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Incidence and prevalence of hamstring injuries in field-based team sports: a systematic review and meta-analysis of 5952 injuries from over 7 million exposure hours
  1. Nirav Maniar1,2,
  2. Declan Singleton Carmichael1,
  3. Jack Thomas Hickey1,2,
  4. Ryan Gregory Timmins1,2,
  5. Argell Joseph San Jose1,
  6. Jessica Dickson3,
  7. David Opar1,2
  1. 1School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
  2. 2Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
  3. 3Library and Academic Research Services, Australian Catholic University, Melbourne, Victoria, Australia
  1. Correspondence to Nirav Maniar, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC 3065, Australia; nirav.maniar{at}acu.edu.au

Abstract

Objective This study aimed to systematically review and meta-analyse the incidence and prevalence of hamstring injuries in field-based team sports. A secondary aim was to determine the impact of other potential effect moderators (match vs training; sport; playing surface; cohort age, mass and stature; and year when data was collected) on the incidence of hamstring injury in field-based team sports.

Design Systematic review and meta-analysis.

Data sources CINAHL, Cochrane Library, MEDLINE Complete (EBSCO), Embase, Web of Science and SPORTDiscus databases were searched from database inception to 5 August 2020.

Eligibility criteria Prospective cohort studies that assessed the incidence of hamstring injuries in field-based team sports.

Method Following database search, article retrieval and title and abstract screening, articles were assessed for eligibility against predefined criteria then assessed for methodological quality using the Critical Appraisal Tool for prevalence studies. Meta-analysis was used to pool data across studies, with meta-regression used where possible.

Results Sixty-three articles were included in the meta-analysis, encompassing 5952 injuries and 7 262 168 hours of exposure across six field-based team sports (soccer, rugby union, field hockey, Gaelic football, hurling and Australian football). Hamstring injury incidence was 0.81 per 1000 hours, representing 10% of all injuries. Prevalence for a 9-month period was 13%, increasing 1.13-fold for every additional month of observation (p=0.004). Hamstring injury incidence increased 6.4% for every 1 year of increased average cohort age, was 9.4-fold higher in match compared with training scenarios (p=0.003) and was 1.5-fold higher on grass compared with artificial turf surfaces (p<0.001). Hamstring injury incidence was not significantly moderated by average cohort mass (p=0.542) or stature (p=0.593), was not significantly different between sports (p=0.150) and has not significantly changed over the last 30 years (p=0.269).

Conclusion Hamstring injury represents 10% of all injuries in field-based team sports, with 13% of the athletes experiencing a hamstring injury over a 9-month period most commonly during matches. More work is needed to reduce the incidence of hamstring injury in field-based team sports.

PROSPERO registration number CRD42020200022.

  • epidemiology
  • hamstring muscles
  • risk factor
  • prospective studies
  • thigh

https://doi.org/10.1136/bjsports-2021-104936

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    Footnotes

    • Twitter @niravmaniar91, @dsc_carmichael, @JackHickey89, @ryan_timmins, @davidopar

    • Contributors Conceptualisation: NM, JTH, RGT, DO; data curation: NM, DSC, JTH, RGT, AJSJ, DO; formal analysis: NM, JTH, RGT, DO; investigation: NM, DSC, JTH, RGT, AJSJ, JD, DO; methodology NM, DSC, JTH, RGT, AJSJ, JD, DO; visualisation: NM; writing—original draft: NM, JTH, RGT, DO; writing—review and editing: NM, DSC, JTH, RGT, AJSJ, JD, DO.

    • 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.

    • 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.