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Hamstring Strains: No improvement in 3 decades

June 12, 2018

 

 Hamstring strains are one of the most common sporting injuries. Anyone involved in any type of running sport can attest to this. I’ve already seen multiple hamstring injuries at my local hockey club even though I’ve only being helping out for the past few weeks. According to the research hamstring injuries account for 6-29% of all sporting injuries (this value differs slightly depending on which paper you read) (Mendiguchia, 2011) (Woods, 2004). As you would expect there certainly is a wealth of information available on hamstring injuries, one quick search in PubMed (a research search engine) showed that ~2000 papers related to hamstring injuries have been published in the past 5 years alone. However, as I was perusing through some research I came across an interesting editorial piece published in the British Journal of Sports Medicine (BJSM) “Hamstring Strains: Are we heading in the right direction?” (Mendiguchia, 2011). This editorial piece shows that despite a wealth of information available about hamstring strains there has actually been noimprovement in hamstring injury and re-injury rates over the past 3 decades (Mendiguchia, 2011). So, despite everything we’ve learned over the past 30 years we are still seeing the same rates of hamstring injury as 1990. Why is this?

 

30 years is a long time, I wasn’t even born 30 years ago. The fact that there have been no improvements in reducing hamstring injury and re-injury rates is interesting, is something being overlooked? More on this later. First what typically happens when someone sustains a hamstring injury? Hopefully, that individual will begin some form of supervised rehabilitation program where they are progressing from stage to stage until they eventually meet specific return to play to play criteria and are allowed back onto the field. These programs are extremely thorough and designed according to the best evidence available, yet despite this we still see the same injury rates as 3 decades ago. Why? Could it be that individuals are not completing their rehabilitation correctly? (Faber, 2015) Or that athletes return to play before reaching the required criteria? (Menta 2016) Well the research suggests that both of these actually occur. Now to play devil’s advocate here it is known that there is a time lag of about 17 years from scientific discovery to implementation into health care (Morris, 2011). Which is why as health practitioners we are expected to keep up to date the current literature (many don’t). However, even at the elite sporting level with highly skilled practitioners (who we can expect to be reading the latest research) and dedicated athletes comm