Summary of: Petersen J et al. (2011) Preventive effect of eccentric training on acute hamstring injuries in men's soccer: a cluster-randomized controlled trial. Am J Sports Med 39: 2296-2303. [Prepared by Nicholas Taylor, CAP Co-ordinator.]. Question: Does eccentric muscle training of hamstring muscles reduce the rate of hamstring injuries in male soccer players? Design: Cluster randomised, controlled trial with concealed allocation. Setting: The 5 top men's soccer divisions in Denmark. Participants: First team squad soccer players from teams in the top 5 national soccer divisions were included. Players who joined a team after the start of the trial were excluded. Randomisation of 54 teams allocated 26 to the intervention group and 28 to a control group. Interventions: Both groups followed their usual training program. In addition, the intervention group completed 27 sessions of the eccentric hamstring muscle training in a 10-week period during the midseason break, and once a week in the second half of the season. The hamstring exercise (the Nordic curl) involves the player using hamstrings to resist forward falling of the trunk from a kneeling position. Players completed 2-3 sets of 5-12 repetitions of the exercise for 1-3 sessions per week. Outcome measures: The primary outcome was the number of overall, new, and recurrent acute hamstring injuries during one full soccer season. A hamstring injury was defined as any acute physical complaint in the region of the posterior thigh sustained during a soccer match or training. Recurrence of an injury already reported in the trial period was not included to avoid recording the same injury more than once. Results: 50 teams with 942 players completed the study. At the end of the season, there had been 15 hamstring injuries (12 new, 3 recurrent) in the eccentric hamstring exercise group and 52 injuries (32 new, 20 recurrent) in the control group. The number needed to treat (NNT) to prevent 1 hamstring injury (new or recurrent) was 13 (95% CI 9 to 23). The NNT to prevent 1 new injury was 25 (95% CI 15 to 72) and the NNT for recurrent injury was 3 (95% CI 2 to 6). Apart from short term muscle soreness no adverse events were reported in the exercise group. Conclusion: An eccentric strengthening exercise program for the hamstring muscles that can be performed during training can help prevent hamstring injuries in soccer players. © 2012 Australian Physiotherapy Association.
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