Loughborough University

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Hamstring muscle injuries in athletics

journal contribution
posted on 2023-04-17, 10:09 authored by Spyridon A. Iatropoulos, Patrick WheelerPatrick Wheeler

Hamstring muscle injuries (HMI) are a common and recurrent issue in the sport of athletics, particularly in sprinting and jumping disciplines. This review summarises the latest literature on hamstring muscle injuries in athletics from a clinical perspective. The considerable heterogeneity in injury definitions and reporting methodologies among studies still needs to be addressed for greater clarity. Expert teams have recently developed evidenced-based muscle injury classification systems whose application could guide clinical decision-making; however, no system has been adopted universally in clinical practice, yet.

The most common risk factor for HMI is a previously sustained injury, particularly early after return-to-sport. Other modifiable (e.g., weakness of thigh muscles, high-speed running exposure) and non-modifiable (e.g., older age) risk factors have limited evidence linking them to injury. Reducing injury may be achieved through exercise-based programmes, but their specific components and their practical applicability remain unclear.

Post-injury management follows similar recommendations to other soft tissue injuries, with a graded progression through stages of rehabilitation to full return to training and then competition, based on symptoms and clinical signs to guide the individual speed of the recovery journey. Evidence favouring surgical repair is conflicting and limited to specific injury sub-types (e.g., proximal avulsions). Further research is needed on specific rehabilitation components and progression criteria, where more individualised approaches could address the high rates of recurrent HMI. Prognostically, a combination of physical examination and magnetic resonance imaging (MRI) seems superior to imaging alone when predicting “recovery duration”, particularly at the individual level.



  • Sport, Exercise and Health Sciences

Published in

The Physician and Sportsmedicine


Taylor & Francis


  • AM (Accepted Manuscript)

Rights holder

© Informa UK Limited, trading as Taylor & Francis Group

Publisher statement

This is an Accepted Manuscript version of the following article, accepted for publication in The Physician and Sportsmedicine. Dr Spyridon A. Iatropoulos & Dr Patrick C. Wheeler (2023) Hamstring muscle injuries in athletics, The Physician and Sportsmedicine, DOI: 10.1080/00913847.2023.2188871. It is deposited under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Prof Patrick Wheeler. Deposit date: 2 March 2023