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Evidence-based hamstring injury prevention is not adopted by the majority of Champions League or Norwegian Premier League football teams: the Nordic Hamstring survey
  1. Roald Bahr1,2,
  2. Kristian Thorborg3,4,
  3. Jan Ekstrand5
  1. 1Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
  2. 2Department of Sports Medicine, Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  3. 3Department of Orthopedic Surgery, Sports Orthopedic Research Center-Copenhagen (SORC-C), Amager-Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark
  4. 4Physical Medicine and Rehabilitation-Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark
  5. 5Football Research Group, Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  1. Correspondence to Professor Roald Bahr, Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, PB 4014 Ullevål Stadion, Oslo 0806, Norway; roald{at}nih.no

Abstract

Background The Nordic hamstring (NH) exercise programme was introduced in 2001 and has been shown to reduce the risk of acute hamstring injuries in football by at least 50%. Despite this, the rate of hamstring injuries has not decreased over the past decade in male elite football.

Aim To examine the implementation of the NH exercise programme at the highest level of male football in Europe, the UEFA Champions League (UCL), and to compare this to the Norwegian Premier League, Tippeligaen, where the pioneer research on the NH programme was conducted.

Design Retrospective survey.

Setting/participants 50 professional football teams, 32 from the UCL and 18 from Tippeligaen.

Methods A questionnaire, based on the Reach, Efficacy, Adoption, Implementation and Maintenance framework, addressing key issues related to the implementation of the NH programme during three seasons from 2012 through 2014, was distributed to team medical staff using electronic survey software.

Results The response rate was 100%. Of the 150 club-seasons covered by the study, the NH programme was completed in full in 16 (10.7%) and in part in an additional 9 (6%) seasons. Consequently, 125 (83.3%) club-seasons were classified as non-compliant. There was no difference in compliance between the UCL and Tippeligaen in any season (χ2: 0.41 to 0.52).

Conclusions Adoption and implementation of the NH exercise programme at the highest levels of male football in Europe is low; too low to expect any overall effect on acute hamstring injury rates.

  • Lowever extremity
  • Football
  • Injuries
  • Implementation

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