Hamstring Injury Treatment

The recent paper by Mendiguchía, et al.A Multifactorial, Criteria-based Progressive Algorithm for Hamstring Injury Treatment” is worth a blog piece. Here is the abstract:


Introduction: Given the prevalence of hamstring injuries in football, a rehabilitation program that effectively promotes muscle tissue repair and functional recovery is paramount to minimize re-injury risk and optimize player performance and availability.

Purpose: To assess the concurrent effectiveness of administering an individualized and multifactorial criteria-based algorithm (RA) on hamstring injury rehabilitation in comparison to employing a general rehabilitation protocol (RP).

Methods: Implementing a double-blind randomised controlled trial approach, two equal groups of 24 football players (48 total) completed either an RA group or a validated RP group five days following an acute hamstring injury.

Results: Within 6 months after return to sport, 6 hamstring re-injuries occurred in RP versus 1 in RA [relative risk = 6 (90% confidence interval: 1-35); clinical inference: very likely beneficial effect]. The average duration of return to sport was possibly quicker (ES=0.34+/-0.42) in RP (23.2+/-11.7 days) than in RA (25.5+/-7.8 days) (-13.8%, 90%CI: -34.0 to 3.4%; clinical inference: possibly small effect). At the time to return to sport, RA players showed substantially better 10-m time, maximal sprinting speed as well as greater mechanical variables related to speed (i.e., maximum theoretical speed and maximal horizontal power) than the RP.

Conclusions: Although return to sport was slower, male football players who underwent an individualized, multifactorial, criteria-based algorithm with a performance- and primary risk factor-oriented training program from the early stages of the process markedly decreased the risk of re-injury compared to a general protocol where long length strength training exercises were prioritized.

The full paper is available at ResearchGate.

Here are the exercises and progressions used in the study:

Make sure to follow Hamstring Rehab for the updates on the latest research about hamstring injuries rehab, prevention and return to sport.

Also, make sure to check Jack Hickey‘s paper: Criteria for Progressing Rehabilitation and Determining Return-to-Play Clearance Following Hamstring Strain Injury:A Systematic Review

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