Hamstring injuries are increasing in men’s professional football: every cloud has a silver lining?

Correspondence to Dr Cristiano Eirale, Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; [email protected]

Ekstrand et al recently showed that since 2001 hamstring injuries have increased by 4% annually in men’s professional football.¹ A reason could be that evidence-based preventive measures are only partially implemented at the elite level,² despite that they have been proven to be effective in the reduction of hamstring injuries in football in professional and amateur Danish footballers.³ However, while the rate of hamstring injuries increased during training sessions (4%/year), there was not a significant increase of these injuries during matches.¹ The authors speculate that this may be due to the fact that the training sessions are more intense with the aim to better prepare the players to the match. They also hypothesise that this new training approach may be protective during matches and therefore the hamstring injury rate during match play has not changed¹ despite that match intensity has increased in professional football.⁴ The authors conclude that the increasing injury rate is worrying, and prevention of hamstring injury should be given the highest priority.

Since the hamstring injury rate increased only during training, could we interpret these findings in another way? Would it be possible that the reason of this negative trend is already the result of a prevention strategy?

In their surveillance, Ekstrand et al are using a time loss definition of injury, as recommended by the consensus statement on...