Background Hamstring injuries remain a substantial problem in male football. Proximal neuromuscular control (‘core stability’) is considered to be of key importance in hamstring injury prevention, although scientific evidence regarding the exact nature of the core-hamstring association is non-existing at present.

Objective To investigate whether core muscle activation patterns during sprinting are associated with hamstring injury risk.

Design Cohort study.

Setting Amateur football division.

Participants 60 male football players with no recent history of hamstring injury were recruited for the multi-muscle EMG time series analysis during sprint.

Assessment Hamstring-, gluteal and trunk muscle activity time-series during the airborne- and stance phases of over-ground sprint acceleration were collected prior to follow up (1.5 seasons).

Main Outcome Measurements EMG signals of the above-mentioned muscles were processed and explored in function of (1) the time within the running cycle and (2) injury occurrence during follow up.

Results Players that remained injury free, presented significantly higher amounts of gluteal muscle activity during the front swing phase (p=0.018), and higher amounts of trunk muscle activity during the backswing phase of sprinting (p=0.0011). In particular, the risk of sustaining a hamstring injury during follow up lowered 87% and 46%, with each increment in normalized muscle activity of the Gluteus Maximus during front swing and the trunk muscles during backswing, respectively (p<0.02).

Conclusions Muscle activity of the proximal core unit during explosive running presented to be associated with hamstring injury occurrence. Higher amounts of gluteal – and trunk muscle activity during the airborne phases of sprinting were able to protect participants against injury during follow up. Hence, the present results provide a basis for improved, evidence based, rehabilitation and prevention, particularly focusing on increasing neuromuscular control of the gluts and trunk muscle during sport specific activities (eg. sprint drills, agility drills).