Article Text

Download PDFPDF
Therapeutic interventions for acute hamstring injuries: a systematic review
  1. Gustaaf Reurink1,
  2. Gert Jan Goudswaard2,
  3. Johannes L Tol3,
  4. Jan A N Verhaar1,
  5. Adam Weir4,5,
  6. Maarten H Moen6
  1. 1Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, The Netherlands
  2. 2Sports Medical Centre, Royal Netherlands Football Association, Zeist, The Netherlands
  3. 3Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  4. 4Department of Sports Medicine, The Hague Medical Centre, Antoniushove, Leidschendam, The Netherlands
  5. 5Department of Sports Medicine, Sports Medical Advice Centre Haarlem, Haarlem, The Netherlands
  6. 6Department of Rehabilitation, Nursing Science and Sports, University Medical Centre Utrecht, Utrecht, The Netherlands
  1. Correspondence to Gustaaf Reurink, Department of Orthopaedics, Erasmus Medical Centre, PO Box 2040, 3000 CA Rotterdam, The Netherlands; g.reurink{at}


Background Despite the high rate of hamstring injuries, there is no consensus on their management, with a large number of different interventions being used. Recently several new injection therapies have been introduced.

Objective To systematically review the literature on the effectiveness of therapeutic interventions for acute hamstring injuries.

Data sources The databases of PubMed, EMBASE, Web of Science, Cochrane Library, CINAHL and SPORTDiscus were searched in May 2011.

Study eligibility criteria Prospective studies comparing the effect of an intervention with another intervention or a control group without intervention in subjects with acute hamstring injuries were included.

Data analysis Two authors independently screened the search results and assessed risk of bias. Quality assessment of the included studies was performed using the Physiotherapy Evidence Database score. A best evidence synthesis was used to identify the level of evidence.

Main results Six studies were included in this systematic review. There is limited evidence for a positive effect of stretching, agility and trunk stability exercises, intramuscular actovegin injections or slump stretching in the management of acute hamstring injuries. Limited evidence was found that there is no effect of non-steroidal anti-inflammatory drugs or manipulation of the sacroiliac joint.

Conclusions There is a lack of high quality studies on the treatment of acute hamstring injuries. Only limited evidence was found to support the use of stretching, agility and trunk stability exercises, intramuscular actovegin injections or slump stretching. Further research is needed using an appropriate control group, randomisation and blinding.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.