Article Text

Download PDFPDF
Running exposure is associated with the risk of hamstring strain injury in elite Australian footballers
  1. Joshua D Ruddy1,
  2. Christopher W Pollard1,
  3. Ryan G Timmins1,
  4. Morgan D Williams2,
  5. Anthony J Shield3,
  6. David A Opar1
  1. 1School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia
  2. 2School of Health, Sport and Professional Practice, University of South Wales, Wales, UK
  3. 3School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
  1. Correspondence to Joshua D Ruddy, School of Exercise Science, Australian Catholic University, 17 Young Street, Melbourne, VIC 3065, Australia; joshua.ruddy{at}


Background To investigate the association between running exposure and the risk of hamstring strain injury (HSI) in elite Australian footballers.

Methods Elite Australian footballers (n=220) from 5 different teams participated. Global positioning system (GPS) data were provided for every athlete for each training session and match for the entire 2015 season. The occurrences of HSIs throughout the study period were reported. Receiver operator characteristic curve analyses were performed and the relative risk (RR) of subsequent HSI was calculated for absolute and relative running exposure variables related to distance covered above 10 and 24 km/hour in the preceding week/s.

Results 30 prospective HSIs occurred. For the absolute running exposure variables, weekly distance covered above 24 km/hour (>653 m, RR=3.4, 95% CI 1.6 to 7.2, sensitivity=0.52, specificity=0.76, area under the curve (AUC)=0.63) had the largest influence on the risk of HSI in the following week. For the relative running exposure variables, distance covered above 24 km/hour as a percentage of distance covered above 10 km/hour (>2.5%, RR=6.3, 95% CI 1.5 to 26.7, sensitivity=0.93, specificity=0.34, AUC=0.63) had the largest influence on the risk of HSI in the following week. Despite significant increases in the RR of HSI, the predictive capacity of these variables was limited.

Conclusions An association exists between absolute and relative running exposure variables and elite Australian footballers' risk of subsequent HSI, with the association strongest when examining data within 7–14 days. Despite this, the use of running exposure variables displayed limited clinical utility to predict HSI at the individual level.

  • Hamstring
  • Injury
  • Prospective
  • Global positioning system
  • Running

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.


  • Twitter Follow Joshua Ruddy @joshua_ruddy, Ryan Timmins @ryan_timmins, Morgan Williams @drmorgs, Anthony Shield @das_shield and David Opar @davidopar

  • Contributors JDR and DAO contributed to the design of the study. JDR, RGT, AJS and DAO contributed to the collection of the data. JDR and CWP performed the data analysis. JDR, RGT, MDW and DAO performed the statistical analysis. JDR and DAO drafted the manuscript. CWP, RGT, MDW and AJS contributed to the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval This study was approved by the Queensland University of Technology and Australian Catholic University Human Research Ethics Committees.

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

  • Data sharing statement Data will be made available on request.