chakraverty J, et al. Time to return to full training is delayed and recurrence rate is higher in intratendinous (‘c’) acute hamstring injury in elite track and field athletes: clinical application of the British Athletics Muscle Injury Classification. Br J Sports Med. 2016;50(5):305–310.
  • McAleer S, Macdonald B, Lee J, et al. Time to return to full training and recurrence of rectus femoris injuries in elite track and field athletes 2010–2019; a 9‐year study using the British Athletics Muscle Injury Classification. Scand J Med Sci Sports. Published Online First 2022 Mar 31;32(7):1109–1118.
  • Shamji R, James SLJ, Botchu R, et al. Association of the British Athletic Muscle Injury Classification and anatomic location with return to full training and reinjury following hamstring injury in elite football. BMJ Open Sport Exerc Med. 2021;7(2):e001010.
  • Paton BM, Court N, Giakoumis M, et al. London International Consensus and Delphi study on hamstring injuries part 1: classification. Br J Sports Med. 2023; bjsports-2021. 105371.
  • Plastow R, Kerkhoffs GMMJ, Wood D, et al. London International Consensus and Delphi study on hamstring injuries part 2: operative management. Br J Sports Med. 2023; bjsports-2021. 105383.
  • Paton BM, Read P, van Dyk N, et al. London International Consensus and Delphi study on hamstring injuries part 3: rehabilitation, running and return to sport. Br J Sports Med. 2023; bjsports-2021. 105384.
  • van Mechelen W, Hlobil H, Kemper HC. Incidence, severity, aetiology and prevention of sports injuries. A review of concepts. Sports Med. 1992;14(2):82–99.
  • Meeuwisse WH, Tyreman H, Hagel B, et al. A dynamic model of etiology in sport injury: the recursive nature of risk and causation. Clin J Sport Med. 2007;17(3):215–219.
  • Afonso J, Rocha-Rodrigues S, Clemente FM, et al. The hamstrings: anatomic and physiologic variations and their potential relationships with injury risk. Front Physiol. 2021;12:12.
  • 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. Br J Sports Med. 2020;54(18):1081–1088.
  • Malliaropoulos N, Bikos G, Meke M, et al. Higher frequency of hamstring injuries in elite track and field athletes who had a previous injury to the ankle - a 17 years observational cohort study. J Foot Ankle Res. 2018;11:11.
  • Huygaerts S, Cos F, Cohen DD, et al. Does muscle–tendon unit structure predispose to hamstring strain injury during running? A critical review. Sports Med. 2021;51(2):215–224.
  • Sugiura Y, Saito T, Sakuraba K, et al. Strength deficits identified with concentric action of the Hip extensors and eccentric action of the hamstrings predispose to hamstring injury in elite sprinters. J Orthop Sports Phys Ther. 2008;38(8):457–464.
  • Kalema RN, Schache AG, Williams MD, et al. Sprinting biomechanics and hamstring injuries: is there a link? A literature review. Sports. 2021;9(10):141.
  • Mendiguchia J, Alentorn-Geli E, Brughelli M. Hamstring strain injuries: are we heading in the right direction? Br J Sports Med. 2012;46(2):81–85.
  • Bezodis NE, Willwacher S, Salo AIT. The biomechanics of the track and field sprint start: a narrative review. Sports Med. 2019;49(9):1345–1364.
  • Higashihara A, Nagano Y, Ono T, et al. Differences in hamstring activation characteristics between the acceleration and maximum-speed phases of sprinting. J Sports Sci. 2018;36(12):1313–1318.
  • Bahr R. Why screening tests to predict injury do not work-and probably never will.: a critical review. Br J Sports Med. 2016;50(13):776–780.
  • Green B, Bourne MN, Pizzari T. Isokinetic strength assessment offers limited predictive validity for detecting risk of future hamstring strain in sport: a systematic review and meta-analysis. Br J Sports Med. 2018;52(5):329–336.
  • Rudisill SS, Varady NH, Kucharik MP, et al. Evidence-based hamstring injury prevention and risk factor management: a systematic review and meta-analysis of randomized controlled trials. Am J Sports Med. 2022;3635465221083998. DOI:10.1177/03635465221083998
  • Vatovec R, Kozinc Ž, Šarabon N. Exercise interventions to prevent hamstring injuries in athletes: a systematic review and meta-analysis. Eur J Sport Sci. 2020;20(7):992–1004.
  • 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. Br J Sports Med. 2019;53(21):1362–1370.
  • Impellizzeri FM, McCall A, van Smeden M. Why methods matter in a meta-analysis: a reappraisal showed inconclusive injury preventive effect of Nordic hamstring exercise. J Clin Epidemiol. 2021;140:111–124.
  • Malliaropoulos N, Mendiguchia J, Pehlivanidis H, et al. Hamstring exercises for track and field athletes: injury and exercise biomechanics, and possible implications for exercise selection and primary prevention. Br J Sports Med. 2012;46(12):846–851.
  • Pincheira PA, Riveros-Matthey C, Lichtwark GA. Isometric fascicle behaviour of the biceps femoris long head muscle during Nordic hamstring exercise variations. J Sci Med Sport. 2022;25(8):684–689.
  • Alt T, Roos T, Nolte K, et al. Modulating the Nordic Hamstring Exercise from ‘zero to hero” – a stepwise progression explored in a high-performance athlete.’ J Athl Train. Published Online First 2022 Aug 22;DOI:10.4085/1062-6050-0010.22
  • Bourne MN, Timmins RG, Opar DA, et al. An evidence-based framework for strengthening exercises to prevent hamstring injury. Sports Med. 2018;48(2):251–267.
  • Kellis E, Blazevich AJ, Motealleh A. Hamstrings force-length relationships and their implications for angle-specific joint torques: a narrative review. BMC Sports Sci Med Rehabil. 2022;14(1):14.
  • van Hooren B, Vanwanseele B, Rossom S, et al. Muscle forces and fascicle behavior during three hamstring exercises. Scand J Med Sci Sports. Published Online First 2022 Mar 26;32(6):997–1012.
  • Dubois B, Esculier JF. Soft-tissue injuries simply need PEACE and LOVE. Br J Sports Med. 2020;54(2):72–73.
  • Chang JS, Kayani B, Plastow R, et al. Management of hamstring injuries: current concepts review. Bone Joint J. 2020;102(10):1281–1288.
  • Erickson LN, Sherry MA. Rehabilitation and return to sport after hamstring strain injury. J Sport Health Sci. 2017;6(3):262–270.
  • Bayer ML, Hoegberget-Kalisz M, Jensen MH, et al. Role of tissue perfusion, muscle strength recovery, and pain in rehabilitation after acute muscle strain injury: a randomized controlled trial comparing early and delayed rehabilitation. Scand J Med Sci Sports. 2018;28(12):2579–2591.
  • Bayer ML, Magnusson SP, Kjaer M. Early versus delayed rehabilitation after acute muscle injury. N Engl J Med. 2017;377(13):1300–1301.
  • Mendiguchia J, Brughelli M. A return-to-sport algorithm for acute hamstring injuries. Phys Ther Sport. 2011;12(1):2–14.
  • Mendiguchia J, Martinez-Ruiz E, Edouard P, et al. A multifactorial, criteria-based progressive algorithm for hamstring injury treatment. Med Sci Sports Exerc. 2017;49(7):1482–1492.
  • Aspetar Orthopaedic and Sports Medicine Hospital. Aspetar hamstring protocol. [Cited 2023 Jan 5]. https://aspetar.com/en/professionals/aspetar-hamstring-protocol
  • Kayani B, Ayuob A, Begum F, et al. Surgical repair of distal musculotendinous T junction injuries of the biceps femoris. Am J Sports Med. 2020;48(10):2456–2464.
  • Ayuob A, Kayani B, Haddad FS. Musculotendinous junction injuries of the proximal biceps femoris: a prospective study of 64 patients treated surgically. Am J Sports Med. 2020;48(8):1974–1982.
  • Bodendorfer BM, Curley AJ, Kotler JA, et al. Outcomes after operative and nonoperative treatment of proximal hamstring avulsions: a systematic review and meta-analysis. Am J Sports Med. 2018;46(11):2798–2808.
  • van der Made AD, Peters RW, Verheul C, et al. Proximal hamstring tendon avulsions: comparable clinical outcomes of operative and non-operative treatment at 1-year follow-up using a shared decision-making model. Br J Sports Med. 2022;56(6):340–348.
  • Grassi A, Napoli F, Romandini I, et al. Is Platelet-Rich Plasma (PRP) effective in the treatment of acute muscle injuries? A systematic review and meta-analysis. Sports Med. 2018;48(4):971–989.
  • Moen MH, Reurink G, Weir A, et al. Predicting return to play after hamstring injuries. Br J Sports Med. 2014;48(18):1358–1363.
  • Jacobsen P, Witvrouw E, Muxart P, et al. A combination of initial and follow-up physiotherapist examination predicts physician-determined time to return to play after hamstring injury, with no added value of MRI. Br J Sports Med. 2016;50(7):431–439.
  • de Vos RJ, Reurink G, Goudswaard GJ, et al. Clinical findings just after return to play predict hamstring re-injury, but baseline MRI findings do not. Br J Sports Med. 2014;48(18):1377–1384.
  • Wangensteen A, Tol JL, Witvrouw E, et al. Hamstring reinjuries occur at the same location and early after return to sport. Am J Sports Med. 2016;44(8):2112–2121.
  • Reurink G, Almusa E, Goudswaard GJ, et al. No association between fibrosis on magnetic resonance imaging at return to play and hamstring reinjury risk. Am J Sports Med. 2015;43(5):1228–1234.

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