Injury rate,mechanism, and risk factors of hamstring strain injuries in sports: A review of the literature

Hamstring strains are one of most common sports injuries. The purpose of this literature review is to summarize studies on hamstring strain injury rate, mechanism, and risk factors in the last several decades with a focus on the prevention and rehabilitation of this injury. Hamstring injury commonly occurs in sporting events in which high speed sprinting and kicking are frequently performed, such as Australian football, English rugby, American football, and soccer. Basic science studies have demonstrated that a muscle strain injury occurs due to excessive strain in eccentric contraction instead of force, and that elongation speed and duration of activation before eccentric contraction affect the severity of the injury. Hamstring strain injury is likely to occur during the late swing phase and late stance phase of sprint running. Shortened optimum muscle length, lack of muscle flexibility, strength imbalance, insufficient warm-up, fatigue, lower back injury, poor lumbar posture, and increased muscle neural tension have been identified as modifiable risk factors while muscle compositions, age, race, and previous injuries are non-modifiable risk factors. The theoretical basis of some of these risk factors, however, is lacking, and the results of clinical studies on these risk factors are inconsistent. Future studies are needed to establish the cause-and-effect relationships between those proposed risk factors and the injury.