Determinants for recurrent hamstring injuries
| Determinants | Study reference number | Best-evidence synthesis |
|---|---|---|
| Age | 2, 5 | Limited evidence |
| Height | 2, 5 | Limited evidence |
| Weight | 2, 5 | Limited evidence |
| Time to return to sports | All | Limited evidence |
| Size of the initial injury | 1, 2 | Limited evidence |
| Cross-sectional area of the initial injury | 1, 2, 3, 5↑ | Conflicting evidence |
| Volume of the initial injury | 5↑ | Limited evidence |
| Grade 1 injuries according to Peetrons | 1↑, 3↑ | Limited evidence |
| Muscle involved | 2, 3, 5 | Limited evidence |
| Location in the muscle* | 2, 3, 5 | Limited evidence |
| Pain severity score (VAS) 12–18 h after the initial injury | 5 | Limited evidence |
| Presence of a haematoma | 3 | Limited evidence |
| Dominant leg injured | 5 | Limited evidence |
| Previous hamstring injury† | 2 | Limited evidence |
| Previous ACL reconstruction | 2↑ | Limited evidence |
| Rehabilitation ‘agility and stabilisation’‡ | 4↓ | Limited evidence |
| Outcome functional tests§ | 4 | Limited evidence |
1=Gibbs et al9; 2=Koulouris et al17; 3=Malliaropoulos et al10; 4=Sherry and Best19; 5=Verrall et al18
↑=Risk factor for re-injury.
↓=Protective factor for re-injury.
↵* Location in the muscle: upper, middle or lower thigh. Or musculotendinous junction compared with myofascial.
↵† Positive for a history of a hamstring injury before the first injury during the competition.
↵‡ Rehabilitation programme of ‘agility and stabilisation’ compared with a programme of ‘strengthening and eccentric stretching’ exercises.
↵§ Functional tests performed: hop for height, hop for distance, 4 hop crossover test, 40 yard sprint.
ACL, anterior cruciate ligament; VAS, visual analogue scale.