Consensus statements and percentage agreement for round 2 survey—global expert panel and return to running
| Statements related to return to running | True | False | Undecided | Samples of typical responses—discussion points or areas of disagreement |
| On pitch/track/field (sport specific) running is a significant part of hamstring rehabilitation. | 98.4% | 1.6% | 0.0% | Levels of agreement for these two questions reflects the importance of running as part of hamstring injury (HSI) rehabilitation. |
| Running dosages should be gradually increased to ensure return to full sprinting. | 100.0% | 0.0% | 0.0% | Hamstring muscle function discussed and difference in function at speed was acknowledged. |
| Sprinting dosage loads should approach game level intensities and volumes to reduce risk of recurrence on return to sport. | 95.2% | 4.8% | 0.0% | Sprinting in games presents injury risk and sprint work is a key component in final phase rehabilitation. |
| Further research should investigate the specific actions, bias, roles of individual muscles in function of running and sprinting to aid rehab exercise prescription. | 84.7% | 0.0% | 15.3% | Differences in muscle roles were discussed and the panel expressed need for more research into how the differences in muscle function will then impact rehabilitation. |
| Further research should investigate types (styles) and dosages of running (quantity, speed) that promote adaptations but reduce risk of recurrence. | 90.3% | 1.6% | 8.1% | Discussions suggested that running had not been prioritised sufficiently in literature and identified a research need. |
| Further research should investigate safe time frames to commence running post HSI or surgery. | 90.3% | 1.6% | 8.1% | Risk of reinjury is high when re-exposing HSI athletes to running—and the panel wanted after time frames for return—and more research into timeframes. |
| Mild pain with running is permissible in rehabilitating certain HSI, but we need to consider the function of the individual, the anatomy, injury, classification and the 24-hour pain pattern (subjective and objective). | 83.9% | 9.7% | 6.5% | The panel acknowledged many athletes have pain when restarting running—there was less agreement on how much pain was permissible/deleterious—the stated consideration factors reached agreement but other factors did not. |
| In HSI, pain-free running is a criterion for return to sprinting. | 85.5% | 8.1% | 6.5% | The panel agreed that pain levels should be reduced prior to permitting sprinting—the panel acknowledged that the initial commencement of full sprinting—was a high-risk period for reinjury. |
MDT, multidisciplinary team.