ArticleSports medicine - open2025
The Relationship Between Running Load, Strength, Muscle Architecture and Hamstring Strain Injury Across Two Seasons of Elite Male Australian Football: A Prospective Cohort Study.
Article in Sports medicine - open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPrevious research has demonstrated a relationship between modifiable (e.g. hamstring strength, muscle fascicle length and high-speed running load), non-modifiable factors (e.g. age, previous injury) and hamstring strain injury (HSI) risk. However, these factors have mostly been assessed in isolation and no study to date has investigated the associations between running load, strength and muscle architecture with HSI risk. The study aim was to explore the interactions between modifiable HSI risk factors that are commonly assessed within elite Australian footballers.
methodsA prospective cohort study design. Eccentric knee flexor strength and biceps femoris long head (BFlh) fascicle lengths were measured in 299 unique elite-level Australian Football players (age 24 ± 4 years, height 188 ± 8 cm, and weight 87 ± 9 kg) during two pre-seasons. Data from wearable micro-sensor units (high-speed running at ≥ 24k/hr and total distance) were collected over two seasons of elite Australian Football.
resultsAcross 408 player-seasons there were 67 HSIs (16.4%), which took an average of 17 ± 10 days and 23 ± 12 days to return to full training and competitive matches, respectively. Univariate analysis showed that BFlh pennation angle (OR 1.6, 95% CI 1.2-2.2), fascicle length (OR 0.6, 95% CI 0.5-0.9), weekly high-speed running distance (OR 1.7, 95% CI 1.2-2.4), weekly change in total distance (OR 1.5, 95% CI 1.1-2.2) and weekly change in high-speed running distance (OR 1.6, 1.2-2.2) were significantly different between the injured and uninjured group (P < 0.05). Combining strength and architectural variables of BFlh pennation angle, fascicle length and peak force was able to explain 12% of variance in the risk of sustaining a HSI. The addition of running load exposure variables of weekly distance and change in weekly distance to the multivariate model increased the explained variance to 20%.
conclusionCombining measures of running load exposure with hamstring strength and architecture, increases the variance explained by multivariate models for determining HSI risk. Despite this, there was still approximately 80% of unexplained variance in sustaining a HSI in this study.
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