Georgios Bourogiannis1, Dimitris Hatzimanouil1, Eleni Semanltianou1, Ioannis Georgiadis1, Evaggelos Sykaras1

1Aristotle University Of Thessaloniki, Department of Physical Education & Sport Science

Reintegration Program for Professional Football Players after Grade 2 Hamstring Injuries

Monten. J. Sports Sci. Med. 2023, 12(1), 35-42 | DOI: 10.26773/mjssm.230305


Hamstring strains are among the most common injuries in soccer, with an increased risk of recurrence. There are three stages in injuries: 1 Diagnosis, 2 Physiotherapy – Rehabilitation, 3 Reintegration. The present study investigated the reintegration actions (return to play – RTP) for eight professional footballers (Super League 1) after hamstring strain. Eight professional soccer players who had hamstring injuries with Grade 2 strain were measured and evaluated. Two measurements were taken before and after injury. The first measurement involved maximum effort field tests of 30, 40, 50 and 60 meters in a straight line without a ball, using global positioning system (GPS) devices placed on the athletes for the interpretation and evaluation of their results. The second measurement aimed to evaluate the maximum strength of the eight players before and after their injury, using squats, bench presses and leg curl exercises on the machine. The statistical analysis included descriptive and inductive statistics (paired t-test). Analysis of the data collected showed that all soccer players had higher performance in the measurements taken after injury, both in speed and in maximal strength. In conclusion, following the appropriate rehabilitation and reintegration, the eight athletes were not affected by their injury and managed to return to competitive action (RTP) without recurrence and maximizing their performance.


Reintegration, injury, hamstrings, footballer, rehabilitation

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Altmann, S., Ringhof, S., Neumann, R., Woll, A., & Rumpf, M. C. (2019). Validity and reliability of speed tests used in soccer: A systematic review. PloS one, 14(8), e0220982.

Askling, C. M., Tengvar, M., Saartok, T., & Thorstensson, A. (2007). Acute first-time hamstring strains during high-speed running: a longitudinal study including clinical and magnetic resonance imaging findings. Clin. J. Sports Med., 35(2), 197-206.

Bayer, M.L., Hoegberget-Kalisz, M., Jensen, M.H., Olesen, J.L., Svensson, R.B., Couppé, C., & Kjaer, M. (2018). Role of tissue perfusion, muscle strength recovery, and pain in rehabilitation after acute muscle strain injury: A randomized controlled trial comparing early and delayed rehabilitation. Scand. J. Med. Sci. Sports, 28(12), 2579–2591.

Brooks J.H., Fuller C.W., Kemp S.P., & Reddin D.B. (2006). Incidence, risk, and prevention of hamstring muscle injuries in professional rugby union. Am. J. Sports Med., 34(8),1297-1306.

Brughelli M., Cronin J., Mendiguchia J., Kinsella D., & Nosaka K. (2010). Contralateral leg deficits in kinetic and kinematic variables during running in Australian rules football players with previous hamstring injuries. J. Strength Cond. Res., 24(9), 2539–2544.

Carling C, Bradley P, McCall A, Dupont G. Match-to-match variability in high-speed running activity in a professional soccer team. J Sports Sci. 2016 Dec;34(24):2215–23. [PubMed] [Google Scholar]

Cohen S.B., & Bradley J.P. (2007). Acute proximal hamstring rupture. J. Am. Acad. Ortho. Surg., 15(6), 350-355.

Drezner JA. Practical management: hamstring muscle injuries. Clin J Sport Med 2003;13(01):48–52

Ekstrand, J., Hagglund, M., & Walden, M. Epidemiology of muscle injuries in professional football (soccer) (2011). Am. J. Sports Med., 39(6), 1226–1232.

Ekstrand, J., Walden, M., & Hagglund, M. (2016). 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., 50(12), 731–737.

Jiménez-Rubio, S., Navandar, A., Rivilla-García, J., Paredes-Hernández, V., & Gómez-Ruano, M. Á. (2019). Improvements in match-related physical performance of professional soccer players after the application of an on-field training program for hamstring injury rehabilitation. Journal of Sport Rehabilitation, 29(8), 1145-1150.

Kujala U.M., Orava S, & Järvinen M. (1997). Hamstring injuries: current trends in treatment and prevention. Sports Med., 23(6), 397-404.

McCall, A., Carling, C., Davison, M., Nedelec, M., Le Gall, F., Berthoin, S., & Dupont, G. (2015). Injury risk factors, screening tests and preventative strategies: A systematic review of the evidence that underpins the perceptions and practices of 44 football (soccer) teams from various premier leagues. Br. J. Sports Med., 49(9), 583–589.

Mendez-Villanueva, A., Nuñez, F. J., Lazaro-Ramirez, J. L., Rodriguez-Sanchez, P., Guitart, M., Rodas, G. Martin-Garetxana, I., Lekue, J., Di Salvo, V., & Suarez-Arrones, L. (2022). Knee flexor eccentric strength, hamstring muscle volume and sprinting in elite professional soccer players with a prior strained hamstring. Biology, 11(1), 69.

Mendiguchia J, & Brughelli M. (2011). A return-to-sport algorithm for acute hamstring injuries. Phys. Ther. Sport, 12(1), 2–14.

Mendiguchia, J., Samozino, P., Martinez-Ruiz, E., Brughelli, M., Schmikli, S., Morin, J. B., & Mendez-Villanueva, A. (2014). Progression of mechanical properties during on-field sprint running after returning to sports from a hamstring muscle injury in soccer players. International journal of sports medicine, 35(08), 690-695.

Mohr M, Krustrup P, & Bangsbo J. (2003). Match performance of high-standard soccer players with special reference to development of fatigue. J. Sports Sci.,21(7), 519-528.

Orchard J, Best T.M., & Verrall G.M. (2005). Return to play following muscle strains. Clin. J. Sport Med., 15 (6), 436-441.

Schache AG, Dorn TW, Blanch PD, Brown NA, Pandy MG. Mechanics of the human hamstring muscles during sprinting. Med Sci Sports Exerc 2012;44(04):647–658

Schneider-Kolsky M.E., Hoving J.L., Warren P, & Connell D.A. (2006). A comparison between clinical assessment and magnetic resonance imaging of acute hamstring injuries. Am. J. Sports Med., 34(6), 1008-1015.

Sherry M.A., & Best T.M. (2004). A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains. J. Orthop. Sports Phys. Ther., 34(3), 116-125.

Skling C.M., Tengvar M., Tarassova O., & Thorstensson A. (2014). Acute hamstring injuries in Swedish elite sprinters and jumpers: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br. J. Sports Med., 48(7), 532-539.

Slavotinek J.P. (2010). Muscle injury: the role of imaging in prognostic assignment and monitoring of muscle repair. Semin. Musculoskelet Radiol.,14(2), 194-200.

Śliwowski R., Jadczak Ł., Hejna R., & Wieczorek A. (2015). The Effects of Individualized Resistance Strength Programs on Knee Muscular Imbalances in Junior Elite Soccer Players. PLoS ONE, 10(12), e0144021. pone.0144021

Thorborg K. (2012). Why hamstring eccentrics are hamstring essentials. Br. J. Sports Med., 46(7), 463–465.

Tol, J. L., Hamilton, B., Eirale, C., Muxart, P., Jacobsen, P., & Whiteley, R. (2014). At return to play following hamstring injury the majority of professional football players have residual isokinetic deficits. Br. J. Sports Med., 48(18), 1364-1369.

Van Der Horst, N., Backx, F. J. G., Goedhart, E. A., & Huisstede, B. M. (2017). Return to play after hamstring injuries in football (soccer): a worldwide Delphi procedure regarding definition, medical criteria and decision-making. Br. J. Sports Med., 51(22), 1583-1591.

Woods, C., Hawkins, R. D., Maltby, S., Hulse, M., Thomas, A., & Hodson, A. (2004). The Football Association Medical Research Programme: an audit of injuries in professional football—analysis of hamstring injuries. Br. J. Sports Med., 38(1), 36-41.