Hamstring strain injury



A significant rate of hamstring strain injury (HSI) has been observed in soccer (Hägglund et al. 2009), Gaelic football (Wilson et al. 2007) and Australian football (Saw et al. 2018). Following a return to sport, hamstring re-injury rates are high (Roe et al. 2016, Wangensteen et al. 2016) and result in a significant amount of injury-related time loss (Roe et al. 2018).

The aetiology of hamstring injuries is multi-factorial in nature and are thought to be the result of the interaction between several non-modifiable and modifiable risk factors (Mendiguchia et. al 2012). Emphasis has been placed on modifiable risk factors as these have the scope to be altered to reduce injury, by implementing injury reduction strategies (Meeuwisse, 1991). Of these risk factors, eccentric strength has received most attention (Croiser et al. 2008, Sugiura et al. 2008, Yeung et al. 2009).

The NordBord (Vald performance, Australia) has been shown to reliably measure eccentric knee flexor forces during the Nordic hamstring exercise (Opar et al. 2013). Opar et al. (2014) used measures derived from this device to predict athlete’s risk of future HSI. They found that 28 players with low eccentric hamstring strength in pre-season were significantly more likely to sustain a HSI in the subsequent competitive season.

Targeting modifiable risk factors such as eccentric strength in training programmes could have significant implications in injury reduction strategies. A recent systematic review and meta-analysis of 8459 athletes revealed a 50% reduction in HSI when the NHE was introduced as preventative training (van Dyk et al. 2019).

Figure 1. NordBord Hamstring Testing System

Author: Aiveen Lavery

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