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Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study
  1. Ryan G Timmins1,
  2. Matthew N Bourne2,
  3. Anthony J Shield2,
  4. Morgan D Williams3,
  5. Christian Lorenzen1,
  6. David A Opar1
  1. 1School of Exercise Science, Australian Catholic University, Melbourne, Australia
  2. 2School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
  3. 3School of Health, Sport and Professional Practice, University of South Wales, Pontypridd, Wales, UK
  1. Correspondence to Ryan G Timmins, School of Exercise Science, Australian Catholic University, 115 Victoria Parade, Fitzroy, Melbourne 3065, Victoria, Australia; Ryan.Timmins{at}acu.edu.au

Abstract

Background/aim To investigate the role of eccentric knee flexor strength, between-limb imbalance and biceps femoris long head (BFlh) fascicle length on the risk of future hamstring strain injury (HSI).

Methods Elite soccer players (n=152) from eight different teams participated. Eccentric knee flexor strength during the Nordic hamstring exercise and BFlh fascicle length were assessed at the beginning of preseason. The occurrences of HSIs following this were recorded by the team medical staff. Relative risk (RR) was determined for univariate data, and logistic regression was employed for multivariate data.

Results Twenty seven new HSIs were reported. Eccentric knee flexor strength below 337 N (RR=4.4; 95% CI 1.1 to 17.5) and possessing BFlh fascicles shorter than 10.56 cm (RR=4.1; 95% CI 1.9 to 8.7) significantly increased the risk of a HSI. Multivariate logistic regression revealed significant effects when combinations of age, history of HSI, eccentric knee flexor strength and BFlh fascicle length were explored. From these analyses the likelihood of a future HSI in older athletes or those with a HSI history was reduced if high levels of eccentric knee flexor strength and longer BFlh fascicles were present.

Conclusions The presence of short BFlh fascicles and low levels of eccentric knee flexor strength in elite soccer players increases the risk of future HSI. The greater risk of a future HSI in older players or those with a previous HSI is reduced when they have longer BFlh fascicles and high levels of eccentric strength.

  • Prospective
  • Muscle injury

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