Reducing hamstring injuries is at the heart of a good injury prevention program

Effectiveness of injury prevention programs with core muscle strengthening exercises to reduce the incidence of hamstring injuries in football players: a systematic review and meta-analysis.

Al Attar WSA and Husain MA. Sports Health. 2023 [Epub Ahead of Print].

Full text freely available

Take home message

Injury prevention programs with core muscle strengthening exercises reduce the risk of hamstring injuries in football players.

Background

Football players are at risk for many lower limb injuries, especially hamstring injuries. Many researchers have shown that injury prevention programs, which often include core muscle strengthening exercises, can reduce the risk of lower extremity injuries. However, it remains unclear whether injury prevention programs that include core muscle strengthening exercises effectively reduce the risk of hamstring injuries.

Study aim

The researchers completed a systematic review and meta-analysis to investigate whether an injury prevention program, including core strengthening exercises, reduces the number of hamstring injuries.

Methods

Researchers conducted an extensive literature review of randomized clinical trials involving (1) injury prevention training programs that included core strengthening exercises, (2) an outcome measure for the number of hamstring injuries, (3) a control comparison, and (4) football players of any type. level. Two researchers evaluated the risk of bias among the included studies.

Results

The authors analyzed five studies. One study was a randomized controlled trial, while the others were cluster randomized controlled trials. Each trial included 209 to 1,892 participants, for a total of 4,485 participants across all studies. Participants completed the injury prevention programs for 10 weeks to 8 months and had compliance rates ranging from 21% to 91%. Three of the five studies were considered to be at low risk of bias. Across all studies, 171 hamstring injuries were recorded during 379,102 exposures. Overall, completing an injury prevention training program that included core strengthening exercises (e.g. FIFA 11+) resulted in a 47% reduction in hamstring injuries compared to the control group (typically a standard warm-up program).

Viewpoints

Overall, this study supports the implementation of an injury prevention program involving core muscle strengthening exercises to reduce the risk of hamstring injuries in football players. Although this finding is useful to many physicians, gaps remain. For example, the low number of studies that met the inclusion criteria limits our confidence in the results. For example, although we estimate that these prevention programs reduce the risk of hamstring injuries by 47%, we can only be confident that the actual risk reduction likely ranges from 2% to 72%. More studies and a larger sample size would help us better understand how effective these programs are in reducing the risk of hamstring injuries. The studies also did not use identical interventions. While this may frustrate some people because we can’t say we have to do this specific program, it can also reassure us that we may have some flexibility to customize programs for each team and still experience the benefits. Ultimately, injury prevention programs that include core strengthening exercises are low risk and low cost and can help reduce the risk of injuries, especially hamstring injuries.

Clinical implications

Clinicians should encourage football teams to use injury prevention training programs that include core muscle strengthening exercises. These programs are often low riskcheapand completed in less than 15 minutes.

Questions for discussion

What do you look for when evaluating injury prevention programs for implementation? Have you specifically looked for core strengthening in the past? Why or why not?

Written by Kyle Harris
Reviewed by Jeffrey Driban

related posts

Exercises that target specific hamstring muscle groups
Clinical Findings Triumph baseline MRI findings in predicting hamstring re-injury shortly after return to play
Another feather in the cap of the FIFA 11+ Injury Prevention Program
FIFA 11+ reduces the risk of injuries for football players