Recurrent hamstring muscle injury: applying the limited evidence in the professional football setting with a seven-point programme

Abstract

Recurrent hamstring injuries are a major problem in sports such as football. The aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent hamstring injuries and examine the evidence for each intervention. A professional footballer sustained five hamstring injuries in a relatively short period of time. The injury was managed successfully with a seven-point programme-biomechanical assessment and correction, neurodynamics, core stability, eccentric strengthening, an overload running programme, injection therapies and stretching/relaxation. The evidence for each of these treatment options is reviewed. It is impossible to be definite about which aspects of the programme contributed to a successful outcome. Only limited evidence is available in most cases; therefore, decisions regarding the use of different treatment modalities must be made by using a combination of clinical experience and research evidence.

Keywords: Exercise Rehabilitation; Hamstring Injuries; Muscle Damage/Injuries; Soccer; Soft Tissue Injuries.

Figure 1

Axial T2-weighted image with fat saturation showing small region of muscle fibre disruption (arrows) reflecting grade 2 injury, involving aponeurosis of long head of biceps femoris.

Figure 2

Axial T2-weighted image with fat saturation showing interfascicular oedema (arrows) centrally reflecting grade 1 injury, in the long head of biceps femoris.

Figure 3

Axial T2-weighted image with fat saturation showing small region of muscle fibre disruption (arrows) reflecting grade 2 injury, involving the long head of biceps femoris with myofascial oedema.

Figure 4

Axial T2-weighted image showing interfascicular and myofascial oedema (arrows) reflecting grade 1 injury, involving the long and short heads of biceps femoris.