Citation

Clin. J. Sport. Med. 2012; 22(1): 75.

Copyright

(Copyright © 2012, Canadian Academy of Sport Medicine, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/01.jsm.0000410962.83723.98

PMID

22228290

Abstract

OBJECTIVE: To identify risk factors for hamstring injury among subelite adult male soccer players. DESIGN: Cohort study. SETTING: Community study in 2004 of Norwegian first, second, and third division men's amateur soccer teams in the Oslo area. PARTICIPANTS: Of 35 teams (769 players) in the 3 divisions invited to participate, 31 teams (508 players) agreed to take part, could speak Norwegian, and completed the study. ASSESSMENT OF RISK FACTORS: Preseason clinical testing was done by sports physical therapists and physicians without knowledge of the player's history of injuries. The examination included assessment of hip range of motion; pain on palpation of the hamstrings, iliopsoas, and psoas muscles; measurement of the hamstring length; and the Nordic hamstring strength test. In this test, the player kneels and then lowers his straight body toward the floor as far as possible. The hamstrings were classified as strong if the player was able to hold the body at ≥30 degrees of forward flexion. In addition, uninjured players did 3 countermovement jumps and 2 sprint tests (40 m). Players completed questionnaires on age, height, and weight; playing history; and history and severity of previous hamstring injuries. They also completed a function score for the hamstrings (HaOS) adapted from the Knee Injury and Osteoarthritis Outcome Score that included scales for symptoms, pain, soreness, function in sports, and quality of life. MAIN OUTCOME MEASURES: The main end point of the study was the association of measured risk factors with acute and overuse muscle injuries to the posterior thigh that occurred as a result of play during a soccer match or training, that made the player seek medical assistance, and that required the player to miss full participation in future training or match play. Injury reporting was done by a team physiotherapist. Hamstring injuries were classified as such by 2 investigators blinded to risk factor information. Overuse injuries that caused continuing pain but not time loss were also included. Coaches recorded attendance at training and minutes of match participation. MAIN RESULTS: The incidence of hamstring injuries per 1000 playing hours was 0.7, 1.8 during matches and 0.3 during training, for a total of 76 hamstring injuries (40 on the right and 36 on the left side) that affected 65 legs and 61 players (12.0%). Thirteen players sustained ≥2 hamstring injuries. There were 51 acute and 25 overuse injuries. In univariate analysis, previous acute hamstring injury, worse HaOS function scores, older age, and player position were associated with hamstring injury (P < 0.10). In multivariate logistic regression, only previous acute hamstring injury [adjusted odds ratio (AOR), 2.19; 95% confidence interval (CI), 1.19-4.03] independently predicted hamstring injuries. CONCLUSIONS: Subelite adult male soccer players with a history of acute hamstring injury were twice as likely to sustain a new hamstring injury. Performance and strength tests, anthropomorphic characteristics, and clinical findings did not predict risk for hamstring injury.

Language: en