Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study

Ryan G Timmins, Matthew N Bourne, Anthony J Shield, Morgan D Williams, Christian Lorenzen, David A Opar

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Abstract

Background/aim
To investigate the role of eccentric knee flexor strength, between-limb imbalance and biceps femoris long head (BFlh) fascicle length on the risk of future hamstring strain injury (HSI).

Methods
Elite soccer players (n=152) from eight different teams participated. Eccentric knee flexor strength during the Nordic hamstring exercise and BFlh fascicle length were assessed at the beginning of preseason. The occurrences of HSIs following this were recorded by the team medical staff. Relative risk (RR) was determined for univariate data, and logistic regression was employed for multivariate data.

Results
Twenty seven new HSIs were reported. Eccentric knee flexor strength below 337 N (RR=4.4; 95% CI 1.1 to 17.5) and possessing BFlh fascicles shorter than 10.56 cm (RR=4.1; 95% CI 1.9 to 8.7) significantly increased the risk of a HSI. Multivariate logistic regression revealed significant effects when combinations of age, history of HSI, eccentric knee flexor strength and BFlh fascicle length were explored. From these analyses the likelihood of a future HSI in older athletes or those with a HSI history was reduced if high levels of eccentric knee flexor strength and longer BFlh fascicles were present.

Conclusions
The presence of short BFlh fascicles and low levels of eccentric knee flexor strength in elite soccer players increases the risk of future HSI. The greater risk of a future HSI in older players or those with a previous HSI is reduced when they have longer BFlh fascicles and high levels of eccentric strength.
Original languageEnglish
Pages (from-to)1524-1535
JournalBritish Journal of Sports Medicine
Volume50
Issue number24
Early online date28 Nov 2015
DOIs
Publication statusPublished - 16 Dec 2016

Keywords

  • Elite Soccer Players
  • eccentric knee flexor strength
  • between-limb imbalance
  • biceps femoris long head fascicle length
  • hamstring strain injury
  • BFlh
  • HSI
  • Football
  • atheletes
  • Sports Injuries

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