The Effectiveness of Nordic Hamstring Exercises in Reducing Hamstring Injuries in Competitive Soccer Players: A Critically Appraised Topic

2017 ◽  
Vol 22 (3) ◽  
pp. 12-17
Author(s):  
Jennifer W. Cuchna ◽  
Lauren Welsch ◽  
Taylor Meier ◽  
Chyrsten L. Regelski ◽  
Bonnie Van Lunen
Keyword(s):  
Incidence Rates ◽  
Soccer Players ◽  
Hamstring Injury ◽  
Injury Incidence ◽  
Clinical Question ◽  
Bottom Line ◽  
Injury Rates ◽  
Hamstring Strain ◽  
Hamstring Injuries

Clinical Question:Are Nordic hamstring exercises more effective than standardized training in reducing hamstring strain injury rates in competitive soccer players over the course of at least one season?Clinical Bottom Line:The evidence supports the use of Nordic hamstring exercises to reduce hamstring injury incidence rates over a competitive soccer season. Therefore, progressive Nordic hamstring exercises should be included within some aspect of a practice to prevent the occurrence of hamstring injuries.

Eccentric Exercises Reduce Hamstring Strains in Elite Adult Male Soccer Players: A Critically Appraised Topic

2017 ◽  
Vol 26 (6) ◽  
pp. 573-577 ◽  
Author(s):  
Ian B. Shadle ◽  
Paul A. Cacolice
Keyword(s):  
Adult Male ◽  
Sports Medicine ◽  
Extended Period ◽  
Soccer Players ◽  
Hamstring Injury ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Bottom Line ◽  
Level Of Evidence ◽  
Hamstring Strain

Clinical Scenario:Hamstring strains are a common sport-related injury, which may limit athletic performance for an extended period of time. These injuries are common in the soccer setting. As such, it is important to determine an appropriate prevention program to minimize the risk of such an injury for these athletes. Eccentric hamstring training may be an effective and practical hamstring strain prevention strategy.Clinical Question:What is the effect of eccentric exercises on hamstring strain prevention in adult male soccer players?Summary of Key Findings:Current literature was searched for studies of level 2 evidence or higher that investigated the effect of eccentric exercises in preventing hamstring strains in adult male soccer players. Three articles returned from the literature search met the inclusion criteria. A fourth article looked at differences in strength gains between eccentric and concentric hamstring strengthening exercises, but did not record hamstring strain incidence. A fifth article, a systematic review, met all the criteria except for the correct population. Of the 3 studies, 2 were randomized control trails and 1 was a cohort study.Clinical Bottom Line:There is robust supportive evidence that eccentric hamstring exercises can prevent a hamstring injury to an elite adult male soccer player. Therefore, it is recommended that athletic trainers and other sports medicine providers evaluate current practices relating to reducing hamstring strains and consider implementing eccentric exercise based prevention programs.Strength of Recommendation:All evidence was attained from articles with a level of evidence 2b or higher, based on the Center for Evidence-Based Medicine (CEBM) criteria, stating that eccentric exercises can decrease hamstring strains.

scholarly journals Measuring the Hip Adductor to Abductor Strength Ratio in Ice Hockey and Soccer Players: A Critically Appraised Topic

2020 ◽  
Vol 29 (1) ◽  
pp. 116-121
Author(s):  
Robert Rodriguez
Keyword(s):  
Ice Hockey ◽  
Soccer Players ◽  
Injury Incidence ◽  
Strength Ratio ◽  
Bottom Line ◽  
Injury Rates ◽  
Final Study ◽  
Hockey Players ◽  
Level 3 ◽  
Abductor Strength

Clinical Scenario: Ice hockey and soccer are both dynamic sports that involve continuous, unpredictable play. These athletes consistently demonstrate higher rates of groin strains compared with other contact sports. Measuring the hip adductor/abductor ratio has the potential to expose at-risk players, reduce injury rates, and preserve groin health in players with chronic strains. Focused Clinical Question: What is the clinical utility of measuring the hip adductor/abductor ratio for preseason and in-season ice hockey and soccer players? Summary of Key Findings: Three studies, all of which were prospective cohort designs, were included. One study involved assessing preseason strength and flexibility as a risk factor for adductor strains in professional ice hockey players. Another study performed with the same professional hockey team used preseason hip adductor/abductor strength ratios to screen for those players who would benefit from a strengthening intervention aimed at reducing the incidence of adductor strains. The final study, which was performed in elite U17 soccer players, assessed the effectiveness of monthly in-season strength monitoring as a guide to trigger in-season interventions to decrease injury incidence. Clinical Bottom Line: Measuring the hip adductor/abductor strength ratio in hockey and soccer players can be a beneficial preseason and in-season tool to predict future groin strain risk and screen for athletes who might benefit from a strengthening intervention. Strength of Recommendation: Level 3 evidence exists to support monitoring the hip adductor/abductor strength ratio to assess and reduce the risk of adductor strains in ice hockey and soccer players.

Preventive Effect of Eccentric Training on Acute Hamstring Injuries in Men’s Soccer

2011 ◽  
Vol 39 (11) ◽  
pp. 2296-2303 ◽  
Author(s):  
Jesper Petersen ◽  
Kristian Thorborg ◽  
Michael Bachmann Nielsen ◽  
Esben Budtz-Jørgensen ◽  
Per Hölmich
Keyword(s):  
Training Program ◽  
Intervention Group ◽  
Soccer Players ◽  
Hamstring Injury ◽  
Control Group ◽  
Eccentric Training ◽  
Preventive Effect ◽  
Injury Rates ◽  
Hamstring Injuries ◽  
Recurrent Injury

Background: The incidence of acute hamstring injuries is high in several sports, including the different forms of football. Purpose: The authors investigated the preventive effect of eccentric strengthening of the hamstring muscles using the Nordic hamstring exercise compared with no additional hamstring exercise on the rate of acute hamstring injuries in male soccer players. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Fifty Danish male professional and amateur soccer teams (942 players) were allocated to an intervention group (461 players) or a control group (481 players). Players in the intervention group conducted a 10-week progressive eccentric training program followed by a weekly seasonal program, whereas players in the control group followed their usual training program. The main outcome measures were numbers of overall, new, and recurrent acute hamstring injuries during 1 full soccer season. Results: Fifty-two acute hamstring injuries in the control group compared with 15 injuries in the intervention group were registered. Comparing intervention versus the control group, overall acute hamstring injury rates per 100 player seasons were 3.8 versus 13.1 (adjusted rate ratio [RR], 0.293; 95% confidence interval [CI], 0.150-0.572; P < .001). New injury rates per 100 player seasons were 3.1 versus 8.1 (RR, 0.410; 95% CI, 0.180-0.933; P = .034), whereas recurrent injury rates per 100 player seasons were 7.1 versus 45.8 (RR, 0.137; 95% CI, 0.037-0.509; P = .003). Number needed to treat [NNT] to prevent 1 acute hamstring injury (new or recurrent) is 13 (95% CI, 9-23) players. The NNT to prevent 1 new injury is 25 (95% CI, 15-72) players, and NNT to prevent 1 recurrent injury is 3 (95% CI, 2-6) players. Conclusion: In male professional and amateur soccer players, additional eccentric hamstring exercise decreased the rate of overall, new, and recurrent acute hamstring injuries.

scholarly journals Does the FIFA 11+ Program Prevent Hamstring Injuries in College-Aged Male Soccer Players? A Critically Appraised Topic

2021 ◽  
Vol 30 (1) ◽  
pp. 158-160
Author(s):  
Scott Benson Street ◽  
Thomas Kaminski
Keyword(s):  
Lower Extremity ◽  
Soccer Players ◽  
Lower Extremity Injury ◽  
Clinical Question ◽  
Bottom Line ◽  
Warm Up ◽  
Lower Extremity Injuries ◽  
Hamstring Injuries ◽  
Male College ◽  
Extremity Injuries

Clinical Scenario: Hamstring injuries are the most prevalent lower-extremity injury among soccer players. The Fédération Internationale de Football Association (FIFA) has addressed this issue by developing the FIFA 11+ program, which is focused on improving strength and decreasing the incidence of lower-extremity injuries in the sport. This critically appraised topic focuses on this program as well as one of its components, the Nordic hamstring exercise, in the prevention of hamstring injuries. Clinical Question: Does the FIFA 11+ program prevent hamstring injuries in college-aged male soccer players? Summary of Key Findings: Four studies were selected to be critically appraised. The PEDro checklist was used to score the articles on methodology and consistency. All 4 articles demonstrated support for the clinical question. Clinical Bottom Line: There is moderate evidence to support the use of the FIFA 11+ program and Nordic hamstring exercise as part of a college soccer team’s warm-up routine. Strength of Recommendation: Grade B evidence exists in support of incorporating the FIFA 11+ program to reduce the incidence of hamstring injuries in male college soccer players.

scholarly journals Validity of an On-Field Readaptation Program Following a Hamstring Injury in Professional Soccer

2019 ◽  
Vol 28 (6) ◽  
Author(s):  
Sergio Jiménez-Rubio ◽  
Archit Navandar ◽  
Jesús Rivilla-García ◽  
Victor Paredes-Hernández
Keyword(s):  
Neuromuscular Control ◽  
Rehabilitation Program ◽  
Lower Limbs ◽  
Return To Play ◽  
Soccer Players ◽  
Hamstring Injury ◽  
Strength And Conditioning ◽  
Hamstring Strain ◽  
Professional Soccer ◽  
Hamstring Injuries

Context: Despite the presence of various injury prevention programs, the rate of hamstring injuries and reinjuries is increasing in soccer, warranting the need for a soccer-specific rehabilitation program. Objective: To develop and validate a new, functional on-field program for the rehabilitation and readaptation of soccer players after a hamstring strain injury through a panel of experts; and determine the usefulness of the program through its application in professional soccer players. Design: A 13-item program was developed, which was validated by a panel of experts and later applied to professional soccer players. Setting: Soccer training ground. Participants: Fifteen strength and conditioning and rehabilitation fitness coaches with a professional experience of 15.40 (1.57) years in elite clubs and national teams in Europe validated the program. The program was later applied to 19 professional soccer players of the Spanish First Division (La Liga). Interventions: Once a player sustained a clinically diagnosed injury, the player would first be subject to mobilization and strengthening exercises in the gym after undergoing treatment by percutaneous needle electrolysis. The player would then complete an on-field readaptation program consisting of 13 drills arranged in a progressive manner in terms of complexity. The drills integrated various aspects of repeated sprint abilities, retraining and reeducation of biomechanical patterns, and neuromuscular control of the core and lower limbs. Main Outcome Measures: Aiken’s V for each item of the program and number of days taken by the players to return to play. Results: The experts evaluated all items of the program very highly, as seen from Aiken’s V values between 0.78 and 0.98 (0.63–0.99) for all drills, while the return to play was in 22.42 (2.32) days. Conclusion: This program has the potential to help a player suffering from a hamstring strain injury to adapt to real-match conditions in the readaptation phase through the application of sports-specific drills that were very similar to the different injury mechanisms.

scholarly journals Potential prognostic factors for hamstring muscle injury in elite male soccer players: A prospective study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241127
Author(s):  
Ismet Shalaj ◽  
Masar Gjaka ◽  
Norbert Bachl ◽  
Barbara Wessner ◽  
Harald Tschan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Injury Rate ◽  
Strength Test ◽  
Soccer Players ◽  
Hamstring Injury ◽  
Isokinetic Strength ◽  
Injury Incidence ◽  
Functional Tests ◽  
Hamstring Injuries ◽  
Potential Risk Factors

Hamstring injuries remain the most common injury type across many professional sports. Despite a variety of intervention strategies, its incidence in soccer players playing in the UEFA Champions League has increased by 4% per year over the last decade. Test batteries trying to identify potential risk factors have produced inconclusive results. The purpose of the current study was to prospectively record hamstring injuries, to investigate the incidence and characteristics of the injuries, and to identify possible risk factors in elite male soccer players, playing in the Kosovo national premier league. A total of 143 soccer players from 11 teams in Kosovo were recruited. To identify possible prevalent musculoskeletal or medical conditions a widespread health and fitness assessment was performed including isokinetic strength testing, Nordic hamstring strength test, functional tests, and a comprehensive anamnesis surveying previous hamstring injuries. On average 27.9% of the players sustained at least one hamstring injury with three players suffering bilateral strains with the re-injury rate being 23%. Injured players were significantly older and heavier and had a higher body mass index compared to non-injured ones (p < 0.05). There was a lower passing rate in the Nordic hamstring strength test and a higher injury incidence among the previously injured players compared to non-injured ones (p < 0.05). Except for hamstring/quadriceps ratio and relative torque at 60°/sec (p < 0.05) for dominant and non-dominant leg, there were no other significant differences in isokinetic strength regardless of the angular velocity. No differences were observed for functional tests between cohorts. Regression analysis revealed that age, Nordic hamstring strength test, previous injury history, and isokinetic concentric torque at 240°/sec could determine hamstring injuries by 25.9%, with no other significant predicting risk factors. The battery of laboratory and field-based tests performed during preseason to determine performance related skills showed limited diagnostic conclusiveness, making it difficult to detect players at risk for future hamstring injuries.

scholarly journals Descriptive Epidemiology of Injuries in Professional Ultimate Frisbee Athletes

2020 ◽  
Vol 55 (2) ◽  
pp. 195-204 ◽  
Author(s):  
Matthew C. Hess ◽  
David I. Swedler ◽  
Christine S. Collins ◽  
Brent A. Ponce ◽  
Eugene W. Brabston
Keyword(s):  
Incidence Rate ◽  
Epidemiologic Study ◽  
Incidence Rates ◽  
Thigh Muscle ◽  
Surveillance Program ◽  
Injury Incidence ◽  
Descriptive Epidemiology ◽  
Injury Rates ◽  
Ultimate Frisbee ◽  
Rate Ratios

Context Injuries in professional ultimate Frisbee (ultimate) athletes have never been described. Objective To determine injury rates, profiles, and associated factors using the first injury-surveillance program for professional ultimate. Design Descriptive epidemiology study. Setting American Ultimate Disc League professional ultimate teams during the 2017 season. Patients or Other Participants Sixteen all-male teams. Main Outcome Measure(s) Injury incidence rates (IRs) were calculated as injuries per 1000 athlete-exposures (AEs). Incidence rate ratios were determined to compare IRs with 95% confidence intervals, which were used to calculate differences. Results We observed 299 injuries over 8963 AEs for a total IR of 33.36 per 1000 AEs. Most injuries affected the lower extremity (72%). The most common injuries were thigh-muscle strains (12.7%) and ankle-ligament sprains (11.4%). Running was the most frequent injury mechanism (32%). Twenty-nine percent of injuries involved collisions; however, the concussion rate was low (IR = 0.22 per 1000 AEs). Injuries were more likely to occur during competition and in the second half of games. An artificial turf playing surface did not affect overall injury rates (Mantel-Haenszel incidence rate ratio = 1.28; 95% confidence interval = 0.99, 1.67). Conclusions To our knowledge, this is the first epidemiologic study of professional ultimate injuries. Injury rates were comparable with those of similar collegiate- and professional-level sports.

No Relationship Between Hamstring Flexibility and Hamstring Injuries in Male Amateur Soccer Players: A Prospective Study

2016 ◽  
Vol 45 (1) ◽  
pp. 121-126 ◽  
Author(s):  
Mitchell C.M. van Doormaal ◽  
Nick van der Horst ◽  
Frank J.G. Backx ◽  
Dirk-Wouter Smits ◽  
Bionka M.A. Huisstede
Keyword(s):  
Multivariate Logistic Regression Analysis ◽  
Soccer Players ◽  
Hamstring Injury ◽  
Level Of Evidence ◽  
Hamstring Injuries ◽  
Hamstring Flexibility ◽  
A Prospective Study ◽  
The Relationship ◽  
Control Study

Background: In soccer, although hamstring flexibility is thought to play a major role in preventing hamstring injuries, the relationship between hamstring flexibility and hamstring injuries remains unclear. Purpose: To investigate the relationship between hamstring flexibility and hamstring injuries in male amateur soccer players. Study Design: Case-control study; Level of evidence, 3. Methods: This study included 450 male first-class amateur soccer players (mean age, 24.5 years). Hamstring flexibility was measured by performing the sit-and-reach test (SRT). The relationship between hamstring flexibility and the occurrence of hamstring injuries in the following year, while adjusting for the possible confounding effects of age and previous hamstring injuries, was determined with a multivariate logistic regression analysis. Results: Of the 450 soccer players, 21.8% reported a hamstring injury in the previous year. The mean (±SD) baseline score for the SRT was 21.2 ± 9.2 cm. During the 1-year follow-up period, 23 participants (5.1%) suffered a hamstring injury. In the multivariate analysis, while adjusting for age and previous injuries, no significant relationship was found between hamstring flexibility and hamstring injuries ( P = .493). Conclusion: In this group of soccer players, hamstring flexibility (measured with the SRT) was not related to hamstring injuries. Age and previous hamstring injuries as possible confounders did not appear to influence this relationship. Other etiological factors need to be examined to further elucidate the mechanism of hamstring injuries.

scholarly journals Hamstring injuries in elite Gaelic football: an 8-year investigation to identify injury rates, time-loss patterns and players at increased risk

2016 ◽  
Vol 52 (15) ◽  
pp. 982-988 ◽  
Author(s):  
Mark Roe ◽  
John C Murphy ◽  
Conor Gissane ◽  
Catherine Blake
Keyword(s):  
Management Strategies ◽  
Fold Increase ◽  
Hamstring Injury ◽  
Time Loss ◽  
Match Play ◽  
Injury Rates ◽  
Musculotendinous Junction ◽  
Hamstring Injuries ◽  
Increased Risk ◽  
Prevention Programmes

BackgroundHamstring injuries occur frequently in field sports, yet longitudinal information to guide prevention programmes is missing.AimInvestigate longitudinal hamstring injury rates and associated time loss in elite Gaelic football, while identifying subgroups of players at increased risk.Methods38 data sets from 15 elite male Gaelic football teams were received by the National Gaelic Athletic Association (GAA) Injury Surveillance Database between 2008 and 2015. Injury and exposure data were provided by the team's medical staff via an online platform.Results391 hamstring injuries were sustained accounting for 21% (95% CI 20.0% to 21.7%) of all injuries. Prevalence was 21% (95% CI 19.2% to 23.4%). Incidences were 2.2 (95% CI 1.9 to 2.4) per 1000 exposure hours, and 7.0 (95% CI 6.5 to 7.1) times greater in match play than in training. Typically each team sustained 9.0 (95% CI 7.0 to 11.0) hamstring injuries per season affecting the: bicep femoris belly (44%; 95% CI 39.4% to 48.7%); proximal musculotendinous junction (13%; 95% CI 9.8% to 16.3%); distal musculotendinous junction (12%; 95% CI 8.6% to 14.9%) and semimembranosis/semitendinosis belly (9%; 95% CI 6.3% to 11.7%). ∼36% (95% CI 31.5% to 41.0%) were recurrent injuries. Mean time loss was 26.0 (95% CI 21.1 to 33.0) days, which varied with age, injury type and seasonal cycle. Hamstring injuries accounted for 31% (95% CI 25.8% to 38.2%) of injury-related time loss. Previously injured players (rate ratio (RR)=3.3), players aged 18–20 years (IRR=2.3) or >30 years (RR=2.3), as well as defensive (IRR=2.0) and midfield players (RR=1.5), were most at risk of sustaining a hamstring injury. Comparisons of 2008–2011 with 2012–2015 seasons revealed a 2-fold increase in hamstring injury incidences. Between 2008 and 2015 training incidence increased 2.3-fold and match-play incidences increased 1.3-fold.ConclusionsHamstring injuries are the most frequent injury in elite Gaelic football, with incidences increasing from 2008–2011 to 2012–2015. Tailoring risk management strategies to injury history, age and playing position may reduce the burden of hamstring injuries.

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