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  • Dr. Norbert Martin, DPT

How To Prevent and Recover from Hamstrings Injuries in Soccer


Soccer players in action


Soccer is a sport that requires speed, agility, endurance, and skill. It also puts a lot of stress on the muscles of the lower body, especially the hamstrings. The hamstrings are a group of three muscles that run along the back of the thigh: the biceps femoris, the semitendinosus, and the semimembranosus. They help you extend your leg straight back and bend your knee. They also play a key role in sprinting, kicking, jumping, and changing direction.


Unfortunately, hamstring injuries are very common in soccer players. They account for about 17% of all soccer injuries and can range from mild strains to complete tears. Hamstring injuries can affect your performance, cause pain and limit your mobility. They can also take a long time to heal and increase your risk of re-injury.


In this article, we will explore the common causes and risk factors associated with hamstring injuries in soccer. We will also discuss the impact of hamstring injuries on soccer performance and the road to recovery for soccer players. Finally, we will provide specific soccer-specific exercises and stretches to strengthen the hamstrings and reduce injury risk. We will also explain the importance of warm-up routines and proper techniques in preventing hamstring injuries in soccer.



What Causes Hamstring Injuries in Soccer?

Hamstring injuries in soccer are usually caused by muscle overload. This happens when the muscle is stretched beyond its capacity or challenged with a sudden load. For example, when you sprint, your hamstring muscles contract eccentrically as the back leg is straightened and the toes are used to push off and move forward. This means that the muscles are lengthening and shortening at the same time, while also bearing your body weight and the force required for forward motion. This creates a lot of tension and stress on the muscle fibers and tendons.


Another common cause of hamstring injuries in soccer is fatigue. When you play soccer, you have to perform repeated bursts of high-intensity activity with short rest periods. This can deplete your energy reserves and impair your muscle function. As a result, your hamstrings may not be able to cope with the demands of the game and become more prone to injury.


Other factors that can contribute to hamstring injuries in soccer include:


  • Poor flexibility. Tight muscles are more vulnerable to strain. If your hamstrings are not flexible enough, they may not be able to stretch properly during soccer movements and become overstretched or torn.

  • Muscle imbalance. When one muscle group is much stronger than its opposing muscle group, the imbalance can lead to strain. For example, if your quadriceps (the muscles at the front of your thigh) are stronger than your hamstrings, they may overpower them and cause them to overwork or tear.

  • Previous injury. If you have had a hamstring injury before, you are more likely to have another one. This is because scar tissue may form at the site of injury, which can reduce the elasticity and strength of the muscle. Also, if you return to play too soon or without proper rehabilitation, you may not have fully recovered from the injury and risk re-injury.

  • Age. As you get older, your muscles tend to lose some of their strength and flexibility. This can make them more susceptible to injury when exposed to high-intensity activity like soccer.

  • Genetics. Some people may have a genetic predisposition to hamstring injuries due to factors such as muscle fiber type, tendon length, and collagen structure. These factors may affect how well your hamstrings can handle stress and strain during soccer movements.



How Do Hamstring Injuries Affect Soccer Performance?

Hamstring injuries can have a negative impact on your soccer performance in several ways. Depending on the severity of the injury, you may experience some or all of these effects:


  • Pain: Hamstring injuries can cause mild to severe pain in the back of your thigh or buttock area. The pain may be worse when you try to move your leg, especially when you extend it or bend your knee. The pain may also radiate to your lower back or calf. The pain can interfere with your ability to run, kick, jump, and change direction on the field.

  • Swelling: Hamstring injuries can cause inflammation and fluid accumulation in the injured area. This can result in swelling, bruising, and tenderness. The swelling can limit your range of motion and make your leg feel stiff and heavy.

  • Weakness: Hamstring injuries can damage the muscle fibers and tendons that are responsible for generating force and power in your leg. This can reduce your strength and endurance in your hamstrings and affect your speed, acceleration, and agility on the field.

  • Instability: Hamstring injuries can compromise the stability of your knee joint, which is supported by the hamstrings and other muscles. This can make your knee feel unstable or wobbly when you move it or put weight on it. This can affect your balance, coordination, and confidence on the field.



How Can You Recover from a Hamstring Injury?

The recovery time for a hamstring injury depends on the type and severity of the injury, as well as your individual factors such as age, fitness level, and medical history. In general, mild hamstring strains may heal in a few days or weeks, while severe hamstring tears may take months to heal.


There are three grades of hamstring injury, ranging from mild to severe:


  • Grade 1: A mild muscle strain. You may feel some pain and tenderness in the back of your thigh, but your strength and movement are not affected. This type of injury may heal within a few days with proper rest and care.

  • Grade 2: A partial muscle tear. You may feel more pain and swelling in the injured area, and you may have some bruising and loss of strength. You may also have difficulty moving your leg or bending your knee. This type of injury may take several weeks to heal, and you will need physical therapy to fully regain your function as quickly as possible.

  • Grade 3: A complete muscle tear. You may feel severe pain and tenderness in the back of your thigh, and you may have heard or felt a pop when the injury occurred. You may also have significant swelling, bruising, and muscle weakness. You may not be able to walk or stand on your injured leg. This type of injury may take several months to heal, and you may need surgery to repair the torn muscle.


The treatment for a hamstring injury usually involves four phases: Protection, Rest, Ice, Compression, and Elevation (PRICE); pain relief and anti-inflammatory medication; physical therapy; sometimes surgery, and finally a gradual return to activity.


  • PRICE. This is the initial phase of treatment that aims to reduce pain, swelling, and bleeding in the injured area. You should protect your hamstrings from further damage by avoiding activities that cause pain or discomfort. You may need to use crutches or a brace to support your leg and prevent further damage. You should rest your leg as much as possible and/or avoid putting weight on it. You should apply ice packs to the injured area for 15 to 20 minutes every two to three hours for the first 48 to 72 hours after the injury. Wrap the ice pack in a towel or cloth to protect your skin from frostbite. You should wrap a compression bandage around your thigh to limit swelling and support your hamstrings. Make sure the bandage is not too tight so that it cuts off your blood circulation. You should elevate your leg above the level of your heart to help drain excess fluid and reduce swelling.


  • Pain relief and anti-inflammatory medication. You may take over-the-counter painkillers such as ibuprofen or acetaminophen to help ease the pain and inflammation caused by the injury. However, you should consult your physician before taking any medication, especially if you have any medical conditions or allergies. You should also avoid taking aspirin, as it can increase bleeding in the injured area.


  • Physical therapy. This is the phase of treatment that aims to restore the function and strength of your hamstrings and prevent re-injury. You should see a physical therapist who can design a personalized rehabilitation program for you based on your goals and needs. The program may include exercises, stretches, massage, ultrasound, electrical stimulation, and other modalities to help heal your hamstrings and improve their flexibility, mobility, stability, and power. You should follow the instructions of your physical therapist carefully and progress gradually according to their feedback.


  • Surgery. In rare cases, you may need surgery to repair a severely torn hamstring muscle or tendon. This is usually done by stitching the ends of the torn tissue together or grafting a piece of healthy tissue from another part of your body. The recovery from surgery may take longer than nonsurgical treatment, and you will need to follow a specific rehabilitation program.


  • Gradual return to activity. This is the final phase of treatment that aims to help you resume your normal activities safely and effectively. You should not return to soccer until you have fully recovered from the injury and have regained your pre-injury level of performance. You should also consult your physician or physical therapist before returning to soccer to make sure you are ready and have no signs of re-injury. You should start with low-intensity activities such as jogging, cycling, or swimming, and gradually increase the intensity, duration, and frequency of your workouts as tolerated. You should also incorporate soccer-specific drills such as sprinting, kicking, jumping, and changing direction into your training routine to prepare your hamstrings for the demands of the game.



How Can You Prevent Hamstring Injuries in Soccer?

Hamstring injuries in soccer are not always preventable, but there are some steps you can take to reduce your risk of getting them. Here are some tips to help you prevent hamstring injuries in soccer:


  • Warm up properly. A good warm-up routine can prepare your hamstrings for soccer by increasing blood flow, oxygen delivery, muscle temperature, and elasticity in the area. You should warm up for at least 10 to 15 minutes before every soccer session, starting with low-intensity activities such as jogging or skipping, followed by dynamic stretches such as leg swings, lunges, or high knees. You should also include some soccer-specific movements such as sprinting, kicking, jumping, and changing direction to activate your hamstrings and other muscles involved in soccer. You should also include some soccer-specific warm-up exercises such as:


1- High knees: Knee drive: Good start to activate the muscles in the legs and hips.

2- Butt kicks: Hamstrings.

3- High knee lift: Quad and hip flexor stretch.

4- Hurdler/lunge: Helps with range of motion.

5- RDL/birdfeeder: Hamstring; balance.

6- Toy soldier: Hip flexor; range of motion.

7- Ladder scissors: Hip stability; hip rotation; balance; footwork; helps to increase intensity and athletic movement.


You should perform each exercise for 30 to 60 feet (10 to 20 yards) and repeat 2 to 3 times. You should also warm up your upper body by doing some arm circles, shoulder shrugs, and trunk rotations.


  • Strengthen your hamstrings. Strong hamstrings can withstand more stress and strain during soccer movements and reduce the risk of injury. You should include some hamstring-strengthening exercises in your regular training routine, such as:


1- Hamstring curls: Lie on your stomach with your legs straight and a resistance band looped around your ankles. Bend your knees and bring your heels towards your buttocks against the resistance of the band. Hold for a second and then slowly lower your legs back to the starting position. Repeat 10 to 15 times for 2 to 3 sets. This exercise can be performed using a leg curl machine to adjust the load.

Thera-Band Loop Hamstring Curl in Prone

Leg curl exercise using a machine

2- Glute bridges: Lie on your back with your knees bent and your feet flat on the floor. Squeeze your glutes and lift your hips off the floor until your body forms a straight line from your shoulders to your knees. Hold for a second and then slowly lower your hips back to the floor. Repeat 10 to 15 times for 2 to 3 sets. To make it harder, you can lift one leg off the floor and extend it straight out while keeping your hips level or use a barbell to increase/adjust the load.



The barbell glute bridge exercise

3- Nordic hamstring curls: Kneel on a mat with a partner holding your ankles firmly. Slowly lower your torso towards the floor by bending at the hips and keeping your back straight. Use your hamstrings to resist gravity as much as possible. When you can no longer control the descent, catch yourself with your hands and push yourself back up to the starting position. Repeat 6 to 10 times for 2 to 3 sets.



You should perform these exercises 2 to 3 times per week on non-consecutive days. You should also vary the intensity, volume, and frequency of these exercises depending on your training phase and goals.


  • Stretch your hamstrings. Flexible hamstrings can move through a full range of motion during soccer movements and prevent overstretching or tearing. You should include some hamstring-stretching exercises in your cool-down routine after every soccer session, such as:


1- Standing hamstring stretch: Stand with one leg slightly in front of the other and bend the front knee slightly. Keep the back leg straight and lean forward from the hips until you feel a stretch in the back of your thigh. Hold for 15 to 30 seconds and then switch legs. Repeat this stretch 2 to 3 times for each leg.

2- Seated hamstring stretch: Sit on the floor with one leg extended in front of you and the other leg bent with the foot resting against the inner thigh of the extended leg. Reach forward with both hands towards the toes of the extended leg until you feel a stretch in the back of your thigh. Hold for 15 to 30 seconds and then switch legs. Repeat 2 to 3 times for each leg.

3- Lying hamstring stretch: Lie on your back with one leg bent and the foot flat on the floor. Lift the other leg straight up towards the ceiling and loop a towel or a band around the ankle or foot. Gently pull on the towel or band until you feel a stretch in the back of your thigh. Hold for 15 to 30 seconds and then switch legs. Repeat 2 to 3 times for each leg.


You should perform these stretches when your muscles are warm and relaxed. You should also avoid bouncing or forcing the stretch beyond your comfort level.


  • Hydration. Hydrate yourself by drinking enough fluids before, during, and after your activity. Dehydration can cause muscle cramps and impair your performance.

  • Healthy Weight. Maintain a healthy weight by eating a balanced diet that includes lean protein, complex carbohydrates, healthy fats, fruits, and vegetables. Excess weight can put more stress on your muscles and joints and increase your risk of injury.

  • Prevention of muscle imbalance. Balance your hamstrings with your quadriceps by doing exercises such as squats, lunges, leg presses, and step-ups. These exercises can work both the front and back of your thighs and prevent muscle imbalance that can lead to injury.


Success Stories of Soccer Players Who Have Overcome Hamstring Injuries

Hamstring injuries can be frustrating and challenging to deal with, but they are not the end of your soccer career. Many soccer players have overcome hamstring injuries and returned to play at a high level. Here are some examples of success stories of soccer players who have recovered from hamstring injuries:



1- Lionel Messi


Lionel Messi stands with owners, from left, Jorge Mas, Jose Mas and David Beckham after he was introduced at DRV PNK Stadium, Sunday, July 16, 2023, in Fort Lauderdale (AP Photo/Marta Lavandier)
(AP Photo/Marta Lavandier)

2013 was a tough year for the Argentine superstar. He suffered from a series of hamstring injuries that sidelined him for weeks. His form and confidence took a hit. He decided to go back to Argentina and start a special rehabilitation program. He focused on strengthening his core and lower body muscles, as well as improving his diet and lifestyle. He also talked to a psychologist to deal with his mental barriers and regain his motivation. In 2014, he returned to the field and showed everyone why he is one of the best players in the world. He won several individual and team awards, including the FIFA World Cup Golden Ball in 2014 and the FIFA Ballon d’Or in 2015.



2- Gareth Bale


Real Madrid’s Gareth Bale holds his leg as Cristiano Ronaldo looks on during the Champions League match against Sporting Lisbon on Tuesday.
(Photograph: Armando Franca/AP)

The Welsh wizard had a major setback in 2017. He injured his hamstring and missed two months of action. He was worried he would not be able to play in the 2018 World Cup qualifiers, where he wanted to lead his team to glory. He did everything in his power to recover as quickly as possible. He underwent various therapies and treatments, such as physical therapy, hydrotherapy, cryotherapy, and electrotherapy. He also followed a strict diet and sleep routine to optimize his healing. He managed to recover in time for the 2018 Club World Cup and helped his team win the title. He scored three goals and assisted one in the tournament.




3- Alex Morgan


Alex Morgan celebrating winning the 2019 FIFA Women's World Cup and the tournament's Silver Boot
(Getty Image)

In 2017, she injured her hamstring while playing for Lyon in the Champions League final. She recovered fully to join the USWNT for the 2019 Women’s World Cup, where she scored six goals and won the Silver Boot award.






These are just some examples of soccer players who have overcome hamstring injuries and achieved great things on the field. They show that with proper treatment, dedication, and perseverance, you can recover from a hamstring injury and return to your best form.



Final Thoughts

Hamstring injuries are common in soccer players, but they can be prevented and treated with the right measures. By following the tips and advice in this article, you can reduce your risk of getting a hamstring injury, recover faster from one if it happens, and improve your performance on the field. Remember to warm up properly before every soccer session, strengthen your hamstrings regularly, stretch them after every soccer session, and seek professional help if you have any signs or symptoms of a hamstring injury. Also, don't forget to enjoy playing soccer and have fun! 😊



References

1. Askling CM, Tengvar M, Tarassova O, Thorstensson A. Acute hamstring injuries in Swedish elite sprinters and jumpers: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br J Sports Med. 2014 Apr;48(7):532-9. doi: 10.1136/bjsports-2013-093214. PMID: 24620041.


2. Croisier JL, Forthomme B, Namurois MH, Vanderthommen M, Crielaard JM. Hamstring muscle strain recurrence and strength performance disorders. Am J Sports Med. 2002 Mar-Apr;30(2):199-203. doi: 10.1177/03635465020300020901. PMID: 11912088.


3. Heiderscheit BC, Sherry MA, Silder A, Chumanov ES, Thelen DG. Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention. J Orthop Sports Phys Ther. 2010 Feb;40(2):67-81. doi: 10.2519/jospt.2010.3047. PMID: 20118524; PMCID: PMC2867336.


4. Petersen J, Hölmich P. Evidence based prevention of hamstring injuries in sport. Br J Sports Med. 2005 Jun;39(6):319-23. doi: 10.1136/bjsm.2005.018549. PMID: 15911599; PMCID: PMC1725237.


5. Tyler TF, Schmitt BM, Nicholas SJ, McHugh MP. Rehabilitation After Hamstring-Strain Injury Emphasizing Eccentric Strengthening at Long Muscle Lengths: Results of Long-Term Follow-Up. J Sport Rehabil. 2017 Apr;26(2):131-140. doi: 10.1123/jsr.2015-0099. Epub 2016 Aug 24. PMID: 27632842.


6. Cuthbert M, Ripley N, McMahon JJ, Evans M, Haff GG, Comfort P. The Effect of Nordic Hamstring Exercise Intervention Volume on Eccentric Strength and Muscle Architecture Adaptations: A Systematic Review and Meta-analyses. Sports Med. 2020 Jan;50(1):83-99. doi: 10.1007/s40279-019-01178-7. Erratum in: Sports Med. 2019 Nov 7;: PMID: 31502142; PMCID: PMC6942028.


7. van der Horst N, Backx F, Goedhart EA on behalf of HIPS-Delphi Group, et al. Return to play after hamstring injuries in football (soccer): a worldwide Delphi procedure regarding definition, medical criteria and decision-makingBritish Journal of Sports Medicine 2017;51:1583-1591.


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