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Optimizing sprinting biomechanics for hamstring injuries prevention

Conference Paper · May 2023

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 Optimizing sprinting biomechanics for hamstring injuries prevention
Morin J-B1, Edouard P1,2, Mendiguchia J3
1Inter-University
Laboratory of Human Movement Biology, UJM-Saint-Etienne, Saint-Etienne, France
2Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
3Department of Physical Therapy, ZENTRUM Rehab and Performance Center, Barañain, Spain

Despite decades of continued efforts in research and practice, sprint-related hamstring injuries (sHMI) are still
an unresolved issue in football1,2. Although improving hamstring strength (force capacity) has been proposed
as an effective solution in some studies, the most recent meta-analyses show that hamstring strength
capacity, as assessed and developed with a practical exercise such as the “Nordic hamstring” curl is not a
sufficient factor for sHMI risk estimation3 or prevention4. In this context, the multifactorial feature of sHMI
requires to consider a multifactorial and individualized approach of the risk puzzle5, and we suggest centering
this approach around the main injury mechanism during high-to-maximal-speed running6. If sHMI are seen as
an overall imbalance between hamstring muscles strain incurred during the sprint task and their capacity to
withstand that mechanical strain, an optimal prevention strategy should focus on (i) developing the capacity,
but also (ii) reducing the strain.
In addition to classical isolated strength and conditioning exercises targeting the posterior chain muscles, the
most direct and sprint-specific way to prepare hamstrings to the sprint task is to program and monitor a
consistent and regulated sprint exposure for each player. Sprinting itself is the only way to maximally
stimulate the hamstrings from a physio-mechanical standpoint: activity (surface EMG), length, open chain fast
knee-hip angular motion, calculated strain, limbs interactions. Based on retrospective studies and a recent
prospective cohort study7, another preventive strategy could also be to develop the sprint-specific
contribution of the hip extensors (including hamstrings) as quantified via the maximal ground reaction force
output in the antero-posterior direction.
On the strain reduction side of the balance, the two main factors we suggest are individual sprint “dose”
regulation and sprint running biomechanics through the influence of the sprint pattern on hamstring strain.
For the first point, as mentioned in the capacity paragraph, an individualized monitoring and regulation of
sprint exposure over the season should help avoid major under- and over-exposures, which are likely both
risky in terms of overall mechanical strain in the muscle-tendon tissues. Regarding sprint kinematic pattern,
functional anatomy basics and modeling studies have shown that trunk and pelvis positions during sprinting
influence the length and thus strain within the hamstrings (that mainly attach proximally to the pelvic ischiatic
tuberosity). This functional link has been confirmed by a recent pilot prospective study and consistent
anecdotal and coaching evidence suggesting higher sHMI risk in players with a greater trunk flexion, anterior
pelvic tilt and touchdown distance at maximal speed. In addition, this running pattern can be considered as a
modifiable factor since a recent study showed clear corrective changes after a specific training program8.
Following the functional anatomy basics earlier mentioned, these changes are collectively associated with a
likely reduced mechanical strain within the hamstrings, which in turn could help reduce sHMI risk, all other
things equal. The latter points are included in a sHMI prevention program that is individualized, sprint-
focused, and addresses each player’s individual “puzzle”9. This protocol is subject to ongoing research in
Football.
Main references
1. Maniar et al., Br. J. Sports Med. (2022) 6. Edouard et al., Br. J. Sports Med. (2022)
2. Ekstrand J. et al., Br. J. Sports Med. (2022) 7. Edouard et al., Int. J. Environ. Res. Public Health (2021)
3. Opar et al., Sport. Med. (2021) 8. Mendiguchia, et al., J. Sports Physiol. Perform. (2022)
4. Impellizzeri et al., J. Clin. Epidemiol. (2021) 9. Lahti et al., BMJ Open Sport and Exercise Medicine (2020)
5. Mendiguchia et al., Br. J. Sports Med. (2012)

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