Table 5

Determinants for recurrent hamstring injuries

DeterminantsStudy reference numberBest-evidence synthesis
Age2, 5Limited evidence
Height2, 5Limited evidence
Weight2, 5Limited evidence
Time to return to sportsAllLimited evidence
Size of the initial injury1, 2Limited evidence
Cross-sectional area of the initial injury1, 2, 3, 5↑Conflicting evidence
Volume of the initial injury5↑Limited evidence
Grade 1 injuries according to Peetrons1↑, 3↑Limited evidence
Muscle involved2, 3, 5Limited evidence
Location in the muscle*2, 3, 5Limited evidence
Pain severity score (VAS) 12–18 h after the initial injury5Limited evidence
Presence of a haematoma3Limited evidence
Dominant leg injured5Limited evidence
Previous hamstring injury2Limited evidence
Previous ACL reconstruction2↑Limited evidence
Rehabilitation ‘agility and stabilisation’4↓Limited evidence
Outcome functional tests§4Limited evidence
  • 1=Gibbs et al9; 2=Koulouris et al17; 3=Malliaropoulos et al10; 4=Sherry and Best19; 5=Verrall et al18

  • ↑=Risk factor for re-injury.

  • ↓=Protective factor for re-injury.

  • * Location in the muscle: upper, middle or lower thigh. Or musculotendinous junction compared with myofascial.

  • Positive for a history of a hamstring injury before the first injury during the competition.

  • Rehabilitation programme of ‘agility and stabilisation’ compared with a programme of ‘strengthening and eccentric stretching’ exercises.

  • § Functional tests performed: hop for height, hop for distance, 4 hop crossover test, 40 yard sprint.

  • ACL, anterior cruciate ligament; VAS, visual analogue scale.