Effect of Injury Prevention Programs that Include the Nordic Hamstring Exercise on Hamstring Injury Rates in Soccer Players: A Systematic Review and Meta-Analysis

Attar, Wesam Saleh A Al; Soomro, Najeebullah; Sinclair, Peter J.; Pappas, Evangelos; Sanders, Ross

doi:10.1007/s40279-016-0638-2

Cited by 205 publications

(130 citation statements)

References 54 publications

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“…The most recent systematic review analysed the effectiveness of injury prevention programmes that included the NHE to reduce hamstring injuries in football while monitoring athlete workload. 8 The results from the meta-analysis suggested that teams using the NHE (in isolation or as part of a larger injury prevention programme) reduced hamstring injury rates up to 51%. However, due to the exclusion of studies that did not provide workload data (training and match exposure) and sports other than football, this meta-analysis omits many studies that also included the NHE.…”

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confidence: 98%

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Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes

2019

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Research questionDoes the Nordic hamstring exercise (NHE) prevent hamstring injuries when included as part of an injury prevention intervention?DesignSystematic review and meta-analysis.Eligibility criteria for selecting studiesWe considered the population to be any athletes participating in any sporting activity, the intervention to be the NHE, the comparison to be usual training or other prevention programmes, which did not include the NHE, and the outcome to be the incidence or rate of hamstring injuries.AnalysisThe effect of including the NHE in injury prevention programmes compared with controls on hamstring injuries was assessed in 15 studies that reported the incidence across different sports and age groups in both women and men.Data sourcesMEDLINE via PubMed, CINAHL via Ebsco, and OpenGrey.ResultsThere is a reduction in the overall injury risk ratio of 0.49 (95% CI 0.32 to 0.74, p=0.0008) in favour of programmes including the NHE. Secondary analyses when pooling the eight randomised control studies demonstrated a small increase in the overall injury risk ratio 0.52 (95% CI 0.32 to 0.85, p=0.0008), still in favour of the NHE. Additionally, when studies with a high risk of bias were removed (n=8), there is an increase of 0.06 in the risk ratio to 0.55 (95% CI 0.34 to 0.89, p=0.006).ConclusionsProgrammes that include the NHE reduce hamstring injuries by up to 51%. The NHE essentially halves the rate of hamstring injuries across multiple sports in different athletes.Trial registration numberPROSPERO CRD42018106150.

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confidence: 98%

“…[5][6][7] A number of intervention studies that used eccentric strengthening reduced hamstring injuries. 8 Three large prospective trials (two randomised and one non-randomised) reduced injuries by approximately 70% by implementing the NHE in a team's training regime. [9][10][11] So why then do we need a systematic review of this type of intervention?…”

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confidence: 99%

Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes

2019

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“…Nordic hamstring curls are performed by kneeling on a pad and anchoring the ankles by a partner or other immovable object, and then lowering the body under control from the knee, keeping the hips in extension. They have regained popularity over the last decade or so for their claimed injury prevention benefits for the avoidance of hamstring injury in soccer players [34], but rely predominantly on the upper body mass of the trainee. In contrast, manual applied resistance uses a partner to apply force against a limb to put the corresponding muscle(s) under tension.…”

Section: Highlight By James P Fisher and Luke Carlsonmentioning

confidence: 99%

“…In practical terms, improved eccentric strength, specifically in the hamstrings muscle group by use of movements such as the Nordic hamstring exercise, appear beneficial in reducing injury risk [34]. Furthermore, based on the necessity for eccentric strength for decelerating forces, including normal locomotion and change of direction, as well as in the storage of elastic recoil energy [25,47], future research should focus upon adaptations attained by using practical approaches to eccentric training using the isoinertial method.…”

Section: Specific and General Eccentric Strength Adaptationsmentioning

confidence: 99%

The “Journal of Functional Morphology and Kinesiology” Journal Club Series: Utility and Advantages of the Eccentric Training through the Isoinertial System

Fisher

Ravalli

Carlson³

et al. 2020

JFMK

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We are glad to introduce the first Journal Club of volume five, the first issue. This edition is focused on relevant studies published in the last years in the field of eccentric training, chosen by our editorial board members and their colleagues. We hope to stimulate your curiosity in this field and to share with you the passion for the sport, seen also from a scientific point of view. The editorial board members wish you an inspiring lecture.

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“…1 Despite interventions showing efficacy in reducing risk of hamstring injuries, rates appear to be increasing in elite Gaelic football and elite soccer. [1][2][3] Modifiable risk factors for hamstring injuries have been identified in elite field sports using metrics derived from an eccentric knee flexor strength assessment. For example, in elite rugby union, eccentric strength imbalances of ≥10% and ≥15% were associated with a relative risk (RR) of 1.4 and 2.4 for future injury, respectively.…”

Section: Introductionmentioning

confidence: 99%

Association between eccentric knee flexor strength and hamstring injury risk in 185 elite Gaelic football players

Roe

Delahunt

McHugh

et al. 2020

Scandinavian Med Sci Sports

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Hamstring strains are the most common time‐loss injury in elite Gaelic football affecting over 20% of players per season. Thus, there is a need to identify factors contributing to the onset of hamstring injuries in order to inform injury risk management strategies. The current study investigated whether eccentric knee flexor strength and between‐limb imbalances were associated with increased risk of sustaining a time‐loss hamstring injury in elite Gaelic football players. A total of 185 elite male players (26.9 ± 2.7 years, 86.4 ± 6.2 kg, 183.4 ± 5.6) were prospectively followed for 12 weeks from the day of testing. Injury data were provided by the team medical staff. Twenty‐eight players (16%) sustained a time‐loss hamstring injury following testing. Players that did not sustain a hamstring injury had greater average between‐limb asymmetries (uninjured = 9.1%, 95% CI 7.8‐10.1; injured = 5.1%, 95% CI 3.7‐6.7; P = .001). Eccentric knee flexor strength profiles were not associated with increased or decreased risk of sustaining a hamstring injury and did not alter the post‐test probability of sustaining a hamstring injury across the investigation period. These findings do not support the use of eccentric knee flexor strength metrics in managing hamstring injury risk in elite male Gaelic football players.

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Effect of Injury Prevention Programs that Include the Nordic Hamstring Exercise on Hamstring Injury Rates in Soccer Players: A Systematic Review and Meta-Analysis

Cited by 205 publications

References 54 publications

Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes

Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes

The “Journal of Functional Morphology and Kinesiology” Journal Club Series: Utility and Advantages of the Eccentric Training through the Isoinertial System

Association between eccentric knee flexor strength and hamstring injury risk in 185 elite Gaelic football players

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