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The pathophysiology and risk factors for muscle-tendon stretch injury are of interest to both clinicians and basic scientists. In this study, the authors have improved our understanding of risk factors for this common problem by analysis of a cohort of elite Australian football players. One particular advantage of this study is the use of MRI to confirm or refute the diagnosis. Multiple regression analysis shows that, in addition to previous injury, age and previous history of knee injury and osteitis pubis are independent risk factors for hamstring injury in this particular cohort. Future studies are recommended to determine whether the same risk factors are identifiable in different populations. Whether the possibility of intervention in athletes with these risk factors can reduce the incidence and severity of injury cannot be ascertained from this study.