Late swing or early stance? A narrative review of hamstring injury mechanisms during high‐speed running

The influence of injuries on team performance in football has only been scarcely investigated.

This review article summarizes the current literature regarding the analysis of running gait. It is compared to walking and sprinting. The current state of knowledge is presented as it fits in the context of the history of analysis of movement. The characteristics of the gait cycle and its relationship to potential and kinetic energy interactions are reviewed. The timing of electromyographic activity is provided. Kinematic and kinetic data (including center of pressure measurements, raw force plate data, joint moments, and joint powers) and the impact of changes in velocity on these findings is presented. The status of shoewear literature, alterations in movement strategies, the role of biarticular muscles, and the springlike function of tendons are addressed. This type of information can provide insight into injury mechanisms and training strategies. Copyright 1998 Elsevier Science B.V.

To conduct a detailed analysis of hamstring injuries sustained in English professional football over two competitive seasons. Club medical staff at 91 professional football clubs annotated player injuries over two seasons. A specific injury audit questionnaire was used together with a weekly form that documented each clubs' current injury status. Completed injury records for the two competitive seasons were obtained from 87% and 76% of the participating clubs respectively. Hamstring strains accounted for 12% of the total injuries over the two seasons with nearly half (53%) involving the biceps femoris. An average of five hamstring strains per club per season was observed. A total of 13 116 days and 2029 matches were missed because of hamstring strains, giving an average of 90 days and 15 matches missed per club per season. In 57% of cases, the injury occurred during running. Hamstring strains were most often observed during matches (62%) with an increase at the end of each half (p<0.01). Groups of players sustaining higher than expected rates of hamstring injury were Premiership (p<0.01) and outfield players (p<0.01), players of black ethnic origin (p<0.05), and players in the older age groups (p<0.01). Only 5% of hamstring strains underwent some form of diagnostic investigation. The reinjury rate for hamstring injury was 12%. Hamstring strains are common in football. In trying to reduce the number of initial and recurrent hamstring strains in football, prevention of initial injury is paramount. If injury does occur, the importance of differential diagnosis followed by the management of all causes of posterior thigh pain is emphasised. Clinical reasoning with treatment based on best available evidence is recommended.