Acute hamstring injury Understanding return to play, reinjury and injury prevention strategies

Acute hamstring injuries represent one of the most prevalent sports-related injuries with a high reinjury rate. However, the scientific knowledge on specific topics related to return to play, reinjury, and injury prevention strategies remains limited. This thesis aims to enhance the comprehensive understanding of acute hamstring injuries by addressing these three key areas.
The first aim was to focus on the return to play prognosis and evaluate the role of MRI in the return to play decision-making process. The second aim focused on identifying reinjury predictors that are essential for reducing reinjury risk. The third aim investigated injury prevention strategies, with specific emphasis on overcoming implementation barriers in primary injury prevention and initiating trials for a hamstring secondary (reinjury) prevention program.
For the first aim, five baseline clinical predictors and two baseline MRI predictors were identified as independent predictors of return to play, and complete normalization on 3.0-T MRI was found not to be expected prior to return-to-play decisions after hamstring injury. Second, two clinical findings, two MRI findings, and time to return to play were associated with increased reinjury risk. Third, our trial demonstrated no superior effect of low-volume Nordic hamstring exercises on performance improvement compared with the regular Nordic hamstring exercise program, indicating that identifying the minimum effective dose of low-volume Nordic hamstring exercise to overcome implementation barriers for injury prevention program remains a challenge.
This thesis concludes by reflecting on the main findings of the research, comparing them with the existing literature, and providing recommendations for clinical practice and future research.