Does a bounding exercise program prevent hamstring injuries in adult male soccer players? – A cluster‐RCT

Abstract

BackgroundAlthough the Nordic Hamstring Exercise (NHE) prevents hamstring injury in soccer players effectively, the annual incidence of these injuries still increases. This may be because of poor long‐term compliance with the program. Furthermore, the timing and amplitude of gluteal and core muscle activation seem to play an important role in hamstring injury prevention, the NHE program was not designed to improve activation of these muscles. Therefore, we propose plyometric training as an alternative to reduce hamstring injuries in soccer players.PurposeTo determine the preventive effect of the Bounding Exercise Program (BEP) on hamstring injury incidence and severity in adult male amateur soccer players.Study designA cluster‐Randomized Controlled Trial.MethodsThirty‐two soccer teams competing in the first‐class amateur league were cluster‐randomized into the intervention or control group. Both groups were instructed to perform their regular training program, and the intervention group additionally performed BEP. Information about player characteristics was gathered at baseline and exposure, hamstring injuries and BEP compliance were weekly registered during one season (2016‐2017).ResultsThe data of 400 players were analyzed. In total, 57 players sustained 65 hamstring injuries. The injury incidence was 1.12/1000 hours in the intervention group and 1.39/1000 hours in the control group. There were no statistically significant differences in hamstring injury incidence (OR = 0.89, 95% CI 0.46‐1.75) or severity between the groups (P > 0.48).ConclusionIn this large cluster‐randomized controlled trial, no evidence was found for plyometric training in its current form to reduce hamstring injuries in amateur soccer players.

Diagnosis, prevention and treatment of common lower extremity muscle injuries in sport – grading the evidence: a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF)

“…These observations, regarding low compliance, could likely explain the continuous rise in hamstring strain injuries in elite football 14 21 52. We also found moderate quality of evidence for a trivial non-significant effect of a comprehensive bounding programme involving plyometric and running drills directed towards the injury mechanisms during high-speed running 63…”

“…Based on this, the Nordic hamstring exercise protocol showed a large and significant risk reduction (RR: 0.35, 95% CI 0.22 to 0.54; I 2 =0.0%) compared with usual care on hamstring injuries in football (n=1521) (high quality of evidence) 56 57. Data from individual studies62–65 are presented in table 2.…”

“…In total 2468 studies were identified in the literature search. Three systematic reviews52–54 and 12 RCT’s was included 21 55–65. A systematic review and meta-analysis performed by van Dyk et al (2019) showed a medium and significant risk reduction (RR: 0.55, 95% CI 0.34 to 0.89; I 2 =67.0%) of hamstring injuries in football players in interventions including the Nordic hamstring exercise versus usual care (n=5362) (moderate quality of evidence) 53.…”

Implementing Strength Training Strategies for Injury Prevention in Soccer: Scientific Rationale and Methodological Recommendations

“…This study reported no statistically significant differences in hamstring injury incidence (odds ratio = 0.89 [95% CI 0.46, 1.75]) or severity between the groups. 40…”

An Inertial Measurement Unit Based Method to Estimate Hip and Knee Joint Kinematics in Team Sport Athletes on the Field

“…The video component of this article can be found at https://www.jove.com/video/60857/ 14,15,16,17 . Furthermore, the number of athletes that sustain a hamstring strain injury rises each year 18,19 , despite that multiple programs have been introduced to prevent hamstring strain injuries 12,13,20,21…”