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Injury-inciting circumstances of sudden-onset hamstring injuries: video analyses of 63 match injuries in male professional football players in the Qatar Stars League (2013–2020)
  1. Robin Vermeulen1,2,
  2. Nicol van Dyk1,3,4,
  3. Rod Whiteley1,
  4. Karim Chamari1,5,
  5. Warren Gregson6,7,
  6. Lorenzo Lolli6,7,
  7. Roald Bahr1,8,
  8. Johannes L Tol1,2,
  9. Andreas Serner1,9
  1. 1 Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  2. 2 Amsterdam University Medical Centers, Academic Medical Center, Amsterdam Movement Sciences, Academic Center for Evidence Based Sports Medicine, Amsterdam IOC Center, ACHSS, Amsterdam, The Netherlands
  3. 3 School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
  4. 4 Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
  5. 5 Naufar, Wellness and Recovery Center, Doha, Qatar
  6. 6 Football Performance and Science Department, Aspire Academy, Doha, Qatar
  7. 7 Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester, UK
  8. 8 Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway
  9. 9 FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
  1. Correspondence to Dr Robin Vermeulen; drrvermeulen{at}gmail.com

Abstract

Objective To describe and categorise the injury-inciting circumstances of sudden-onset hamstring match injuries in professional football players using systematic video analysis.

Methods Using a prospective injury surveillance database, all sudden-onset hamstring match injuries in male football players (18 years and older) from the Qatar Stars League between September 2013 and August 2020 were reviewed and cross-referenced with broadcasted match footage. Videos with a clear observable painful event (ie, a player grabbing their posterior thigh) were included. Nine investigators independently analysed all videos to describe and categorise injury-inciting circumstances. We used three main categories: playing situation (eg, time of injury), player action(s) (eg, running) and other considerations (eg, contact). Player action(s) and other considerations were not mutually exclusive.

Results We included 63 sudden-onset hamstring match injuries out of 295 registered injuries between 2013 and 2020. Running was involved in 86% of injuries. Hamstring injuries occurred primarily during acceleration of 0–10 m (24% of all injuries) and in general at different running distances (0–50 m) and speeds (slow to fast). At 0–10 m distance, indirect player-to-player contact and inadequate balance were involved in 53% and 67% of the cases, respectively. Pressing occurred in 46% of all injuries (injured player pressing opponent: 25%; being pressed by opponent: 21%) and frequently involved player-to-player contact (69% of the cases when the injured player was pressing vs 15% of the cases when the opponent was pressing) and inadequate balance (82% vs 50%, respectively). Other player actions that did not involve running (n=9, 14% of all injuries) were kicking (n=6) and jumping (n=3).

Conclusion The injury-inciting circumstances of sudden-onset hamstring match injuries in football varied. The most common single-player action (24%) was acceleration over a distance of <10 m. Pressing, inadequate balance and indirect contact were frequently seen player actions. Injury prevention research in football should look beyond high-speed running as the leading risk factor for sudden-onset hamstring injuries.

  • Rehabilitation
  • Hamstring Muscles
  • Sporting injuries

Data availability statement

Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Not applicable.

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Data availability statement

Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Not applicable.

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Footnotes

  • X @rbnvrmln, @NicolvanDyk, @RodWhiteley, @ProfChamari, @spswgreg, @Lorenzo_Lolli90, @aserner

  • Contributors All authors were involved in the data collection, drafting of the manuscript and study design. RV is guarantor.

  • Funding This study was internally funded by Aspire Zone Foundation (AZF)

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally 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.