Skip to main content

Hamstring Injury Prevention Practices in Elite Sport: Evidence for Eccentric Strength vs. Lumbo-Pelvic Training

Abstract

Hamstring strain injuries are endemic in running-based sports. Given the economic and performance implications of these injuries, a significant body of research has emerged in recent years in an attempt to identify risk factors and develop or optimise injury prevention strategies. Surveys of injury prevention practices among medical and conditioning staff in elite sport suggest that many sporting clubs invest significant efforts in eccentric hamstring conditioning and lumbo-pelvic or trunk stability programmes. The purpose of this narrative review was to critically evaluate the evidence underpinning these practices. Single-exercise eccentric training interventions have proven effective in the prevention of primary and recurrent hamstring strains, when compliance is adequate. However, despite its almost universal acceptance, the authors are aware of only one, very recent, prospective risk factor study examining the effect of lumbo-pelvic motion during sprinting on hamstring injury risk. Furthermore, the interventions exploring the effect of lumbo-pelvic training on hamstring injury rates have not measured stability in any way. An improved understanding of the evidence underpinning commonly employed hamstring injury prevention practices may enable clinicians and coaches to better prioritise effective strategies in the increasingly complex environment of elite sport.

This is a preview of subscription content, access via your institution.

References

  1. Opar DA, Drezner J, Shield A, et al. Acute hamstring strain injury in track-and-field athletes: a 3-year observational study at the Penn Relay Carnival. Scand J Med Sci Sports. 2013;24(4):e254–9.

    PubMed  Article  Google Scholar 

  2. Orchard JW, Seward H, Orchard JJ. Results of 2 decades of injury surveillance and public release of data in the Australian Football League. Am J Sports Med. 2013;41(4):734–41.

    PubMed  Article  Google Scholar 

  3. Ekstrand JM, Hagglund M, Walden M. Injury incidence and injury patterns in professional football: the UEFA injury study. Br J Sports Med. 2011;45(7):553–8.

    CAS  PubMed  Article  Google Scholar 

  4. Opar DA, Williams MD, Shield AJ. Hamstring strain injuries: factors that lead to injury and re-injury. Sports Med. 2012;42(3):209–26.

    PubMed  Article  Google Scholar 

  5. Hickey J, Shield AJ, Williams MD, et al. The financial cost of hamstring strain injuries in the Australian Football League. Br J Sports Med. 2013;48(8):729–30.

    PubMed  Article  Google Scholar 

  6. Woods C, Hawkins RD, Maltby S, et al. The Football Association Medical Research Programme: an audit of injuries in professional football: analysis of hamstring injuries. Br J Sports Med. 2004;38(1):36–41.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  7. Brooks JHM, Fuller CW, Kemp SPT, et al. Incidence, risk, and prevention of hamstring muscle injuries in professional rugby union. Am J Sports Med. 2006;34(8):1297–306.

    PubMed  Article  Google Scholar 

  8. Brooks JHM, Fuller CW, Kemp SPT, et al. Epidemiology of injuries in English professional rugby union: part 1 match injuries. Br J Sports Med. 2005;39:757–66.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  9. Proske U, Morgan DL. Muscle damage from eccentric exercise: mechanism, mechanical signs, adaptation and clinical applications. J Physiol. 2001;537(Pt 2):333–45.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  10. Arnason A, Andersen TE, Holme I, et al. Prevention of hamstring strains in elite soccer: an intervention study. Scand J Med Sci Sports. 2008;18(1):40–8.

    CAS  PubMed  Article  Google Scholar 

  11. Petersen J, Thorborg K, Nielsen MB, et al. Preventive effect of eccentric training on acute hamstring injuries in men’s soccer a cluster-randomized controlled trial. Am J Sports Med. 2011;39(11):2296–303.

    PubMed  Article  Google Scholar 

  12. van der Horst N, Smits DW, Petersen J, et al. The preventive effect of the nordic hamstring exercise on hamstring injuries in amateur soccer players: a randomized controlled trial. Am J Sports Med. 2015;43(6):1316–23.

    PubMed  Article  Google Scholar 

  13. Askling CM, Tengvar M, Thorstensson A. Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br J Sports Med. 2013;47(15):953–9.

    PubMed  Article  Google Scholar 

  14. Askling CM, Tengvar M, Tarassova O, et al. Acute hamstring injuries in Swedish elite sprinters and jumpers: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br J Sports Med. 2014;48(7):532–9.

    PubMed  Article  Google Scholar 

  15. Sherry MA, Best TM. A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains. J Orthop Sports Phys Ther. 2004;34(3):116–25.

    PubMed  Article  Google Scholar 

  16. Fyfe JJ, Opar DA, Williams MD, et al. The role of neuromuscular inhibition in hamstring strain injury recurrence. J Electromyogr Kinesiol. 2013;23(3):523–30.

    PubMed  Article  Google Scholar 

  17. Mendiguchia J, Martinez-Ruiz E, Edouard P, et al. A multifactorial, criteria-based progressive algorithm for hamstring injury treatment. Med Sci Sports Exerc. 2017;49(7):1482–92.

    PubMed  Article  Google Scholar 

  18. Ekstrand J, Hagglund M, Kristenson K, et al. Fewer ligament injuries but no preventive effect on muscle injuries and severe injuries: an 11-year follow-up of the UEFA Champions League injury study. Br J Sports Med. 2013;47(12):732–7.

    PubMed  Article  Google Scholar 

  19. Ekstrand J, Walden M, Hagglund M. Hamstring injuries have increased by 4% annually in men’s professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study. Br J Sports Med. 2016;50(12):731–7.

    PubMed  Article  Google Scholar 

  20. Ekstrand J, Healy JC, Walden M, et al. Hamstring muscle injuries in professional football: the correlation of MRI findings with return to play. Br J Sports Med. 2012;46(2):112–7.

    PubMed  Article  Google Scholar 

  21. Barnes C, Archer DT, Hogg B, et al. The evolution of physical and technical performance parameters in the English Premier League. Int J Sports Med. 2014;35(13):1095–100.

    CAS  PubMed  Article  Google Scholar 

  22. Bahr R, Thorborg K, Ekstrand J. Evidence-based hamstring injury prevention is not adopted by the majority of Champions League or Norwegian Premier League football teams: the Nordic Hamstring survey. Br J Sports Med. 2015;49(22):1466–71.

    PubMed  Article  Google Scholar 

  23. Verhagen E, Voogt N, Bruinsma A, et al. A knowledge transfer scheme to bridge the gap between science and practice: an integration of existing research frameworks into a tool for practice. Br J Sports Med. 2014;48(8):698–701.

    PubMed  Article  Google Scholar 

  24. McCall A, Carling C, Nedelec M, et al. Risk factors, testing and preventative strategies for non-contact injuries in professional football: current perceptions and practices of 44 teams from various premier leagues. Br J Sports Med. 2014;48(18):1352–7.

    PubMed  Article  Google Scholar 

  25. Donaldson A, Cook J, Gabbe B, et al. Bridging the gap between content and context: establishing expert consensus on the content of an exercise training program to prevent lower-limb injuries. Clin J Sport Med. 2015;25(3):221–9.

    PubMed  Article  Google Scholar 

  26. Pizzari T, Coburn P. Management of hamstring muscle strain injuries in the Australian Football League (AFL): a survey of current practice. J Sci Med Sport. 2010;13:e76.

    Article  Google Scholar 

  27. Melegati G, Tornese D, Gevi M, et al. Reducing muscle injuries and reinjuries in one Italian professional male soccer team. Muscles Ligaments Tendons J. 2013;3(4):324–30.

    PubMed  Google Scholar 

  28. Brukner P, Nealon A, Morgan C, et al. Recurrent hamstring muscle injury: applying the limited evidence in the professional football setting with a seven-point programme. Br J Sports Med. 2014;48(11):929–38.

    PubMed  Article  Google Scholar 

  29. Ekstrand J, Walden M, Hagglund M. A congested football calendar and the wellbeing of players: correlation between match exposure of European footballers before the World Cup 2002 and their injuries and performances during that World Cup. Br J Sports Med. 2004;38(4):493–7.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  30. Bengtsson H, Ekstrand J, Hagglund M. Muscle injury rates in professional football increase with fixture congestion: an 11-year follow-up of the UEFA Champions League injury study. Br J Sports Med. 2013;47(12):743–7.

    PubMed  Article  Google Scholar 

  31. Reed CA, Ford KR, Myer GD, et al. The effects of isolated and integrated ‘core stability’ training on athletic performance measures: a systematic review. Sports Med. 2012;42(8):697–706.

    PubMed  PubMed Central  Article  Google Scholar 

  32. Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med. 2006;36(3):189–98.

    PubMed  Article  Google Scholar 

  33. Hibbs AE, Thompson KG, French D, et al. Optimizing performance by improving core stability and core strength. Sports Med. 2008;38(12):995–1008.

    PubMed  Article  Google Scholar 

  34. Willson JD, Dougherty CP, Ireland ML, et al. Core stability and its relationship to lower extremity function and injury. J Am Acad Orthop Surg. 2005;13(5):316–25.

    PubMed  Article  Google Scholar 

  35. Chuter VH, de Jonge XA, Thompson BM, et al. The efficacy of a supervised and a home-based core strengthening programme in adults with poor core stability: a three-arm randomised controlled trial. Br J Sports Med. 2015;49(6):395–9.

    CAS  PubMed  Article  Google Scholar 

  36. Willardson JM. Core stability training: applications to sports conditioning programs. J Strength Cond Res. 2007;21(3):979–85.

    PubMed  Google Scholar 

  37. Biering-Sorensen F. Physical measurements as risk indicators for low-back trouble over a one-year period. Spine (Phila PA 1976). 1984;9(2):106–19.

    CAS  Article  Google Scholar 

  38. Weir A, Darby J, Inklaar H, et al. Core stability: inter- and intraobserver reliability of 6 clinical tests. Clin J Sport Med. 2010;20(1):34–8.

    PubMed  Article  Google Scholar 

  39. Chumanov ES, Heiderscheit BC, Thelen DG. The effect of speed and influence of individual muscles on hamstring mechanics during the swing phase of sprinting. J Biomech. 2007;40(16):3555–62.

    PubMed  Article  Google Scholar 

  40. Schache AG, Wrigley TV, Baker R, et al. Biomechanical response to hamstring muscle strain injury. Gait Posture. 2009;29(2):332–8.

    PubMed  Article  Google Scholar 

  41. Garrett W, Safran M, Seaber AV, et al. Biomechanical comparison of stimulated and nonstimulated skeletal muscle pulled to failure. Am J Sports Med. 1987;15(6):448–54.

    PubMed  Article  Google Scholar 

  42. Garrett WE. Muscle strain injuries: clinical and basic aspects. Med Sci Sports Exerc. 1990;22(4):436–43.

    PubMed  Article  Google Scholar 

  43. Mair SD, Seaber AV, Glisson RR, et al. The role of fatigue in susceptibility to acute muscle strain injury. Am J Sports Med. 1996;24(2):137–43.

    CAS  PubMed  Article  Google Scholar 

  44. Lieber RL, Friden J. Functional and clinical significance of skeletal muscle architecture. Muscle Nerve. 2000;23(11):1647–66.

    CAS  PubMed  Article  Google Scholar 

  45. McHugh MP, Connolly DA, Eston RG, et al. Exercise-induced muscle damage and potential mechanisms for the repeated bout effect. Sports Med. 1999;27(3):157–70.

    CAS  PubMed  Article  Google Scholar 

  46. Lynn R, Morgan D. Decline running produces more sarcomeres in rat vastus intermedius muscle fibers than does incline running. J Appl Physiol (1985). 1994;77(3):1439–44.

    CAS  Article  Google Scholar 

  47. Lynn R, Talbot J, Morgan D. Differences in rat skeletal muscles after incline and decline running. J Appl Physiol (1985). 1998;85(1):98.

    CAS  Article  Google Scholar 

  48. Friden J, Lieber RL. Structural and mechanical basis of exercise-induced muscle injury. Med Sci Sports Exerc. 1992;24(5):521–30.

    CAS  PubMed  Article  Google Scholar 

  49. Morgan DL. New insights into the behavior of muscle during active lengthening. Biophys J. 1990;57(2):209–21.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  50. Timmins R, Bourne M, Shield A, et al. Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study. Br J Sports Med. 2015;50(24):1524–35.

    PubMed  Article  Google Scholar 

  51. Jakobsen JR, Mackey AL, Knudsen AB, et al. Composition and adaptation of human myotendinous junction and neighboring muscle fibers to heavy resistance training. Scand J Med Sci Sports. 2016. https://doi.org/10.1111/sms.12794 (Epub ahead of print).

    Google Scholar 

  52. Sherry M, Best T, Heiderscheit B. The core: where are we and where are we going? Clin J Sport Med. 2005;15(1):1–2.

    PubMed  Article  Google Scholar 

  53. Silder A, Sherry MA, Sanfilippo J, et al. Clinical and morphological changes following 2 rehabilitation programs for acute hamstring strain injuries: a randomized clinical trial. J Orthop Sports Phys Ther. 2013;43(5):284–99.

    PubMed  PubMed Central  Article  Google Scholar 

  54. Schuermans J, Van Tiggelen D, Palmans T, et al. Deviating running kinematics and hamstring injury susceptibility in male soccer players: cause or consequence? Gait Posture. 2017;57:270–7.

    PubMed  Article  Google Scholar 

  55. Schuermans J, Danneels L, Van Tiggelen D, et al. Proximal neuromuscular control protects against hamstring injuries in male soccer players: a prospective study with electromyography time-series analysis during maximal sprinting. Am J Sports Med. 2017;45(6):1315–25.

    PubMed  Article  Google Scholar 

  56. Franettovich-Smith MM, Bonacci J, Mendis MD, et al. Gluteus medius activation during running is a risk factor for season hamstring injuries in elite footballers. J Sci Med Sport. 2017;20(2):159–63.

    PubMed  Article  Google Scholar 

  57. Leetun DT, Ireland ML, Willson JD, et al. Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc. 2004;36(6):926–34.

    PubMed  Article  Google Scholar 

  58. Zazulak BT, Hewett TE, Reeves NP, et al. The effects of core proprioception on knee injury: a prospective biomechanical-epidemiological study. Am J Sports Med. 2007;35(3):368–73.

    PubMed  Article  Google Scholar 

  59. Zazulak BT, Hewett TE, Reeves NP, et al. Deficits in neuromuscular control of the trunk predict knee injury risk: a prospective biomechanical-epidemiologic study. Am J Sports Med. 2007;35(7):1123–30.

    PubMed  Article  Google Scholar 

  60. Bennell K, Wajswelner H, Lew P, et al. Isokinetic strength testing does not predict hamstring injury in Australian Rules footballers. Br J Sports Med. 1998;32(4):309–14.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  61. Croisier JL, Forthomme B, Namurois MH, et al. Hamstring muscle strain recurrence and strength performance disorders. Am J Sports Med. 2002;30(2):199–203.

    PubMed  Article  Google Scholar 

  62. Croisier JL, Ganteaume S, Binet J, et al. Strength imbalances and prevention of hamstring injury in professional soccer players. Am J Sports Med. 2008;36(8):1469.

    PubMed  Article  Google Scholar 

  63. Fousekis K, Tsepis E, Poulmedis P, et al. Intrinsic risk factors of non-contact quadriceps and hamstring strains in soccer: a prospective study of 100 professional players. Br J Sports Med. 2011;45(9):709–14.

    PubMed  Article  Google Scholar 

  64. Sugiura Y, Saito T, Sakuraba K, et al. Strength deficits identified with concentric action of the hip extensors and eccentric action of the hamstrings predispose to hamstring injury in elite sprinters. J Orthop Sports Phys Ther. 2008;38(8):457–64.

    PubMed  Article  Google Scholar 

  65. van Dyk N, Bahr R, Whiteley R, et al. Hamstring and quadriceps isokinetic strength deficits are weak risk factors for hamstring strain injuries: a 4-year cohort study. Am J Sports Med. 2016;44(7):1789–95.

    PubMed  Article  Google Scholar 

  66. Opar DA, Williams MD, Timmins RG, et al. Eccentric hamstring strength and hamstring injury risk in Australian footballers. Med Sci Sports Exerc. 2014;47(4):857–65.

    Article  Google Scholar 

  67. Bourne M, Opar DA, Williams M, et al. Eccentric knee-flexor strength and hamstring injury risk in rugby union: a prospective study. Am J Sports Med. 2015;43(11):2663–70.

    PubMed  Article  Google Scholar 

  68. Yeung S, Suen A, Yeung E. A prospective cohort study of hamstring injuries in competitive sprinters preseason muscle imbalance as a possible risk factor. Br J Sports Med. 2009;43:589–94.

    CAS  PubMed  Article  Google Scholar 

  69. Bahr R, Holme I. Risk factors for sports injuries: a methodological approach. Br J Sports Med. 2003;37(5):384–92.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  70. Zvijac JE, Toriscelli TA, Merrick S, et al. Isokinetic concentric quadriceps and hamstring strength variables from the NFL Scouting Combine are not predictive of hamstring injury in first-year professional football players. Am J Sports Med. 2013;41(7):1511–8.

    PubMed  Article  Google Scholar 

  71. van Dyk N, Bahr R, Burnett A, et al. A comprehensive strength testing protocol offers no clinical value in predicting risk of hamstring injury: a prospective cohort study of 413 professional football players. Br J Sports Med. 2017. https://doi.org/10.1136/bjsports-2017-097754 (Epub ahead of print).

    Google Scholar 

  72. Impellizzeri FM, Bizzini M, Dvorak J, et al. Physiological and performance responses to the FIFA 11 + (part 2): a randomised controlled trial on the training effects. J Sports Sci. 2013;31(13):1491–502.

    PubMed  Article  Google Scholar 

  73. Sandrey MA, Mitzel JG. Improvement in dynamic balance and core endurance after a 6-week core-stability-training program in high school track and field athletes. J Sport Rehabil. 2013;22(4):264–71.

    PubMed  Article  Google Scholar 

  74. Sato K, Mokha M. Does core strength training influence running kinetics, lower-extremity stability, and 5000-M performance in runners? J Strength Cond Res. 2009;23(1):133–40.

    PubMed  Article  Google Scholar 

  75. Wirth K, Hartmann H, Mickel C, et al. Core stability in athletes: a critical analysis of current guidelines. Sports Med. 2017;47(3):401–14.

    PubMed  Article  Google Scholar 

  76. Roig M, O’Brien K, Kirk G, et al. The effects of eccentric versus concentric resistance training on muscle strength and mass in healthy adults: a systematic review with meta-analysis. Br J Sports Med. 2009;43(8):556–68.

    CAS  PubMed  Article  Google Scholar 

  77. Higbie EJ, Cureton KJ, Warren GL, et al. Effects of concentric and eccentric training on muscle strength, cross-sectional area, and neural activation. J Appl Physiol (1985). 1996;81(5):2173.

    CAS  Article  Google Scholar 

  78. Hortobagyi T, Hill JP, Houmard JA, et al. Adaptive responses to muscle lengthening and shortening in humans. J Appl Physiol (1985). 1996;80(3):765–72.

    CAS  Article  Google Scholar 

  79. Kaminski TW, Wabbersen CV, Murphy RM. Concentric versus enhanced eccentric hamstring strength training: clinical implications. J Athl Train. 1998;33(3):216–21.

    CAS  PubMed  PubMed Central  Google Scholar 

  80. Mjolsnes R, Arnason A, Osthagen T, et al. A 10-week randomized trial comparing eccentric vs. concentric hamstring strength training in well-trained soccer players. Scand J Med Sci Sports. 2004;14(5):311–7.

    PubMed  Article  Google Scholar 

  81. Iga J, Fruer CS, Deighan M, et al. ‘Nordic’ hamstrings exercise: engagement characteristics and training responses. Int J Sports Med. 2012;33(12):1000–4.

    CAS  PubMed  Article  Google Scholar 

  82. Delahunt E, McGroarty M, De Vito G, et al. Nordic hamstring exercise training alters knee joint kinematics and hamstring activation patterns in young men. Eur J Appl Physiol. 2016;116(4):663–72.

    PubMed  Article  Google Scholar 

  83. Bourne MNDS, Timmins RG, Williams MD, et al. Impact of the Nordic hamstring and hip extension exercises on hamstring architecture and morphology: implications for injury prevention. Br J Sports Med. 2017;51(5):469–77.

    PubMed  Article  Google Scholar 

  84. Potier TG, Alexander CM, Seynnes OR. Effects of eccentric strength training on biceps femoris muscle architecture and knee joint range of movement. Eur J Appl Physiol. 2009;105(6):939–44.

    PubMed  Article  Google Scholar 

  85. Timmins RG, Ruddy JD, Presland J, et al. Architectural changes of the biceps femoris after concentric or eccentric training. Med Sci Sports Exerc. 2015;48(3):499–508.

    Article  Google Scholar 

  86. Brockett C, Morgan D, Proske U. Human hamstring muscles adapt to eccentric exercise by changing optimum length. Med Sci Sports Exerc. 2001;33(5):783–90.

    CAS  PubMed  Article  Google Scholar 

  87. Clark R, Bryant A, Culgan JP, et al. The effects of eccentric hamstring strength training on dynamic jumping performance and isokinetic strength parameters: a pilot study on the implications for the prevention of hamstring injuries. Phys Ther Sport. 2005;6(2):67–73.

    Article  Google Scholar 

  88. Kilgallon M, Donnelly AE, Shafat A. Progressive resistance training temporarily alters hamstring torque-angle relationship. Scand J Med Sci Sports. 2007;17(1):18–24.

    CAS  PubMed  Google Scholar 

  89. Pas HI, Reurink G, Tol JL, et al. Efficacy of rehabilitation (lengthening) exercises, platelet-rich plasma injections, and other conservative interventions in acute hamstring injuries: an updated systematic review and meta-analysis. Br J Sports Med. 2015;49(18):1197–205.

    PubMed  Article  Google Scholar 

  90. de Visser HM, Reijman M, Heijboer MP, et al. Risk factors of recurrent hamstring injuries: a systematic review. Br J Sports Med. 2012;46(2):124–30.

    PubMed  Article  Google Scholar 

  91. Perrott M, Pizzari T, Cook J. Lumbopelvic exercise reduces lower limb muscle strain injury in recreational athletes. Phys Ther Rev. 2013;18:24–33.

    Article  Google Scholar 

  92. Pasanen K, Parkkari J, Pasanen M, et al. Neuromuscular training and the risk of leg injuries in female floorball players: cluster randomised controlled study. BMJ. 2008;337:a295.

    PubMed  Google Scholar 

  93. Orishimo KF, McHugh MP. Effect of an eccentrically biased hamstring strengthening home program on knee flexor strength and the length-tension relationship. J Strength Cond Res. 2015;29(3):772–8.

    PubMed  Article  Google Scholar 

  94. Tyler TF, Schmitt BM, Nicholas SJ, et al. Rehabilitation after hamstring strain injury emphasizing eccentric strengthening at long muscle lengths: results of long term follow-up. J Sport Rehabil. 2016;24:1–33.

    Google Scholar 

  95. Guex K, Millet GP. Conceptual framework for strengthening exercises to prevent hamstring strains. Sports Med. 2013;43(12):1207–15.

    PubMed  Article  Google Scholar 

  96. Hides JA, Stanton WR. Can motor control training lower the risk of injury for professional football players? Med Sci Sports Exerc. 2014;46(4):762–8.

    PubMed  Article  Google Scholar 

  97. Seagrave RA, Perez L, McQueeney S, et al. Preventive effects of eccentric training on acute hamstring muscle injury in professional baseball. Orthop J Sports Med. 2014;2(6):2325967114535351.

    PubMed  PubMed Central  Google Scholar 

  98. Engebretsen AH, Myklebust G, Holme I, et al. Prevention of injuries among male soccer players a prospective, randomized intervention study targeting players with previous injuries or reduced function. Am J Sports Med. 2008;36(6):1052–60.

    PubMed  Article  Google Scholar 

  99. Gabbe BJ, Branson R, Bennell KL. A pilot randomised controlled trial of eccentric exercise to prevent hamstring injuries in community-level Australian Football. J Sci Med Sport. 2006;9(1–2):103–9.

    CAS  PubMed  Article  Google Scholar 

  100. Goode AP, Reiman MP, Harris L, et al. Eccentric training for prevention of hamstring injuries may depend on intervention compliance: a systematic review and meta-analysis. Br J Sports Med. 2015;49(6):349–56.

    PubMed  Article  Google Scholar 

  101. Askling C, Karlsson J, Thorstensson A. Hamstring injury occurrence in elite soccer players after preseason strength training with eccentric overload. Scand J Med Sci Sports. 2003;13(4):244–50.

    CAS  PubMed  Article  Google Scholar 

  102. Ratamess NA, Alvar BA, Evetoch TK, et al. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2009;41(3):687–708.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anthony J. Shield.

Ethics declarations

Funding

No sources of funding were used to assist in the preparation of this article.

Conflict of interest

Anthony J. Shield is a co-inventor of a device employed to assess eccentric knee flexor strength (PCT/AU2012/001041.2012) and is also a shareholder in a company responsible for commercialising the device. Matthew N. Bourne has no conflicts of interest directly relevant to the content of this review.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Shield, A.J., Bourne, M.N. Hamstring Injury Prevention Practices in Elite Sport: Evidence for Eccentric Strength vs. Lumbo-Pelvic Training. Sports Med 48, 513–524 (2018). https://doi.org/10.1007/s40279-017-0819-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40279-017-0819-7