I. Stablo1, T. Martin1, M. Zirr2, R. Prill3
1Brandenburg University of Technology Cottbus - Senftenberg, Therapy Sciences, Senftenberg, Germany, 2P3 - Physio Praxis Prill, Sports Physiotherapy, Zeuthen, Germany, 3Brandenburg Medical School Theodor Fontane, Orthopedics and Traumatology, Brandenburg / Havel, Germany
Background: The most common individual diagnosis among professional football players is hamstring strain or rupture of the hamstring muscle fibres. This kind of injury is mainly based on intrinsic factors such as structural overload which accounts for 17% of all moderate and severe competition injuries. Following knee and ankle joint, hamstrings are the third most common structure to suffer from injuries. As previous reviews show, eccentric training, such as the Nordic Hamstring Exercise (NHE), can reduce hamstring injuries. However, in those reviews other sports in addition to soccer were also examined in one sample.
Purpose: The aim of this review is to synthesize the best available evidence on the effectiveness of the NHE as an intervention in the prevention of hamstring injuries in soccer players.
Methods: The search for the studies was done in the PubMed, PEDro, Cochrane Library and EB-SCO databases. There was no language or time restrictions. Titles, abstracts and full texts of the respective studies were verified by two independent reviewers and selected using the inclusion criteria. In addition, critical evaluation tools were used to assess the methodological qualities of the respective studies followed by data extraction in JBI SUMARI. Meta-analysis was performed.
Results: Four studies were included in this systematic review. Three studies compared NHE as an intervention with conventional football training and one study conducted hamstring curls as a control intervention. The duration of the studies ranged from 2.5 to 6.75 months, with a total of 28312 NHE sessions and 25918 training sessions in the control groups. The intervention groups showed a total of 30 hamstring injuries and the control groups developed a total of 80 injuries. A sample of 1780 soccer players were examined, 909 in the intervention groups and 871 in the control groups. The overall mean odds' ratio was significantly below one (95% CI, P= 0.335). The probability of suffering a hamstring injury was between 0.22 and 0.53 times lower in the intervention group than in the control group. The test for heterogeneity showed no significance (I² = 9).
Conclusion(s): The NHE can help to reduce hamstring injuries in football players. However, due to the small number of studies included, the result should be interpreted with caution and more clinical studies should be conducted in the future.
Implications: Looking at the total number of days lost per player in a season, professional football has a total of approximately 25,900 days lost, which is three times more than in other sports. Every injury is associated with lost time and additional costs. This review aimed to examine a cost-efficient exercise for its preventive effect. To counteract injuries in soccer and the factors associated with them,. showing chances to reach those goals.
Funding, acknowledgements: none
Keywords: Hamstring injuries, muscle injuries, Soccer
Topic: Sport & sports injuries
Did this work require ethics approval? No
Institution: P3 - Physio Praxis Prill
Committee: P3 - Physio Praxis Prill
Reason: It is a systematic review and does not need any ethical approval.
All authors, affiliations and abstracts have been published as submitted.
