Injury-inciting circumstances of sudden-onset hamstring injuries: video analyses of 63 match injuries in male professional football players in the Qatar Stars League (2013–2020)

Vermeulen, Robin ORCID: https://orcid.org/0000-0001-9456-8892, van Dyk, Nicol ORCID: https://orcid.org/0000-0002-0724-5997, Whiteley, Rod ORCID: https://orcid.org/0000-0002-1452-6228, Chamari, Karim ORCID: https://orcid.org/0000-0001-9178-7678, Gregson, Warren ORCID: https://orcid.org/0000-0001-9820-5925, Lolli, Lorenzo ORCID: https://orcid.org/0000-0001-8670-3361, Bahr, Roald ORCID: https://orcid.org/0000-0001-5725-4237, Tol, Johannes L and Serner, Andreas ORCID: https://orcid.org/0000-0003-4308-901X (2024) Injury-inciting circumstances of sudden-onset hamstring injuries: video analyses of 63 match injuries in male professional football players in the Qatar Stars League (2013–2020). British Journal of Sports Medicine, 58 (20). pp. 1196-1204. ISSN 0306-3674

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Abstract

Objective: To describe and categorise the injury-inciting circumstances of sudden-onset hamstring match injuries in professional football players using systematic video analysis. Methods: Using a prospective injury surveillance database, all sudden-onset hamstring match injuries in male football players (18 years and older) from the Qatar Stars League between September 2013 and August 2020 were reviewed and cross-referenced with broadcasted match footage. Videos with a clear observable painful event (ie, a player grabbing their posterior thigh) were included. Nine investigators independently analysed all videos to describe and categorise injury-inciting circumstances. We used three main categories: playing situation (eg, time of injury), player action(s) (eg, running) and other considerations (eg, contact). Player action(s) and other considerations were not mutually exclusive. Results: We included 63 sudden-onset hamstring match injuries out of 295 registered injuries between 2013 and 2020. Running was involved in 86% of injuries. Hamstring injuries occurred primarily during acceleration of 0–10 m (24% of all injuries) and in general at different running distances (0–50 m) and speeds (slow to fast). At 0–10 m distance, indirect player-to-player contact and inadequate balance were involved in 53% and 67% of the cases, respectively. Pressing occurred in 46% of all injuries (injured player pressing opponent: 25%; being pressed by opponent: 21%) and frequently involved player-to-player contact (69% of the cases when the injured player was pressing vs 15% of the cases when the opponent was pressing) and inadequate balance (82% vs 50%, respectively). Other player actions that did not involve running (n=9, 14% of all injuries) were kicking (n=6) and jumping (n=3). Conclusion: The injury-inciting circumstances of sudden-onset hamstring match injuries in football varied. The most common single-player action (24%) was acceleration over a distance of <10 m. Pressing, inadequate balance and indirect contact were frequently seen player actions. Injury prevention research in football should look beyond high-speed running as the leading risk factor for sudden-onset hamstring injuries.