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TG and CK are joint first authors.
Introduction
Injuries of the muscle–tendon complex are one of the most frequent injuries in professional football (soccer).1 2 A recent analysis showed that muscle injury rates have not decreased over the last 18 years, neither in training nor in matches.3 Thigh muscle injuries are the most common injuries in professional football4 with a prevalence of up to 25%.5 Hamstring injuries account for 50% of all thigh injuries and typically have a high injury burden in professional football.4–6 In this regard, modifiable and non-modifiable risk factors of hamstring injuries and their interaction are explored concluding a multifactorial aetiology.7 8 Little attention has been given to understanding typical patterns of hamstring injuries, most frequently occurring during non-contact and indirect contact, while it represents one key factor in injury risk mitigation research.4
The hamstring muscle complex, consisting of the biceps femoris (including the long head and short head), semimembranosus and semitendinosus, is for the most part a biarticular muscle group integrating hip extension and knee flexion.9 Approximately 83%, 11% and 5% of all hamstring injuries affect the biceps femoris, semimembranosus and semitendinosus muscles, respectively.6 The biarticular nature of the hamstring muscle complex likely accounts for different mechanisms of injury which have been reported. A recent systematic review, mostly in running-related sports, revealed that ‘stretch-type’ injury patterns are caused by extensive hip flexion with an extended knee joint.10 In contrast, ‘sprinting-type’ injury patterns are most likely to occur during eccentric muscle contractions in the late swing phase of the running gait cycle.10 A recent analysis of professional football players showed that rapid movements with high eccentric demands of the posterior thigh (ie, sprinting or lunging) are the most frequent causes of non-contact injury.4
However, specific descriptions of hamstring injury events in professional football players regarding sprint-related versus stretch-related patterns, as well as joint and trunk kinematics are not available. These descriptions would be of great help to improve risk mitigation strategies by more accurately targeting the specific injury mechanisms. Therefore, the aim of this study was to analyse inciting events of hamstring injury in professional male football players using a systematic video analysis.
Methods
Study design and population
In this...
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