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Hamstring injury patterns in professional male football (soccer): a systematic video analysis of 52 cases
  1. Thomas Gronwald1,
  2. Christian Klein2,
  3. Tim Hoenig3,
  4. Micha Pietzonka2,
  5. Hendrik Bloch2,
  6. Pascal Edouard4,5,
  7. Karsten Hollander1
  1. 1 Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
  2. 2 Department of Sports Injury Prevention, VBG, German Statutory Accident Insurance for the Administrative Sector, Hamburg, Germany
  3. 3 Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  4. 4 Inter‐university Laboratory of Human Movement Sciences (LIBM EA 7424), University of Lyon, University Jean Monnet, Saint Etienne, France
  5. 5 Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
  1. Correspondence to Professor Thomas Gronwald, Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg 20457, Germany; thomas.gronwald{at}medicalschool-hamburg.de

Abstract

Objective To closely describe the injury inciting events of acute hamstring injuries in professional male football (soccer) using systematic video analysis.

Methods Video footage from four seasons (2014–2019) of the two highest divisions in German male football was searched for moderate and severe (ie, time loss of >7 days) acute non-contact and indirect contact match hamstring injuries. Two raters independently categorised inciting events using a standardised procedure to determine specific injury patterns and kinematics.

Results 52 cases of hamstring injuries were included for specific pattern analysis. The pattern analysis revealed 25 sprint-related (48%) and 27 stretch-related hamstring injuries (52%). All sprint-related hamstring injuries occured during linear acceleration or high-speed running. Stretch-related hamstring injuries were connected with closed chain movements like braking or stopping with a lunging or landing action and open chain movements like kicking. The kinematic analysis of stretch-related injuries revealed a change of movement involving knee flexion to knee extension and a knee angle of <45° at the assumed injury frame in all open and closed chain movements. Biceps femoris was the most affected muscle (79%) of all included cases.

Conclusion Despite the variety of inciting events, rapid movements with high eccentric demands of the posterior thigh are likely the main hamstring injury mechanism. This study provides important data about how hamstring injuries occur in professional male football and supports the need for demand-specific multicomponent risk reduction programmes.

  • soccer
  • hamstring muscles

Data availability statement

Data may be obtained from a third party and are not publicly available. General personal information of the participants are available in a public, open access repository via www.transfermarkt.de and www.kicker.de.Epidemiologic background data was available via the German statutory accident insurance for professional athletes (VBG). These data are not publicly available. The authors have no permission to make the data available.Video footage was available via the media portal (http://mediaportal.sportcast.de) of the German Football League (DFL). The costs for the access to the media portal were borne by the VBG. These data are not publicly available. The authors have no permission to make the data available.

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Data availability statement

Data may be obtained from a third party and are not publicly available. General personal information of the participants are available in a public, open access repository via www.transfermarkt.de and www.kicker.de.Epidemiologic background data was available via the German statutory accident insurance for professional athletes (VBG). These data are not publicly available. The authors have no permission to make the data available.Video footage was available via the media portal (http://mediaportal.sportcast.de) of the German Football League (DFL). The costs for the access to the media portal were borne by the VBG. These data are not publicly available. The authors have no permission to make the data available.

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Footnotes

  • TG and CK are joint first authors.

  • Twitter @G_Ron_Woods, @Chrs_Kln, @hoenig_tim, @Hendrik_Bloch, @PascalEdouard42, @K_Hollander_

  • Correction notice This article has been corrected since it published Online First. The title has been corrected.

  • Contributors TG and CK were responsible for the conception and design of the study. CK and MP collected the video footage and the injury data from the German statutory accident insurance for professional athletes (VBG). CK was head of the initial video analysis process, MP and HB also rated the video footage. TG and TH analysed the video footage regarding situational patterns and biomechanical characteristics. All authors participated in the consensus discussions, but mainly KH made the decision in disagreeing cases. TG and CK interpreted the data. TG wrote the first draft of the paper, which was critically revised by all co-authors. TG and CK are responsible for the overall content as guarantors.

  • Funding The costs for the access to the media portal of the German Football League were borne by the German statutory accident insurance for professional athletes (VBG).

  • Competing interests CK, MP and HB are employee of the German statutory accident insurance for professional athletes (VBG). PE is Associate Editor for the BJSM and for the BMJ Open Sports and Exercise Medicine. PE is the Speciality Chief Editor for the Injury Prevention and Rehabilitation section of Frontiers in Sports and Active Living.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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