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A survey of flexibility training protocols and hamstring strains in professional football clubs in England
  1. B Dadebo1,
  2. J White2,
  3. K P George1
  1. 1Department of Exercise and Sport Sciences, Manchester Metropolitan University, Crewe and Alsager Faculty, Hassal Road, Alsager ST7 2HL, UK
  2. 2University of Nottingham Centre for Sports Medicine, Orthopaedic and Accident Surgery, Queen’s Medical Centre, Nottingham NG7 2UH, UK
  1. Correspondence to:
 Dr Dadebo
 Department of Exercise and Sport Sciences, Manchester Metropolitan University, Crewe and Alsager Faculty, Hassal Road, Alsager ST7 2HL, UK;


Objectives: To investigate the relation between current flexibility training protocols, including stretching, and hamstring strain rates (HSRs) in English professional football clubs.

Method: Questionnaire based data on flexibility training methods and HSRs were collected from 30 English professional football clubs in the four divisions during the 1998/99 season. Data were coded and analysed using cross tabulation, correlation, and multiple regression.

Results: Flexibility training protocols were characterised by wide variability, with static stretching the most popular stretching technique used. Hamstring strains represented 11% of all injuries and one third of all muscle strains. About 14% of hamstring strains were reinjuries. HSRs were highest in the Premiership (13.3 (9.4)/1000 hours) with the lowest rates in Division 2 (7.8 (2.9)/1000 hours); values are mean (SD). Most (97%) hamstring strains were grade I and II, two thirds of which occurred late during training/matches. Forwards were injured most often. Use of the standard stretching protocol (SSP) was the only factor significantly related to HSR (r  =  −0.45, p  =  0.031) in the correlation analysis, suggesting that the more SSP is used, the lower the HSR. About 80% of HSR variability was accounted for by stretching holding time (SHT), SSP, and stretching technique (STE) in the multiple regression equation: HSR  =  37.79 − (0.33SHT − 10.05SSP + 2.24STE) ± 2.34. SHT (negatively correlated with HSR) was the single highest predictor, and accounted for 30% of HSR variability, and an additional 40% in combination with SSP.

Conclusions: Flexibility training protocols in the professional clubs were variable and appeared to depend on staffing expertise. Hamstring stretching was the most important training factor associated with HSR. The use of SSP, STE, and SHT are probably involved in a complex synergism which may reduce hamstring strains. Modification of current training patterns, especially stretching protocols, may reduce HSRs in professional footballers.

  • HSF, hamstring stretching frequency or repetitions per session
  • HSR, hamstring strain rates
  • PNF, proprioceptive neuromuscular facilitation
  • SHT, static stretching holding time
  • SSP, standard stretching protocol
  • STE, stretching technique employed
  • flexibility training
  • stretching
  • hamstring strain rate
  • football

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