Skip to main content

Advertisement

SpringerLink
Log in

Recurrent Posterior Thigh Symptoms Detrimental to Performance in Rugby Union

Predisposing Factors

  • Injury Clinic
  • Published:
Sports Medicine Aims and scope Submit manuscript

Abstract

Recurrent hamstring injury is a very common problem in rugby union, but has been largely ignored in the literature. It is concluded that a multifactorial aetiology may be present, and that these symptoms may be part of a continuum of symptoms that may lead to more serious injuries. Effective management needs to focus not just locally, but include proximal issues such as lumbo-pelvic stability and correcting lumbar spine dysfunction. The factors addressed in a prevention programme are likely to contribute to performance gains.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Finch CF. An overview of some definitional issues for sports injury surveillance. Sports Med 1997; 24 (3): 158–63

    Article  Google Scholar 

  2. van Mechelen W, Hlobil H, Kemper HCG. Incidence, severity, etiology and prevention of sports injuries. Sports Med 1992; 14 (2): 82–99

    Article  PubMed  Google Scholar 

  3. Wekesa M, Asembo JM, Njororai WWS. Injury surveillance in a Rugby tournament. Br J Sports Med 1996; 30: 61–3

    Article  PubMed  CAS  Google Scholar 

  4. Dixon G. Morbidity of rugby union injuries in New Zealand. N Z J Sports Med 1993; 21 (2): 18–20

    Google Scholar 

  5. Seward H, Orchard J, Hazard H, et al. Football injuries in Australia at the elite level. Med J Aust 1993; 159 (5): 298–301

    PubMed  CAS  Google Scholar 

  6. Familton N. All Blacks 1987: injuries and the World Cup. N Z J Sports Med 1989; 17 (4): 57–8

    Google Scholar 

  7. Lysens RJ, de Weerdt W, Nieuwboer A. Factors associated with injury proneness. Sports Med 1991; 12 (5): 281–9

    Article  PubMed  CAS  Google Scholar 

  8. Garraway M, Macleod D. Epidemiology of rugby football injuries. Lancet 1995; 345 (8963): 1485–7

    Article  PubMed  CAS  Google Scholar 

  9. Dalley DR, Laing DR, McCartin PJ. Injuries in rugby football, Christchurch 1989. N Z J Sports Med 1992; 20 (1): 2–5

    Google Scholar 

  10. Kauffman T. Rugby injuries sustained during tournament play. J Orthop Sports Phys Ther 1985; 7 (1): 16–19

    PubMed  CAS  Google Scholar 

  11. Lee AJ, Garraway WM. Epidemiological comparison of injuries in school and senior club rugby. Br J Sports Med 1996; 30: 213–17

    Article  PubMed  CAS  Google Scholar 

  12. Lower T. Injury data collection in the rugby codes. Aust J Sci Med Sport 1995; 27 (2): 43–7

    Google Scholar 

  13. Dalley DR, Laing DR, Rowberry JM, et al. Rugby injuries: an epidemiological survey, Christchurch 1980. N Z J Sports Med 1980; 10 (3): 5–17

    Google Scholar 

  14. Roux CE, Goedeke R, Visser GR, et al. The epidemiology of schoolboy rugby injuries. S Afr Med J 1987; 71: 307–13

    PubMed  CAS  Google Scholar 

  15. Gerrard DF, Waller AE, Bird YN. The New Zealand rugby injury and performance project: II. Previous injury experience of a rugby-playing cohort. Br J Sports Med 1994; 28 (4): 229–33

    Article  PubMed  CAS  Google Scholar 

  16. Williams PL, editor. Gray’s anatomy. 38th ed. London: Churchill Livingstone, 1995

    Google Scholar 

  17. Pool-Goudzwaard AL, Vleeming A, Stoeckart R, et al. Insufficient lumbopelvic stability: a clinical, anatomical and biomechanical approach to ‘a-specific’ low back pain. Manual Ther 1998; 3 (1): 12–20

    Article  Google Scholar 

  18. Kendall HO, Kendall FP, Wadsworth GE. Tests for length of hamstring muscles. In: Kendall HO, Kendall FP, Wadsworth GE, editors. Muscles: testing and function. 2nd ed. Baltimore (MD): Williams & Wilkins, 1971: 165–7

    Google Scholar 

  19. Kornberg C, Lew P. The effect of stretching neural structures on grade one hamstring strains. J Orthop Sports Phys Ther 1989; 13: 481–7

    Google Scholar 

  20. Gajdosik RL, Rieck MA, Sullivan DK, et al. Comparison of four clinical tests for assessing hamstring muscle length. J Orthop Sports Phys Ther 1993; 18 (5): 614–18

    PubMed  CAS  Google Scholar 

  21. Gajdosik R, Lusin G. Hamstring muscle tightness: reliability of an active-knee-extension test. Phys Ther 1983; 63 (7): 1085–90

    PubMed  CAS  Google Scholar 

  22. Breig A, Troup JG. Biomechanical considerations in the straight-leg-raising test: cadaveric and clinical studies of the effects of medial hip rotation. Spine 1979; 4 (3): 242–9

    Article  PubMed  CAS  Google Scholar 

  23. Butler DS. Mobilisation of the nervous system. 1st ed. Melbourne: Churchill Livingstone, 1991

    Google Scholar 

  24. Maitland G. Vertebral manipulation. 5th ed. London: Butterworth & Co, 1986

    Google Scholar 

  25. Sihvonen T. Flexion relaxation of the hamstring muscles during lumbar-pelvic rhythm. Arch Phys Med Rehabil 1997; 78 (5): 486–90

    Article  PubMed  CAS  Google Scholar 

  26. Esola MA, McClure PW, Fitzgerald GK, et al. Analysis of lumbar spine and hip motion during forward bending in subjects with and without a history of low back pain. Spine 1996; 21 (1):71–8

    Article  PubMed  CAS  Google Scholar 

  27. Richardson CA, Jull GA. Muscle control — pain control: what exercises would you prescribe? Manual Ther 1995; 1: 2–10

    Article  CAS  Google Scholar 

  28. O’Sullivan PB, Twomey L, Allison GT. Dysfunction of the neuro-muscular system in the presence of low back pain: implications for physical therapy management. J Manual Manipulative Ther 1997; 5 (1): 20–6

    Google Scholar 

  29. O’Sullivan PB, Twomey L, Allison GT. Altered abdominal muscle recruitment in patients with chronic back pain following a specific exercise intervention. J Orthop Sports Phys Ther 1998; 27 (2): 114–24

    PubMed  Google Scholar 

  30. Turl SE, George KP. Adverse neural tension: a factor in repetitive hamstring strain. J Orthop Sports Phys Ther 1998; 27 (1): 16–21

    PubMed  CAS  Google Scholar 

  31. Orava S, Rantanen J, Kujala UJ. Fasciotomy of the posterior femoral muscle compartment in athletes. Int J Sports Med 1998; 19 (1): 71–5

    Article  PubMed  CAS  Google Scholar 

  32. Zuluaga M, Briggs C, Carlisle J, et al., editors. Sports physiotherapy: applied science and practice. 1st ed. Melbourne: Churchill Livingstone, 1995

    Google Scholar 

  33. Puranen J, Orava S. The hamstring syndrome: a new diagnosis of gluteal sciatic pain. Am J Sports Med 1988; 16 (5): 517–21

    Article  PubMed  CAS  Google Scholar 

  34. Garrett WE, Nikolaou PK, Ribbeck BM, et al. The effect of muscle architecture on the biomechanical failure properties of skeletal muscle under passive extension. Am J Sports Med 1988; 16 (1): 7–12

    Article  PubMed  Google Scholar 

  35. Cibulka MT, Rose SJ, Delitto A, et al. Hamstring muscle strain treated by mobilizing the sacroiliac joint. Phys Ther 1986; 66 (8): 1220–3

    PubMed  CAS  Google Scholar 

  36. Takata K, Takahashi K. Hamstring tightness and sciatica in young patients with disc herniation. J Bone Joint Surg Br 1994; 76 (2): 220–4

    PubMed  CAS  Google Scholar 

  37. Boden SD, Davis DO, Dina TS. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. J Bone Joint Surg Am 1990; 72: 403–8

    PubMed  CAS  Google Scholar 

  38. Spencer DL, Irwin GS, Miller JAA. Anatomy and significance of fixation of the lumbosacral nerve roots in sciatica. Spine 1983; 8 (6): 672–9

    Article  PubMed  CAS  Google Scholar 

  39. Mooney V, Robertson J. The facet syndrome. Clin Orthop 1976; 115: 149–56

    PubMed  Google Scholar 

  40. Gould JA, editor. Orthopaedic and sports physical therapy. 2nd ed. St Louis (MO): C.V Mosby, 1990

    Google Scholar 

  41. Brandser EA, El-Khoury GY, Kathol MH, et al. Hamstring injuries: radiographic, conventional tomographic, CT, and MR imaging characteristics. Radiology 1995; 197 (1): 256–62

    Google Scholar 

  42. Lew PC, Connor BT, Buirski G, et al. Correlation between the clinical findings and hamstring pathology as determined by ultrasonographic and magnetic resonance imaging measurements. Australian Conference of Sport and Medicine in Sport; 1995 Oct 17–20; Hobart

    Google Scholar 

  43. Dorland’s illustrated medical dictionary. 27th ed. Philadelphia (PA): W.B. Saunders Co, 1988

  44. Agre JC. Hamstring injuries: proposed aetiological factors, prevention, and treatment. Sports Med 1985; 2: 21–33

    Article  PubMed  CAS  Google Scholar 

  45. Orchard J, Marsden J, Lord S, et al. Preseason hamstring muscle weakness associated with hamstring muscle injury in Australian footballers. Am J Sports Med 1997; 25 (1): 81–5

    Article  PubMed  CAS  Google Scholar 

  46. Mann RA, Moran GT, Dougherty SE. Comparative electromyography of the lower extremity in jogging, running, and sprinting. Am J Sports Med 1986; 14 (6): 501–10

    Article  PubMed  CAS  Google Scholar 

  47. Aagaard P, Simonsen EB, Magnusson P, et al. A new concept for isokinetic hamstring: quadriceps muscle strength ratio. Am J Sports Med 1998; 26 (2): 231–7

    PubMed  CAS  Google Scholar 

  48. Worrell TW, Perrin DH, Gansneder BM, et al. Comparison of isokinetic strength and flexibility measures between hamstring injured and non-injured athletes. J Orthop Sports Phys Ther 1991; 13 (3): 118–25

    PubMed  CAS  Google Scholar 

  49. Jonhagen S, Nemeth G, Eriksson E. Hamstring injuries in sprinters: the role of concentric and eccentric hamstring muscle strength and flexibility. Am J Sports Med 1994; 22 (2): 262–6

    Article  PubMed  CAS  Google Scholar 

  50. Shacklock M. Neurodynamics. Physiotherapy 1995; 81 (1): 9–16

    Article  Google Scholar 

  51. Targett GS. Injuries in professional rugby union. Clin J Sports Med 1998; 8 (4): 280–5

    Article  CAS  Google Scholar 

  52. Upton PAH, Noakes TD, Juritz JM. Thermal pants may reduce the risk of recurrent hamstring injuries in rugby players. Br J Sports Med 1996; 30: 57–60

    Article  PubMed  CAS  Google Scholar 

  53. Mair SD, Seaber AV, Glisson RR, et al. The role of fatigue in susceptibility to acute muscle strain injury. Am J Sports Med 1996; 24 (2): 137–43

    Article  PubMed  CAS  Google Scholar 

  54. Safran MR, Garrett WE, Seaber AV, et al. The role of warn-up in muscular injury prevention. Am J Sports Med 1988; 16 (2): 123–9

    Article  PubMed  CAS  Google Scholar 

  55. O’Brien B, Payne W, Gastin W, et al. A comparison of active and passive warn ups on energy system contribution and performance in moderate heat. Aust J Sci Med Sport 1997; 29 (4): 106–9

    PubMed  Google Scholar 

  56. Bach DK, Green DS, Jensen GM, et al. A comparison of muscular tightness in runners and nonrunners and the relationship of muscle tightness to low back pain in runners. J Orthop Sports Phys Ther 1985; 6 (6): 315–23

    PubMed  CAS  Google Scholar 

  57. Coole WG, Gieck JH. An analysis of hamstring strains and their rehabilitation. J Orthop Sports Phys Ther 1987; 9 (2): 77–85

    PubMed  CAS  Google Scholar 

  58. Almekinders LC, Gilbert JA. Healing of experimental muscle strains and the effects of non-steroidal anti-inflammatory medication. Am J Sports Med 1986; 14: 303–8

    Article  PubMed  CAS  Google Scholar 

  59. Reynolds JF, Noakes TD, Schwellnus MP, et al. Non-steroidal anti-inflammatory drugs fail to enhance healing of acute hamstring injuries treated with physiotherapy. S Afr Med J 1995; 85 (6): 517–22

    PubMed  CAS  Google Scholar 

  60. Thorsson O, Rantanen J, Hurme T, et al. Effects of nonsteroidal antiinflammatory medication on satellite cell proliferation during muscle regeneration. Am J Sports Med 1998; 26 (2): 172–6

    PubMed  CAS  Google Scholar 

  61. Almekinders LC. Anti-inflammatory treatment of muscular injuries in sports. Sports Med 1993; 15 (3): 139–45

    Article  PubMed  CAS  Google Scholar 

  62. Stanton P, Purdam C. Hamstring injuries in sprinting. J Orthop Sports Phys Ther 1989; 10: 343–9

    PubMed  CAS  Google Scholar 

  63. Iboshi A, Ae M, Suenaga M, et al. Torque patterns of sprinters who had suffered from hamstring muscle strains. Int Ser Biomech 1987; 7B: 605–9

    Google Scholar 

  64. Bandy WD, Irion JM. The effect of time on static stretch on the flexibility of the hamstring muscles. Phys Ther 1994; 74 (9): 845–52

    PubMed  CAS  Google Scholar 

  65. Webright WG, Randolph BJ, Perrin DH. Comparison of nonballistic active knee extension in neural slump position and static stretch techniques on hamstring flexibility. J Orthop Sports Phys Ther 1997; 26 (1): 7–13

    PubMed  CAS  Google Scholar 

  66. Hennessy L, Watson AWS. Flexibility and posture assessment in relation to hamstring injury. Br J Sports Med 1993; 27 (4): 243–6

    Article  Google Scholar 

  67. Worrell TW, Perrin DH. Hamstring muscle injury: the influence of strength, flexibility, warn-up, and fatigue. J Orthop Sports Phys Ther 1992; 16 (1): 12–8

    PubMed  CAS  Google Scholar 

  68. Worrell TW, Smith TL, Winegardner J. Effect of hamstring stretching on hamstring muscle performance. J Orthop Sports Phys Ther 1994; 20 (3): 154–9

    PubMed  CAS  Google Scholar 

  69. Kornberg C. The effect of neural stretching technique on sympathetic flow to the lower limb. J Orthop Sports Phys Ther 1992; 16 (6): 269–74

    PubMed  CAS  Google Scholar 

  70. Miles A, Bentley P, Polychronis A, et al. Evidence-based medicine: why all the fuss? This is why. J Eval Clin Pract 1997; 3 (2): 83–6

    Article  PubMed  CAS  Google Scholar 

  71. Greenhalgh T, Worrall JG. From EBM to CSM: the evolution of context-sensitive medicine. J Eval Clin Pract 1997; 3 (2): 105–8

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The author would like to thank Dr Di Hopper, School of Physiotherapy, Curtin University of Technology, Perth, Western Australia, Australia and Professor Alan Morton, Department of Human Movement and Exercise Science, University of Western Australia, Perth, Western Australia, Australia.

Author information

Authors and Affiliations

  1. Paddington Physiotherapy, 4/219 Given Terrace, Paddington, Queensland, 4064, Australia

    Liza Devlin

Authors
  1. Liza Devlin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Liza Devlin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Devlin, L. Recurrent Posterior Thigh Symptoms Detrimental to Performance in Rugby Union. Sports Med 29, 273–287 (2000). https://doi.org/10.2165/00007256-200029040-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-200029040-00005

Keywords

Search

Navigation