Hamstring Injury Prevention for Elite Soccer Players: A Real-World Prevention Program Showing the Effect of Players’ Compliance on the Outcome

During the first and last season (2012/2013 and 2016/2017), no hamstring preventive action was implemented. For the seasons 2013/2014, 2014/2015, and 2015/2016, a non-compulsory (few players refusing to participate) NHE prevention program was implemented with accurate recording of the players’ training and match exposure and attendance to the prevention sessions. The first 10 weeks of the season were used to progressively increase the volume and intensity of the NHE exercises, and at the end of the season, players were split in low-, moderate-, and high-attendance groups to the prevention sessions.

Overall, 35 time-loss hamstring strain injuries were accounted for. The injury incidence was 0.30 per player per season, and the injury rate was 0.95 injury/1000 hour of exposure. A non-statistically significant higher risk of hamstring injury was observed in the control, low, and moderate attendance groups compared with the high-attendance group.

The greatest risk of hamstring injury was observed in the low-attendance group (odds ratio 1.77, confidence interval 0.57–5.47, p = 0.32). Implementing a NHE prevention program has a positive effect on the injury rate in a soccer team; however, the compliance of players with such interventions may be critical for its success.

Practical Application

• The implementation of the NHE or eccentric hamstring strengthening exercise if conducted correctly as part of a soccer club preventative strategy may be of significant benefit vs. the fight against hamstring injuries and fatigue resistance.
• Compliance and soccer player ‘buy-in’ to the exercise and protocol is key to the preventative strategy.
• Education provision for the players is key to understanding when and why to perform.

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