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. 2020 Sep 29;21(1):641.
doi: 10.1186/s12891-020-03658-8.

The mechanism of hamstring injuries - a systematic review

Adam Danielsson  1   2 , Alexandra Horvath  3 , Carl Senorski  1 , Eduard Alentorn-Geli  4   5   6 , William E Garrett  7 , Ramón Cugat  4   5   6 , Kristian Samuelsson  1   2 , Eric Hamrin Senorski  8   9
Affiliations

The mechanism of hamstring injuries - a systematic review

Adam Danielsson et al. BMC Musculoskelet Disord. .

Abstract

Background: Injuries to the hamstring muscles are among the most common in sports and account for significant time loss. Despite being so common, the injury mechanism of hamstring injuries remains to be determined.

Purpose: To investigate the hamstring injury mechanism by conducting a systematic review.

Study design: A systematic review following the PRISMA statement.

Methods: A systematic search was conducted using PubMed, EMBASE and the Cochrane Library. Studies 1) written in English and 2) deciding on the mechanism of hamstring injury were eligible for inclusion. Literature reviews, systematic reviews, meta-analyses, conference abstracts, book chapters and editorials were excluded, as well as studies where the full text could not be obtained.

Results: Twenty-six of 2372 screened original studies were included and stratified to the mechanism or methods used to determine hamstring injury: stretch-related injuries, kinematic analysis, electromyography-based kinematic analysis and strength-related injuries. All studies that reported the stretch-type injury mechanism concluded that injury occurs due to extensive hip flexion with a hyperextended knee. The vast majority of studies on injuries during running proposed that these injuries occur during the late swing phase of the running gait cycle.

Conclusion: A stretch-type injury to the hamstrings is caused by extensive hip flexion with an extended knee. Hamstring injuries during sprinting are most likely to occur due to excessive muscle strain caused by eccentric contraction during the late swing phase of the running gait cycle.

Level of evidence: Level IV.

Keywords: Biomechanics; Muscle injury; Running; Sprinting; Strength.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
The running gait cycle
Fig. 2
Fig. 2
The inclusion and exclusion of studies
See this image and copyright information in PMC

References

    1. Ekstrand J, Walden M, Hagglund M. Hamstring injuries have increased by 4% annually in men's professional football, since 2001: a 13-year longitudinal analysis of the UEFA elite Club injury study. Br J Sports Med. 2016;50(12):731–737. doi: 10.1136/bjsports-2015-095359. - DOI - PubMed
    1. Hagel B. Hamstring injuries in Australian football. Clin J Sport Med. 2005;15(5):400. doi: 10.1097/01.jsm.0000179227.01404.d3. - DOI - PubMed
    1. Roe M, Murphy JC, Gissane C, Blake C. Hamstring injuries in elite Gaelic football: an 8-year investigation to identify injury rates, time-loss patterns and players at increased risk. Br J Sports Med. 2016;52(15):982–8. - PubMed
    1. Edouard P, Branco P, Alonso JM. Muscle injury is the principal injury type and hamstring muscle injury is the first injury diagnosis during top-level international athletics championships between 2007 and 2015. Br J Sports Med. 2016;50(10):619–630. doi: 10.1136/bjsports-2015-095559. - DOI - PubMed
    1. Ahmad CS, Dick RW, Snell E, Kenney ND, Curriero FC, Pollack K, et al. Major and minor league baseball hamstring injuries: epidemiologic findings from the Major League Baseball injury surveillance system. Am J Sports Med. 2014;42(6):1464–1470. doi: 10.1177/0363546514529083. - DOI - PubMed

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