The Football Association Medical Research Programme: an audit of injuries in professional football—analysis of hamstring injuries

Abstract

Objective: To conduct a detailed analysis of hamstring injuries sustained in English professional football over two competitive seasons. Methods: Club medical staff at 91 professional football clubs annotated player injuries over two seasons. A specific injury audit questionnaire was used together with a weekly form that documented each clubs' current injury status. Results: Completed injury records for the two competitive seasons were obtained from 87% and 76% of the participating clubs respectively. Hamstring strains accounted for 12% of the total injuries over the two seasons with nearly half (53%) involving the biceps femoris. An average of five hamstring strains per club per season was observed. A total of 13 116 days and 2029 matches were missed because of hamstring strains, giving an average of 90 days and 15 matches missed per club per season. In 57% of cases, the injury occurred during running. Hamstring strains were most often observed during matches (62%) with an increase at the end of each half (p,0.01). Groups of players sustaining higher than expected rates of hamstring injury were Premiership (p,0.01) and outfield players (p,0.01), players of black ethnic origin (p,0.05), and players in the older age groups (p,0.01). Only 5% of hamstring strains underwent some form of diagnostic investigation. The reinjury rate for hamstring injury was 12%. Conclusion: Hamstring strains are common in football. In trying to reduce the number of initial and recurrent hamstring strains in football, prevention of initial injury is paramount. If injury does occur, the importance of differential diagnosis followed by the management of all causes of posterior thigh pain is emphasised. Clinical reasoning with treatment based on best available evidence is recommended.

Soccer-Specific Fatigue and Eccentric Hamstrings Muscle Strength

“…2 In English professional soccer players, 47% of match-play hamstrings strains were incurred during the final 15 minutes of each half. 3 The fatigue associated with soccer match play is specific to the characteristic activity profile. Soccer has an irregular and intermittent activity profile [7][8][9][10] and, thus, when considering soccer-specific fatigue, we should account for both physiologic and mechanical load.…”

“…[1][2][3][4] In an epidemiologic study of English professional soccer athletes, the thigh was the most prevalent site for injury, with 81% of thigh injuries classified as muscular strains. 2 In US Major League Soccer, hamstrings strains incurred during matches and training sessions accounted for 42% of all strain injuries.…”

The Efficacy of Exercise in Preventing Injury in Adult Male Football: A Systematic Review of Randomised Controlled Trials

“…It is believed that they often occur during rapid eccentric loading when they are stretched beyond the optimal torque for generating tension, notably during sprinting [52,58,60]. It has been suggested that eccentric exercise increases this angle of optimal torque and may reduce the risk of injury [61][62][63][64][65].…”

“…Hamstring strains are one of the most common injuries at professional football clubs, accounting for 12-16% of all injuries [5,39,58,59]. It is believed that they often occur during rapid eccentric loading when they are stretched beyond the optimal torque for generating tension, notably during sprinting [52,58,60].…”

Injury Rate in Professional Soccer Players within the Community of Madrid: A Comparative, Epidemiological Cohort Study among the First, Second and Second B Divisions

“…Only a few sports, such as rugby present incidence rates that are higher than soccer [7,8]. It is important to note that in professional soccer, any injury sustained by a player inevitably is associated with, on the one hand, suffering for the player, but also an important economic loss for the club, with the ensuing repercussion in first level events to follow [9]. Despite the high injury rates, there is no consensus regarding the number or injuries or the underlying mechanisms [10,11].…”