Evidence Practice Guidelines: Treating Hamstring Injuries
Hamstring injuries (HSIs) are the most common athletic injury in running and pivoting sports, but despite large amounts of research, injury rates have not declined in the last 2 decades. HSI often recur and many areas are lacking evidence and guidance for optimal rehabilitation. This study aimed to develop an international expert consensus for the management of HSI.
The Delphi study and expert panel suggest that rehabilitation prescription after HSI should be individualised, based on the athlete’s sports- specific hamstring demands, the nature of the injury and required capacities. Decision- making should consider differences in hamstring musculotendinous tissue, individual muscle anatomy and functional roles. This should direct rehabilitation prescription for different muscles and myotendinous tissues after HSI. In early- stage rehabilitation, most experts advocate protection of injured tissue from elastic load or stretch shortening (high strain amount and rate loads), but the types of load/contraction and the order of their application varied greatly between our experts. Experts recommend addressing dysfunctions in the whole lower limb and kinetic chain related to hamstring function. While not reaching consensus, many experts are increasingly using adjuncts such as BFR training to achieve early strength gains with lower tissue loads.
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