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The hamstring strain is a condition well recognised by medical personnel, coaches, and athletes. Such injuries are a major cause of time lost from sport. 1 Hamstring strains are among the most common injuries in sport and are most often observed in sports that involve sprinting and jumping. 2- 4 The initial Football Association Audit of Injuries study found that 12% of all injuries reported over two seasons were hamstring strains, this being the most prevalent injury. Players were 2.5 times more likely to sustain a hamstring strain than a quadriceps strain during a game. 5
Many predisposing factors for hamstring strain have been suggested in the literature, including insufficient warm up, 6, 7 poor flexibility, 6- 8 muscle imbalances, 6, 7, 9 muscle weakness, 9, 10 neural tension, 11 fatigue, 6, 7 dys-synergic contraction of muscle groups, 12 and previous injury. 13, 14 The evidence to substantiate these speculations is minimal and conflicting. 12, 15 The same holds true for the management and treatment of hamstring strains as there is no consensus on optimal rehabilitation, 7, 16 therefore management tends to be based on anecdotal evidence and experience rather than evidence based practice.
Hamstring strains are well known for their high rate of recurrence. 16- 19 It has been suggested that a premature return to play 10, 12, 20 or an inappropriate rehabilitation programme 10, 12, 13, 21 may be responsible for reinjury.
Garrett 22 stated that "Although muscle strains are frequently seen, our understanding of the pathophysiology, treatment, and recovery of these injuries is limited...". The aim of this study was to provide information on the incidence, nature, mechanism of injury, and diagnostic investigation of hamstring strains. This included analysing differences in the age, position, and ethnic origin of players sustaining such injuries in football. The collection of such injury data would help to identify factors involved in injury occurrence, and in establishing the effectiveness of treatment and prevention of hamstring injuries in soccer.
METHODS
Player injuries were prospectively reported from July 1997 through to the end of May 1999 inclusive. A total of 91 of the 92 football clubs from the English football leagues (Premier and Football League) committed themselves to the project. Injuries were recorded by club physiotherapists and/or doctors on...