Treatments for preventing hamstring injuries

A brand new systematic review into the research of hamstring injuries has revealed that not enough is known about the effectiveness of current prevention methods for one of the most common sports injuries.

The review by physiotherapist and Northumbria University graduate Elliott Goldman, 29, has revealed that only six key pieces of research on prevention methods for the injury have been published internationally - despite hamstring injuries blighting the careers of some of the world's top footballers and having a direct impact on the bottom line of clubs worldwide.

Now Elliott is calling on physiotherapists and coaches, from the top flight sports clubs right down to grass roots level, to help prevent hamstring injuries by incorporating prevention techniques, which have been highlighted as being effective in current research, into their prevention programmes. 

These include manual therapy applied to the spine and specialised strengthening exercises and Elliott hopes physiotherapists and coaches will collect their own evidence to develop the research and help facilitate change in practice.

Elliott says: "I really expected to find a huge amount of research material in this area, as hamstring injuries are so common and there are a number of different methods currently used to help prevent injury.  I was keen to find out if there was evidence to support a particular method or range of methods of prevention. 

"However, after an extensive trawl of both published and unpublished literature, I discovered that very little research has been done to support the methods currently used in practice to prevent hamstring injuries.  As these injuries can have a devastating effect on an individual's career and a massive economic impact on some of the top flight clubs, I believe it is essential that further research is undertaken."

Elliott's research 'Interventions for preventing hamstring injuries' has now been published by the influential Cochrane Collaboration in the Cochrane Library - the world leader in evidence-based healthcare - and it analyses the effectiveness and strength of evidence behind current  methods of preventing hamstring injuries.

The hamstring muscles are situated at the back of the thigh and injuries, most commonly seen in footballers and basketball players, can have a devastating impact - causing agonising pain, requiring extensive rehabilitation and very often leaving a player prone to further injury.

A range of techniques are currently used to help prevent the injury.  These include exercise to strengthen and lengthen the hamstring muscles, spinal manual therapy, massage, proprioceptive balance training and plyometrics - although current evidence for the use of these techniques can neither be supported or refuted. 

Elliott's research into the effectiveness or otherwise of the current prevention methods began as part of his MSc in Physiotherapy at Northumbria University, when he undertook the research project for his dissertation.  Following graduation, he teamed up with his research supervisor Dr Anna Jones from Northumbria's School of Health, Community and Education Studies, to approach the Cochrane Collaboration in a bid to develop the research further.  He joined Cochrane's Bone, Joint and Muscle Trauma group and his research was enhanced with input from contributors as far afield as Edinburgh and New Zealand.

He says: "As a practicing physiotherapist, I believe there is real scope for some of the key prevention methods to be incorporated into training programmes to help prevent hamstring injuries.  However, my research findings reveal that much more quantitative research is needed to demonstrate their effectiveness.

"In addition, a shift in focus in future research is needed, moving away from assessing the effectiveness of individual intervention techniques delivered to a group of individuals, towards assessing a combination of interventions tailored to the individual team member, depending on their presenting risk factors.

"In order to convince individuals and teams to incorporate prevention methods into every day practice, we need to have the evidence that proves it works.  That needs the support of academics, practitioners, coaches and individuals alike."

Elliott is now sending his published review to sports clubs across the UK and he hopes coaches and physiotherapists will help take his research a step further.

He says: "Physiotherapists and coaches have a great opportunity to help us all understand how effective the different methods of prevention can be in practice.  They work with youngsters and see them at their peak of fitness.  By incorporating the current evidence-based prevention methods into their team and individual fitness plans, I believe they can both help reduce hamstring injuries amongst their players, and make a real difference to future generations by recording their findings and contributing to future research."

Elliott's research 'Interventions for preventing hamstring injuries' has been published by the Cochrane Collaboration - an international, independent, not-for-profit organisation with 27,000 contributors in over 100 countries.  Contributors work together to produce systematic assessments of healthcare interventions, known as Cochrane Reviews, which are published online in the Cochrane Library to help providers, practitioners and patients make informed decisions about healthcare.