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Bridging Science and Practice for Hamstring Injury Prevention

Hamstring strain injuries (HSI) are the most common injury in elite football and have increased despite advances in sports science.

Injuries negatively impact team performance and finances.

This study provides a holistic, evidence-informed strategy for hamstring injury prevention in elite football.

The applications can be applied to all athletes.

How can elite football teams effectively implement evidence-based strategies to prevent hamstring injuries?

Study: Recommendations for hamstring injury prevention in elite football: translating research into practice​

What did the researchers do?

Strategies for Reducing Hamstring Injuries

Researchers reviewed risk factors and existing evidence-based interventions for hamstring injury prevention and developed a five-point strategy for preventing them:

1. Strength training
2. Load monitoring
3. Hip stability work
4. Movement quality training
5. Physical conditioning

Risk Factors for Hamstring Injuries

The researchers highlight the multifactorial nature of hamstring injuries. Figure 1 diagrams the many factors.

What were the results?

Strength Training is Key

• Eccentric strength training (e.g., Nordic Hamstring Exercise) is the most researched and effective approach.
• Increasing the fascicle length of the biceps femoris long head reduces injury risk.
• Both knee-dominant and hip-dominant exercises should be included.

Training Load Must Be Monitored

• High-speed running (HSR) exposure is protective when adequately dosed.
• Acute: Chronic Workload Ratio (ACWR) should be managed to prevent spikes in load.
• Players need progressive loading to tolerate match demands.

Lumbopelvic Hip Stability Matters

• Weak core and hip stability contribute to hamstring injuries.
• Training should include glute activation, pelvic control, and neuromuscular coordination.

Individualized Physical Conditioning is Essential

• Stronger, more aerobically fit athletes are at lower injury risk.
• Programs should incorporate general strength and conditioning beyond just hamstrings.

Movement Quality Needs Focus

• Sprint mechanics, landing control, and multi-directional agility drills help prevent injuries.
• Movement training should be progressive and sport-specific.

What does this mean?

• Hamstring injury prevention should be multifaceted, not just based on a single exercise.
• Strength training should be targeted and individualized based on player risk profiles.
• Load management is critical—both underloading and overloading increase risk.
• Buy-in from key stakeholders (coaches, players, and staff) is crucial for implementation.

Worth Noting

• Many elite teams fail to implement research-backed interventions fully.
• The study does not provide experimental data but rather a strategic framework.
• Some risk factors, such as neuromuscular coordination and workload balance, need further research.

Coach's Takeaway

• Eccentric hamstring strength training is non-negotiable.
• Hip/core stability training is an underrated but critical component.
• Monitor workload using ACWR to avoid spikes in training intensity.
• Sprint exposure at near-max speeds 1-2 times per week reduces injury risk.
• Movement quality work should be progressive and specific to football demands.

I hope this was helpful.

Ramsey

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