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Strong and stringent hamstring strain science: trials and error!
  1. Kristian Thorborg,
  2. Lasse Ishøi,
  3. Kasper Krommes
  1. Sports Orthopaedic Research Center–Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark, Amager-Hvidovre Hospital, Hvidovre, Copenhagen, Denmark
  1. Correspondence to Prof Kristian Thorborg, Sports Orthopaedic Research Center–Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark, Amager-Hvidovre Hospital, Hvidovre 2650, Denmark; kristianthorborg{at}hotmail.com

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Knowledge on how to optimise rehabilitation of athletes after an acute hamstring strain is progressing.1 Within the last 6 years, eight randomised controlled trials (RCTs) on this topic have emerged—conducted by many eminent clinician-scientists.1

From clinical question to science!

Recent clinically relevant RCTs show that specific exercise-based interventions reduce time to return to sport and risk of re-injuries.1 In particular, lengthening contraction exercises compared with conventional exercises without such emphasis reduce time to return to sport,1 whereas a criteria-based programme including a more running-specific exercise focus, compared with the lengthening approach, seems promising for reducing the risk of re-injury.1 Furthermore, platelet-rich plasma injections provided no additional benefit to current exercise-based rehabilitation.1 This emphasises the importance of specific mechanical loading and progressive running exercises in athletes with hamstring strains—but can we rest on these laurels?

This editorial points out common methodological shortcomings in the existing clinical hamstring trial literature that may help guide and improve scientific robustness of future trials. Based on these, we suggest four practical steps to advance the field by eliminating common errors:

“The aim of science is not to open the door to infinite wisdom, but to set a limit to infinite …

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Footnotes

  • Twitter @KThorborg, @LasseIshoei, @krommes

  • Contributors KT drafted the manuscript and KK drafted Figure 1. All authors critically revised the manuscript and Figure 1 for important intellectual content and approved the final version of the manuscript. KT is the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

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