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Gronwald T, Klein C, Hoenig T, Pietzonka M, Bloch H, Edouard P, Hollander K. Hamstring injury patterns in professional male football (soccer): a systematic video analysis of 52 cases. Br J Sports Med 2021; 56:165-171. [PMID: 34876406 DOI: 10.1136/bjsports-2021-104769] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To closely describe the injury inciting events of acute hamstring injuries in professional male football (soccer) using systematic video analysis. METHODS Video footage from four seasons (2014-2019) of the two highest divisions in German male football was searched for moderate and severe (ie, time loss of >7 days) acute non-contact and indirect contact match hamstring injuries. Two raters independently categorised inciting events using a standardised procedure to determine specific injury patterns and kinematics. RESULTS 52 cases of hamstring injuries were included for specific pattern analysis. The pattern analysis revealed 25 sprint-related (48%) and 27 stretch-related hamstring injuries (52%). All sprint-related hamstring injuries occured during linear acceleration or high-speed running. Stretch-related hamstring injuries were connected with closed chain movements like braking or stopping with a lunging or landing action and open chain movements like kicking. The kinematic analysis of stretch-related injuries revealed a change of movement involving knee flexion to knee extension and a knee angle of <45° at the assumed injury frame in all open and closed chain movements. Biceps femoris was the most affected muscle (79%) of all included cases. CONCLUSION Despite the variety of inciting events, rapid movements with high eccentric demands of the posterior thigh are likely the main hamstring injury mechanism. This study provides important data about how hamstring injuries occur in professional male football and supports the need for demand-specific multicomponent risk reduction programmes.
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Affiliation(s)
- Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Christian Klein
- Department of Sports Injury Prevention, VBG, German Statutory Accident Insurance for the Administrative Sector, Hamburg, Germany
| | - Tim Hoenig
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Micha Pietzonka
- Department of Sports Injury Prevention, VBG, German Statutory Accident Insurance for the Administrative Sector, Hamburg, Germany
| | - Hendrik Bloch
- Department of Sports Injury Prevention, VBG, German Statutory Accident Insurance for the Administrative Sector, Hamburg, Germany
| | - Pascal Edouard
- Inter-university Laboratory of Human Movement Sciences (LIBM EA 7424), University of Lyon, University Jean Monnet, Saint Etienne, France.,Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
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Huygaerts S, Cos F, Cohen DD, Calleja-González J, Pruna R, Alcaraz PE, Blazevich AJ. Does Muscle-Tendon Unit Structure Predispose to Hamstring Strain Injury During Running? A Critical Review. Sports Med 2020; 51:215-224. [PMID: 33368028 DOI: 10.1007/s40279-020-01385-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 12/26/2022]
Abstract
Hamstring strain injury (HSI) remains the most common muscle injury in high-intensity running in humans. The majority of acute HSI occur specifically within the proximal region of the long head of biceps femoris and there is a sustained interest among researchers in understanding the factors that predispose to HSI. The present critical review describes the current understanding of biceps femoris long head (BFlh) structural features that might influence strain injury risk. Inter-individual differences in muscle-tendon architecture and interactions, muscle fiber type and region-specific innervation are likely to influence biceps femoris long head injury risk and might inform why some individuals are at an increased risk of sustaining a HSI during running. However, more research is needed, with future studies focusing on prospective data acquisition, improved computer simulations and direct imaging techniques to better understand the relationship between structural features, hamstring muscle function, and injury risk.
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Affiliation(s)
- Shaun Huygaerts
- UCAM Research Center for High Performance Sport, Catholic University San Antonio, 30830, Murcia, Spain.,Royal Antwerp Football Club, Oude Bosuilbaan 54A, 2100, Deurne, Belgium
| | - Francesc Cos
- Manchester City Football Club, Etihad Stadium, Manchester, M11 3 FF, UK.,National Institute of Physical Education of Catalonia (INEFC), Barcelona Center, University of Barcelona, Barcelona, Spain
| | - Daniel D Cohen
- Masira Institute, University of Santander (UDES), Bucaramanga, Colombia.,Sports Science Center (CCD), Colombian Ministry of Sport (Mindeporte), Bogotá, Colombia
| | - Julio Calleja-González
- Department of Physical Education and Sport, Faculty of Education and Sport, University of the Basque Country, 01007, Vitoria, Spain
| | - Ricard Pruna
- Physician of Football Club Barcelona, Arístides Maillol s/n, 08028, Barcelona, Spain
| | - Pedro E Alcaraz
- UCAM Research Center for High Performance Sport, Catholic University San Antonio, 30830, Murcia, Spain
| | - Anthony J Blazevich
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.
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Sugimoto D, Kelly BD, Mandel DL, d'Hemecourt DA, Carpenito SC, d'Hemecourt CA, d'Hemecourt PA. Running Propensities of Athletes with Hamstring Injuries. Sports (Basel) 2019; 7:sports7090210. [PMID: 31547307 PMCID: PMC6784223 DOI: 10.3390/sports7090210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/29/2019] [Accepted: 09/04/2019] [Indexed: 11/16/2022] Open
Abstract
The current study aims to compare the mechanical propensities between healthy runners and runners with hamstring injuries. Retrospective case-control video analysis was used. A total of 35 (12 male and 23 female) videos of runners with hamstring injuries were compared with videos of sex-, age-, mass-, and height-matched healthy control runners. The main outcome variables were trunk posture angles, overstride angles, and foot strike patterns. An independent t-test and chi-squared tests were employed to analyze the main outcome variables between the runners with hamstring injuries and the healthy control runners. The statistical significance of less than 0.05 (p < 0.05) was used. The runners with hamstring injuries had a 1.6° less forward-trunk posture angles compared with the healthy control runners (p = 0.043). Also, the runners with hamstring injuries demonstrated a 4.9° greater overstride angles compared with the healthy control runners (p = 0.001). Finally, the runners with hamstring injuries had a tendency of rearfoot strike, while the healthy control runners showed a forefoot strike pattern (p = 0.004). In conclusion, the runners with hamstring injuries demonstrated different running mechanical propensities compared with the healthy runners.
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Affiliation(s)
- Dai Sugimoto
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA 02115, USA.
- The Micheli Center for Sports Injury Prevention, Waltham, MA 02453, USA.
- Harvard Medical School, Boston, MA 02115, USA.
| | - Brian D Kelly
- Orthopedic Surgery & Sports Medicine, Phoenix Children's Hospital, Phoenix, AZ 85016, USA.
| | - David L Mandel
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA 02115, USA.
| | - Duncan A d'Hemecourt
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA 02115, USA.
| | - Sara C Carpenito
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA 02115, USA.
- The Micheli Center for Sports Injury Prevention, Waltham, MA 02453, USA.
| | - Charles A d'Hemecourt
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA 02115, USA.
| | - Pierre A d'Hemecourt
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA 02115, USA.
- The Micheli Center for Sports Injury Prevention, Waltham, MA 02453, USA.
- Harvard Medical School, Boston, MA 02115, USA.
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