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Published online: 15 November 2017
© Springer International Publishing AG, part of Springer Nature 2017
Abstract Hamstring strain injuries are endemic in running-based sports. Given the economic and performance implications of these injuries, a significant body of research has emerged in recent years in an attempt to identify risk factors and develop or optimise injury prevention strategies. Surveys of injury prevention practices among medical and conditioning staff in elite sport suggest that many sporting clubs invest significant efforts in eccentric hamstring conditioning and lumbo-pelvic or trunk stability programmes. The purpose of this narrative review was to critically evaluate the evidence underpinning these practices. Single-exercise eccentric training interventions have proven effective in the prevention of primary and recurrent hamstring strains, when compliance is adequate. However, despite its almost universal acceptance, the authors are aware of only one, very recent, prospective risk factor study examining the effect of lumbo-pelvic motion during sprinting on hamstring injury risk. Furthermore, the interventions exploring the effect of lumbo-pelvic training on hamstring injury rates have not measured stability in any way. An improved understanding of the evidence underpinning commonly employed hamstring injury prevention practices may enable clinicians and coaches to better prioritise effective strategies in the increasingly complex environment of elite sport.
1Introduction
Hamstring strain injuries are a significant burden in sports that involve high-speed running [1-4]. In elite Australian Rules football, for example, hamstring strains account for one in six injuries [2], result in 20-21 missed matches per club in each 22-game season [2] and clubs pay approximately Australian $24,6000 a year in wages to players who are unable to take the field [5]. This financial impost does not take into account the significant costs involved in imaging and treatment. In other running-based sports such as track and field, hamstring injuries account for 75% of all lower limb strains [1], while in soccer [3, 6] and rugby union [7, 8], these injuries represent the most common cause of lost playing and training time at the elite level.
There has been significant research interest in hamstring injuries in recent years and this has led to the development of new concepts and practices in injury prevention [9-12] and rehabilitation [13-17]. Unfortunately, it is not clear whether these research findings have had a...