by Liz Pattison
Hamstring injuries are the most prevalent injury in both amateur and elite soccer players. The hamstring muscle group is made up of three separate muscles: biceps femoris, semitendinosus and semimembranosus. The action of the hamstring is two-fold, it flexes the knee and extends the hip.
Injuries to the hamstring occur when external load exceeds the strength of the tissue. These injuries often occur with movements requiring rapid acceleration or deceleration, such as sprinting or kicking. The incidence of hamstring injuries in soccer is increasing rapidly. A two-year analysis of professional soccer teams highlighted that hamstring strains account for 12% of all injuries. Additionally, at the 2014 FIFA World Cup, 25% of all injuries sustained occurred to the hamstring muscle. Therefore, due to the high incidence of hamstring strains, it is imperative to incorporate a hamstring prevention program to reduce the players risk of a hamstring injury.
The greatest risk factor for a hamstring strain is a previous hamstring injury. The recurrence rates of a hamstring injury range from 12 to 41% during the first year of returning to play (Lee, Mok, Hardaway, Yung & Chan, 2018). This highlights the importance of proper hamstring rehabilitation, guided by a physiotherapist. Research by Taberner & Cohen (2018) have demonstrated that muscle strength, both concentric and eccentric and muscle fascicle length could be modified to reduce the athlete’s risk of hamstring injury.
Physiotherapists will work collaboratively with the athlete through their rehabilitation program. In the initial phase of rehabilitation, physiotherapists will commence with isometric hamstring exercises. It is important to load the hamstring, ensuring it is able to cope with the load applied. These exercises will be progressed to dynamic functional exercises – starting with concentric strength and then advancing to eccentric hamstring exercises. Examples include gluteal bridges, hamstring curls, arabesques and nordics. Eccentric hamstring exercises have been proven to be an effective intervention to reduce the risk of hamstring strains. Specifically, a recent study by Shadle & Cacolice (2017) have demonstrated the effectiveness of the nordic hamstring exercise in improving eccentric strength in elite soccer players. Repetitions of this exercise vary depending on the player’s fitness level. Hamstring rehabilitation will also incorporate plyometric exercises, ensuring these exercises incorporate key soccer skills. It is important that the rehabilitation program is devised by a physiotherapist, facilitating a safe return to sport.
If you are interested in seeking further information, visit www.physiohealth.com.au and come and see one of our experienced Physiotherapists.
Junge, A., & Jiri, Dvorak. (2015). Football injuries during the 2014 FIFA World Cup. British Journal of Sports Medicine, 49(9)
Lovell, R., Knox, M., Weston, M., Siegler, J.C., Brennan, S., & Marshall, P.W.M. (2018). Hamstring Injury prevention in soccer: Before or after training? Scandinavian Journal of Medicine and Science in Sports, 28(1), 658-666.
Taberner, M., Cohen, D.D. (2018). Physical preparation of the football player with an intramuscular hamstring tendon tear: clinical perspective with video demonstrations. British Journal of Sports Medicine, 0(0), 1-4