Centre for Sports Science and Human Performance, School of Science, University of Greenwich at Medway, Central Avenue, Chatham Maritime, Kent, ME4 4TB, United Kingdom
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Hamstring strains are the most prevalent non-contact injury associated with participation in sports. In addition to the anatomical and functional characteristics of the hamstrings, such as the biarticular organisation or the dual innervations of biceps femoris, a number of alterable and non-alterable factors have been associated with the risk of hamstring injuries in athletes. Each of these variables would impact upon hamstring injury risk within an integrated approach, by which the possibility of sustaining an injury can vary depending on the particular circumstances of each athlete. The aim of this critical review is to examine the effects of current preventative exercise protocols and to provide basic guidelines for hamstring injury prevention in athletes.
Hamstring injuries occur during high-speed actions or extreme stretching; therefore, in order to prevent the incidence of these types of injuries, specific active lengthening, stretching exercises or sports-specific drills have been integrated into regular training programmes. The response to these intervention programmes has shown mixed results. A conceptual framework is presented proposing that an effective injury prevention programme should include a combination of different specific and non-specific exercises. In addition, special consideration should be given to those eccentric exercises performed over a large muscle lengths and also emphasise the knee stabilising co-contraction actions of the hamstring.
The protective effects elicited by a well-designed preventive programme could be obtained in four weeks, with only two sessions per week involving three sets of six to eight repetitions of three open- and closed-kinetic chain exercises.
Future research should analyse the specific structural and functional modifications elicited by the regular application of different types of exercises and protocols aimed to reduce the risk of hamstring injury.