Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 1;33(3):217-224.
doi: 10.1097/JSM.0000000000001109. Epub 2022 Nov 25.

Mechanisms of Hamstring Injury in Professional Soccer Players: Video Analysis and Magnetic Resonance Imaging Findings

Aleksi Jokela  1   2 , Xavier Valle  3   4 , Jussi Kosola  5 , Gil Rodas  3 , Lluís Til  6 , Maria Burova  7 , Pavel Pleshkov  7 , Håkan Andersson  8 , Giulio Pasta  9 , Paolo Manetti  9 , Gabriel Lupón  10 , Ricard Pruna  2 , Alvaro García-Romero-Pérez  11   12 , Lasse Lempainen  5   13
Affiliations

Mechanisms of Hamstring Injury in Professional Soccer Players: Video Analysis and Magnetic Resonance Imaging Findings

Aleksi Jokela et al. Clin J Sport Med. .

Abstract

Objective: To describe the injury mechanisms and magnetic resonance imaging (MRI) findings in acute hamstring injuries of male soccer players using a systematic video analysis.

Design: Descriptive case series study of consecutive acute hamstring injuries from September 2017 to January 2022.

Setting: Two specialized sports medicine hospitals.

Participants: Professional male soccer players aged between 18 and 40 years, referred for injury assessment within 7 days after an acute hamstring injury, with an available video footage of the injury and positive finding on MRI.

Independent variables: Hamstring injury mechanisms (specific scoring based on standardized models) in relation to hamstring muscle injury MRI findings.

Main outcome measures: Hamstring injury mechanism (playing situation, player/opponent behavior, movement, and biomechanical body positions) and MRI injury location.

Results: Fourteen videos of acute hamstring injuries in 13 professional male soccer players were analyzed. Three different injury mechanisms were seen: mixed-type (both sprint-related and stretch-related, 43%), stretch-type (36%), and sprint-type (21%). Most common actions during injury moments were change of direction (29%), kicking (29%), and running (21%). Most injuries occurred at high or very high horizontal speed (71%) and affected isolated proximal biceps femoris (BF) (36%). Most frequent body positions at defined injury moments were neutral trunk (43%), hip flexion 45-90 degrees (57%), and knee flexion <45 degrees (93%). Magnetic resonance imaging findings showed that 79% were isolated single-tendon injuries.

Conclusions: According to a video analysis, most hamstring injuries in soccer occur during high-speed movements. Physicians should suspect proximal and isolated single-tendon-most often BF-hamstring injury, if represented injury mechanisms are seen during game play. In addition to sprinting and stretching, also mixed-type injury mechanisms occur.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1.
Figure 1.
Assumed injury frames and MRI findings in sprint-type injuries. A, Case 4, proximal BF injury. B, Case 2, proximal BF injury. C, Case 3, proximal BF injury.
Figure 2.
Figure 2.
Assumed injury frames and MRI findings in stretch-type injuries. A, Case 8, distal SM injury. B, Case 11, distal BF injury of the MTJ. C, Case 12, proximal BF + ST avulsion. D, Case 13, proximal SM injury. E, Case 14, proximal BF + ST avulsion. MTJ, myotendinous junction
Figure 3.
Figure 3.
Assumed injury frames and MRI findings in mixed-type injuries. A, Case 1, proximal BF injury. B, Case 5, mid-thigh SM injury. C, Case 6, distal BF avulsion. D, Case 7, proximal BF + ST avulsion. E, Case 9, proximal BF injury. F, Case 10, distal ST injury of the MTJ. MTJ, myotendinous junction
See this image and copyright information in PMC

References

    1. Dalton SL, Kerr ZY, Dompier TP. Epidemiology of hamstring strains in 25 NCAA sports in the 2009-2010 to 2013-2014 academic years. Am J Sports Med. 2015;43:2671–2679. - PubMed
    1. Ekstrand J, Hägglund M, Waldén M. Epidemiology of muscle injuries in professional football (soccer). Am J Sports Med. 2011;39:1226–1232. - PubMed
    1. Vidoni A, Gillett M, Botchu R, et al. . Lower limb muscle injuries: the good, the bad and the ugly. Eur J Radiol. 2018;104:101–107. - PubMed
    1. Askling C, Saartok T, Thorstensson A. Type of acute hamstring strain affects flexibility, strength, and time to return to pre-injury level. Br J Sports Med. 2006;40:40–44. - PMC - PubMed
    1. Opar DA, Drezner J, Shield A, et al. . Acute hamstring strain injury in track-and-field athletes: a 3-year observational study at the Penn Relay Carnival. Scand J Med Sci Sports. 2013;24:e254–e259. - PubMed