Hamstring Strains in Football. Prevention and Rehabilitation Rules. Systematic Review

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Hamstring Strains in Football. Prevention and Rehabilitation Rules. Systematic Review

Journal Title: Biology of Exercise - Year 2016, Vol 12, Issue 1

Abstract

The strain on the hamstrings muscles is one of the most common sport related injury and football seems to hold the biggest percentage of all sports. The aim of this study was to push forward the best prevention and rehabilitation methods to be followed regarding football. Once the key words were identified, there was a randomized search of controlled trials on EBSCO Host, Proquest, Medline, SportDiscus, Cinahl Plus, health source, FreeMedicalJournals.com, PubMed, PubMed Central, SPORTDiscus database and on Google Scholar. In addition, the software H Publish or Perish helped in the process of searching. The particular studies were tested based on the criteria of admission and exclusion that were set and selected as the most appropriate ones for the review. The methodological process of the studies was assessed by Furlan et al (22) criteria and the classification for the level of the evidence of this systematic review was done using the 6 level table of Van Tulden et al (55). Twenty nine randomized controlled trials were selected, with a total of 10686 participants that were placed in the review. Twenty four out of these were related to preventing hamstring strain (6 eccentric exercises, 11 neuromuscular training programs, 7 stretching) and 5 of these rehabilitation (1 eccentric exercise, 2 neuromuscular warm up training programs, 2 stretching). According to Furlan et al (22) all the studies were marked over 50%. Moreover, based on the classification for the level of evidence of Van Tulden et al (55) the eccentric exercises and the different types of neuromuscular warm up programs ( except FIFA 11) are classified in level 1 with positive findings within multiple randomized controlled trials, regarding prevention as well as rehabilitation. As far as prevention is concerned, stretching are classified in level 5, whereas, as far as rehabilitation is concerned they are classified in level 2, since there is an indication of the Slump test effectiveness. Conclusions: 1) As far as prevention is concerned: eccentric exercises and any neuromuscular training programs that include stabilization core exercises, quadriceps eccentric exercises and hamstring eccentric exercises, balance as well as flexibility exercises play an important role in reducing the occurrence of hamstring strain, while stretching exercises do not play an important role, yet they do improve the range of motion. 2) As far as rehabilitation is concerned: eccentric exercises and any neuromuscular training programs that include progressive running, eccentric as well as balance exercises, flexibility and stabilization programs play a major role in restoring the hamstring strain faster without risking recurrence. With regard to stretching, evidence indicate that the Slump test can be effective in terms of fast recovery, however further research is required to establish the validity of these results.

Authors and Affiliations

ATHANASIOU HADJIMICHAEL MICHALIS| Physiotherapist, MA; Physiotherapy Program, Dep. of Health Sciences, School of Sciences, European University, Nicosia, Cyprus, STERGIOULAS APOSTOLOS| Faculty of Human Movement & Quality of Life, Peloponnese University, Sparta, Laconia, Greece

Keywords

EP ID EP15883
DOI http: doi.org/10.4127/jbe.2016.0104
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