Sportphysio 2017; 05(01): 7-15
DOI: 10.1055/s-0042-120900
Georg Thieme Verlag KG Stuttgart · New York

Hamstring-Verletzungen – ein evidenzbasiertes Update

David Opar
Further Information

Publication History

Publication Date:
10 February 2017 (online)


RISIKOFAKTOREN, PRÄVENTIONSSTRATEGIEN UND EINSTUFUNG DER VERLETZUNGSSCHWERE Seit mehr als 40 Jahren ist „hamstring strain injury“ (HSI) die häufigste Verletzung in Laufsportarten. Trotz der sorgfältigen Planung und Implementierung von Risikominderungsstrategien gibt es immer noch eine Reihe von Streitpunkten, insbesondere in Bezug auf die Einstufung der Verletzungsschwere. Aus diesem Grund lohnt es sich, einen Blick auf den aktuellen Stand der Evidenz hinsichtlich Risikofaktoren, präventiven Interventionen und der Einstufung des Verletzungsumfangs bei HSI zu werfen.

  • Literatur

  • 1 Alonso JM, Edouard P, Fischetto G. et al. Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance. Br J Sports Med 2012; 46: 505-514
  • 2 Arnason A, Sigurdsson SB, Gudmundsson A. et al. Risk factors for injuries in football. Am J Sports Med 2004; 32 (Suppl. 01) 5S-16S
  • 3 Askling C, Karlsson J, Thorstensson A. Hamstring injury occurrence in elite soccer players after preseason strength training with eccentric overload. Scand J Med Sci Sports 2003; 13: 244-250
  • 4 Askling CM, Tengvar M, Saartok T. et al. Acute first-time hamstring strains during high-speed running: a longitudinal study including clinical and magnetic resonance imaging findings. Am J Sports Med 2007; 35: 197-206
  • 5 Askling CM, Tengvar M, Thorstensson A. Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br J Sports Med 2013; 47: 953-959
  • 6 Bahr R. Why screening tests to predict injury do not work – and probably never will…: a critical review. Br J Sports Med 2016; 50: 776-780
  • 7 Bahr R, Holme I. Risk factors for sports injuries – a methodological approach. Br J Sports Med 2003; 37: 384-392
  • 8 Bahr R, Thorborg K, Ekstrand J. Evidence-based hamstring injury prevention is not adopted by the majority of Champions League or Norwegian Premier League football teams: the Nordic Hamstring survey. Br J Sports Med 2015; 49: 1466-1471
  • 9 Bennell K, Wajswelner H, Lew P. et al. Isokinetic strength testing does not predict hamstring injury in Australian Rules footballers. Br J Sports Med 1998; 32: 309-314
  • 10 Bourne MN, Opar DA, Williams MD. Eccentric knee flexor strength and risk of hamstring injuries in rugby union: a prospective study. Am J Sports Med 2015; 43: 2663-2670
  • 11 Bradley PS, Portas MD. The relationship between preseason range of motion and muscle strain injury in elite soccer players. J Strength Cond Res 2007; 21: 1155-1159
  • 12 Brooks JH, Fuller CW, Kemp SP. et al. Incidence, risk, and prevention of hamstring muscle injuries in professional rugby union. Am J Sports Med 2006; 34: 1297-1306
  • 13 Christensen CS, Wiseman DC. Strength, the common variable in hamstring strain. Athl Train 1972; 7: 36-40
  • 14 Comin J, Malliaras P, Baquie P. et al. Return to competitive play after hamstring injuries involving disruption of the central tendon. Am J Sports Med 2013; 41: 111-115
  • 15 Connell DA, Schneider-Kolsky ME, Hoving JL. et al. Longitudinal study comparing sonographic and MRI assessments of acute and healing hamstring injuries. AJR Am J Roentgenol 2004; 183: 975-984
  • 16 De Vos RJ, Reurink G, Goudswaard GJ. et al. Clinical findings just after return to play predict hamstring re-injury, but baseline MRI findings do not. Br J Sports Med 2014; 48: 1377-1384
  • 17 Duhig S, Shield AJ, Opar D. et al. Effect of high-speed running on hamstring strain injury risk. Br J Sports Med 2016; 0
  • 18 Ekstrand J, Askling C, Magnusson H. et al. Return to play after thigh muscle injury in elite football players: implementation and validation of the Munich muscle injury classification. Br J Sports Med 2013; 47: 769-774
  • 19 Ekstrand J, Walden M, Hagglund M. Hamstring injuries have increased by 4 % annually in men’s professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study. Br J Sports Med 2016; 50: 731-737
  • 20 Emery CA, Rose MS, McAllister JR. et al. A prevention strategy to reduce the incidence of injury in high school basketball: a cluster randomized controlled trial. Clin J Sport Med 2007; 17: 17-24
  • 21 Engebretsen AH, Myklebust G, Holme I. et al. Prevention of injuries among male soccer players: a prospective, randomized intervention study targeting players with previous injuries or reduced function. Am J Sports Med 2008; 36: 1052-1060
  • 22 Engebretsen AH, Myklebust G, Holme I. et al. Intrinsic risk factors for hamstring injuries among male soccer players: a prospective cohort study. Am J Sports Med 2010; 38: 1147-1153
  • 23 Fleckenstein JL, Shellock FG. Exertional muscle injuries: magnetic resonance imaging evaluation. Top Magn Reson Imaging 1991; 3: 50-70
  • 24 Fousekis K, Tsepis E, Poulmedis P. et al. Intrinsic risk factors of non-contact quadriceps and hamstring strains in soccer: a prospective study of 100 professional players. Br J Sports Med 2011; 45: 709-714
  • 25 Freckleton G, Pizzari T. Risk factors for hamstring muscle strain injury in sport: a systematic review and meta-analysis. Br J Sports Med 2013; 47: 351-358
  • 26 Fyfe JJ, Opar DA, Williams MD. et al. The role of neuromuscular inhibition in hamstring strain injury recurrence. J Electromyogr Kinesiol 2013; 23: 523-530
  • 27 Gabbe BJ, Bennell KL, Finch CF. Why are older Australian football players at greater risk of hamstring injury?. J Sci Med Sport 2006; 9: 327-333
  • 28 Gabbe BJ, Bennell KL, Finch CF. et al. Predictors of hamstring injury at the elite level of Australian football. Scand J Med Sci Sports 2006; 16: 7-13
  • 29 Gabbe BJ, Branson R, Bennell KL. A pilot randomised controlled trial of eccentric exercise to prevent hamstring injuries in community-level Australian football. J Sci Med Sport 2006; 9: 103-109
  • 30 Gabbe BJ, Finch CF, Bennell KL. et al. Risk factors for hamstring injuries in community level Australian football. Br J Sports Med 2005; 39: 106-110
  • 31 Gibbs NJ, Cross TM, Cameron M. et al. The accuracy of MRI in predicting recovery and recurrence of acute grade one hamstring muscle strains within the same season in Australian Rules football players. J Sci Med Sport 2004; 7: 248-258
  • 32 Goode AP, Reiman MP, Harris L. et al. Eccentric training for prevention of hamstring injuries may depend on intervention compliance: a systematic review and meta-analysis. Br J Sports Med 2015; 49: 349-356
  • 33 Hamilton B, Valle X, Rodas G. et al. Classification and grading of muscle injuries: a narrative review. Br J Sports Med 2015; 49: 306
  • 34 Henderson G, Barnes CA, Portas MD. Factors associated with increased propensity for hamstring injury in English Premier League soccer players. J Sci Med Sport 2010; 13: 397-402
  • 35 Koulouris G, Connell DA, Brukner P. et al. Magnetic resonance imaging parameters for assessing risk of recurrent hamstring injuries in elite athletes. Am J Sports Med 2007; 35: 1500-1506
  • 36 Malliaropoulos N, Papacostas E, Kiritsi O. et al. Posterior thigh muscle injuries in elite track and field athletes. Am J Sports Med 2010; 38: 1813-1819
  • 37 Mueller-Wohlfahrt HW, Haensel L, Mithoefer K. et al. Terminology and classification of muscle injuries in sport: the Munich consensus statement. Br J Sports Med 2013; 47: 342-350
  • 38 Opar DA, Williams MD, Shield AJ. Hamstring strain injuries: factors that lead to injury and re-injury. Sports Med 2012; 42: 209-226
  • 39 Opar DA, Williams MD, Timmins RG. et al. Eccentric hamstring strength and hamstring injury risk in Australian footballers. Med Sci Sports Exerc 2015; 47: 857-865
  • 40 Orchard J, Marsden J, Lord S. et al. Preseason hamstring muscle weakness associated with hamstring muscle injury in Australian footballers. Am J Sports Med 1997; 25: 81-85
  • 41 Orchard JW. Intrinsic and extrinsic risk factors for muscle strains in Australian football. Am J Sports Med 2001; 29: 300-303
  • 42 Petersen J, Thorborg K, Nielsen MB. et al. Preventive effect of eccentric training on acute hamstring injuries in men’s soccer: a cluster-randomized controlled trial. Am J Sports Med 2011; 39: 2296-2303
  • 43 Petersen J, Thorborg K, Nielsen MB. et al. The diagnostic and prognostic value of ultrasonography in soccer players with acute hamstring injuries. Am J Sports Med 2014; 42: 399-404
  • 44 Pollock N, James SL, Lee JC. et al. British athletics muscle injury classification: a new grading system. Br J Sports Med 2014; 48: 1347-1351
  • 45 Pollock N, Patel A, Chakraverty J. et al. Time to return to full training is delayed and recurrence rate is higher in intratendinous (‘c’) acute hamstring injury in elite track and field athletes: clinical application of the British Athletics Muscle Injury Classification. Br J Sports Med 2016; 50: 305-310
  • 46 Rachun A. 1966. Standard Nomenclature of Athletic Injuries. 1st ed.. Chicago, Illinois: American Medical Association;
  • 47 Rolls A, George K. The relationship between hamstring muscle injuries and hamstring muscle length in young elite footballers. Phys Ther Sport 2004; 5: 179-187
  • 48 Schneider-Kolsky ME, Hoving JL, Warren P. et al. A comparison between clinical assessment and magnetic resonance imaging of acute hamstring injuries. Am J Sports Med 2006; 34: 1008-1015
  • 49 Slavotinek JP, Verrall GM, Fon GT. Hamstring injury in athletes: using MR imaging measurements to compare extent of muscle injury with amount of time lost from competition. AJR Am J Roentgenol 2002; 179: 1621-1628
  • 50 Soderman K, Werner S, Pietila T. et al. Balance board training: prevention of traumatic injuries of the lower extremities in female soccer players? A prospective randomized intervention study. Knee Surg Sports Traumatol Arthrosc 2000; 8: 356-363
  • 51 Sugiura Y, Saito T, Sakuraba K. et al. Strength deficits identified with concentric action of the hip extensors and eccentric action of the hamstrings predispose to hamstring injury in elite sprinters. J Orthop Sports Phys Ther 2008; 38: 457-464
  • 52 Timmins RG, Bourne MN, Shield AJ. et al. Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study. Br J Sports Med 2015; 0
  • 53 van der Horst N, Smits DW, Petersen J. et al. The preventive effect of the nordic hamstring exercise on hamstring injuries in amateur soccer players: a randomized controlled trial. Am J Sports Med 2015; 43: 1316-1323
  • 54 van Dyk N, Bahr R, Whiteley R. et al. Hamstring and quadriceps isokinetic strength deficits are weak risk factors for hamstring strain injuries: a 4-year cohort study. Am J Sports Med 2016; 44: 1789-1795
  • 55 van Mechelen W, Hlobil H, Kemper HC. et al. Prevention of running injuries by warm-up, cool-down, and stretching exercises. Am J Sports Med 1993; 21: 711-719
  • 56 Verrall GM, Kalairajah Y, Slavotinek JP. et al. Assessment of player performance following return to sport after hamstring muscle strain injury. J Sci Med Sport 2006; 9: 87-90
  • 57 Verrall GM, Slavotinek JP, Barnes PG. et al. Assessment of physical examination and magnetic resonance imaging findings of hamstring injury as predictors for recurrent injury. J Orthop Sports Phys Ther 2006; 36: 215-224
  • 58 Verrall GM, Slavotinek JP, Barnes PG. et al. Clinical risk factors for hamstring muscle strain injury: a prospective study with correlation of injury by magnetic resonance imaging. Br J Sports Med 2001; 35: 435-439 discussion 440
  • 59 Wangensteen A, Almusa E, Boukarroum S. et al. MRI does not add value over and above patient history and clinical examination in predicting time to return to sport after acute hamstring injuries: a prospective cohort of 180 male athletes. Br J Sports Med 2015; 49: 1579-1587
  • 60 Witvrouw E, Danneels L, Asselman P. et al. Muscle flexibility as a risk factor for developing muscle injuries in male professional soccer players. A prospective study. Am J Sports Med 2003; 31: 41-46
  • 61 Woods C, Hawkins RD, Maltby S. et al. The Football Association Medical Research Programme: an audit of injuries in professional football – analysis of hamstring injuries. Br J Sports Med 2004; 38: 36-41
  • 62 Yamamoto T. Relationship between hamstring strains and leg muscle strength. A follow-up study of collegiate track and field athletes. J Sports Med Phys Fitness 1993; 33: 194-199