Module 10: Hamstrings strain prevention

“This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein”


Hamstring Strain injury in soccer – Prevention Strategies



Upon completion of this module the reader will be able to:

  • Understand basic anatomy of the knee joint complex.
  • Understand hamstring injury epidemiology in soccer
  • Understand the mechanisms for hamstring injury in soccer
  • Determine common risk factors that can lead to hamstring injury pain.
  • Incorporate exercises to prevent hamstring injury

Review the «Anatomy and Functional of the hamstrings» topic and the «Injury prevention strategies» topic first. Read the description of “The hamstring injuries in soccer – Prevention strategies” and the corresponding presentation and then follow the proposed videos for some ideas of “Hamstring injury prevention exercises”. End the session with the “Bibliography and the additional learning materials” and assess your understanding with the “Hamstring injuries in soccer” quiz.

The hamstring muscle complex consists of the biceps femoris laterally and the semimembranosus and semitendinosus medially. These are bi-articular muscles as they cross two joints, being extensors of the hip and flexors of the knee. The hamstrings limit knee extension just before and during heel strike, providing dynamic stability to anteroposterior translation of the tibia in relation to the femur.

Τhe proposed preventive strategies for knee injuries include four phases and they propose specific preventive exercises :

   Phase IMuscular conditioning to restore dysfunctional movement patterns that can impede performance

  1a. Inhibition: Inhibit through foam rolling the over-activate muscles: adductors, Tensor fasciae latae &  Iliotibial band, and hamstrings.

  1b.Muscle lengthen: Specific lengthening exercises with static or neuromuscular stretches for   adductors, Tensor fasciae latae & IT-band, and hamstrings.

   Phase IIMuscular performance: Modifying strength and conditioning movements 

  Specific activation exercises through strengthening exercises or positional stabilization exercises for the hamstrings/quads. Core strength.

  Phase III:  Functional exercise: Building efficient movement patterns 

   Starting with proper athletic position, always warm up before playing, perform different Squats and Walking Lunges. Do balance, agility-changing direction and jumping and landing exercises.

Hamstring strain  in soccer  – Prevention Strategies

Injury epidemiology

Hamstring strain injury is one of the most common injuries in sports. It is an important injury because not only can result in a significant loss of training and competition time but quite often it re-occurs and it may have a very negative impact on an athlete’s career. Hamstring injuries commonly occur in the athletes of many popular sport events in which high speed sprinting and kicking and very forced stretching are frequently performed, including Australian football, English rugby, soccer, and American football. Results from European soccer leagues in the past decade show that almost 2 out of 10 soccer players sustain a hamstring injury in a season, the risk is almost 9 times higher during games than training and that this risk increases almost 4% annually (Ekstrand et al. 2016).

Mechanisms of injury

Understanding the general mechanism of muscle strain injury is essential for understanding the specific mechanisms of hamstring muscle strain injury. Tremendous research efforts have been made in the last two decades to understand the general mechanism of muscle strain injury.

There are two main mechanisms of hamstring injury: the sprint-type and the stretch-type. The sprint type injury is the most common type and it occurs during the late phase of the sprinting cycle, just before the foot contacts the ground. This is because the hamstrings experience a very high change in their length while they forced to resist hip and knee joint movement (eccentric contraction). Evidence so far indicates that the biceps femoris long head is primary injured in this type of injury. In contrast, stretch-type of injury occurs during movements which require static over-stretch of the hamstrings such as tacklings and diagonal movements of the hip. This type of injury involves the semimembranosus muscle and it may take more time to recover.


Hamstring strain injuries in soccer  prevention exercises based on previous phases:

Phase I : Muscular conditioning to restore dysfunctional movement patterns that can impede performance



Phase ΙI : Muscular performance – Modifying strength and conditioning movements patterns



Phase III: Functional exercise – Building efficient movement patterns



Bibliography and the additional learning materials

  • Maintain hamstring flexibility in the pre-season and warm-down period
  • Improve your eccentric hamstring strength
  • Work on your sprinting technique with and without the ball
  • When you feel your hamstrings stiff, consult the medical staff
  • Ekstrand J, Waldén M, Hägglund 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(12):731-737. doi:10.1136/bjsports-2015-095359
  • Yu, R.M. Queen, A.N. Abbey, Y. Liu, C.T. Moorman, W.E. GarrettHamstring muscle kinematics and activation during overground sprinting J Biomech, 41 (2008), pp. 3121-3126
  • Garrett Jr W E, Best T M. Anatomy, physiology, and mechanics of skeletal muscle. In: Simon SR Orthopedic Basic Science. Rosemont, IL; American Academy of Orthopaedic Surgeons 1994: 89-125
  • Thelen D G, Chumanov E S, Hoerth D M et al.. Hamstring muscle kinematics during treadmill sprinting. Med Sci Sports Exerc. 2005;  37(1) 108-114
  • Woods C, Hawkins R D, Maltby S, Hulse M, Thomas A, Hodson A. Football Association Medical Research Programme . The Football Association Medical Research Programme: an audit of injuries in professional football—analysis of hamstring injuries. Br J Sports Med. 2004;  38(1) 36-41
  • Tyler TFSchmitt BMNicholas SJMcHugh MP. Rehabilitation After Hamstring-Strain Injury Emphasizing Eccentric Strengthening at Long Muscle Lengths: Results of Long-Term Follow-Up. J Sport Rehabil.2017 Apr;26(2):131-140

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Quiz module 10

Hamstrings strain prevention

1 / 9

The short head of the biceps femoris:

2 / 9

The hamstring injury is important because:

3 / 9

Hamstring injuries occur in sports which involve:

4 / 9

The percentage number of players who experience a hamstring injury in a season is:

5 / 9

The two basic mechanisms of hamstring injury are:

6 / 9

The sprint-type of injury mainly involves the:

7 / 9

A phase 1 exercise for hamstring injury prevention is:

8 / 9

A phase 2 exercise for hamstring injury prevention is:

9 / 9

A phase 3 exercise for hamstring injury prevention is:

Your score is

The average score is 0%



“This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.”