Editorial Commentary: Hamstrung: Do Sex Differences in Hamstring Injury Profile Necessitate a Different Approach to Rehabilitation and Prevention Programs in Female Athletes?
DOI:
https://doi.org/10.53646/jwsm.v1i1.12Keywords:
Hamstring injury, sex-differences, female athlete injuryAbstract
Hamstring strain injury (HSI) is one of the most common injuries encountered in running sports and can lead to significant morbidity, with time lost from participation and high rates of recurrence. Though the incidence is high in both sexes, male athletes appear to have a two to four-fold greater risk of HSI compared to female athletes, with a longer recovery. Multiple potential risk factors have been studied and age, history of hamstring injury, ACL injury and calf injury appear to be the most significant factors in predicting index injury and recurrence. Female athletes may be relatively protected by less hamstring unit stiffness and greater muscle endurance. Other potential sex-influenced risk factors including differences in pelvic, hip and knee structural morphology and limb alignment, musculotendinous flexibility and joint mobility, and kinetic chain (primary posterior) strength imbalances require further investigation. Further research focusing both exclusively on female athlete as well as more robust comparative studies with male athletes will help us to better understand differences in HSI profile. Future investigation is necessary to determine whether a sex-specific approach to HSI rehabilitation and prevention programs will optimize clinical care for both male and female athletes.
References
Ekstrand J, Waldén M, Hägglund M. 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. 2016;50(12):731-737. doi:10.1136/BJSPORTS-2015-095359
Feeley BT, Kennelly S, Barnes RP, et al. Epidemiology of national football league training camp injuries from 1998 to 2007. Am J Sports Med. 2008;36(8):1597-1603. doi:10.1177/0363546508316021
Opar DA, Williams MD, Shield AJ. Hamstring strain injuries: Factors that Lead to injury and re-Injury. Sport Med. 2012. doi:10.2165/11594800-000000000-00000
Green B, Bourne MN, Van Dyk N, Pizzari T. Recalibrating the risk of hamstring strain injury (HSI): A 2020 systematic review and meta-analysis of risk factors for index and recurrent hamstring strain injury in sport. Br J Sport Med. 2020;54:1081-1088. doi:10.1136/bjsports-2019-100983
Cross KM, Gurka KK, Saliba S, Conaway M, Hertel J. Comparison of hamstring strain injury rates between male and female intercollegiate soccer athletes. Am J Sports Med. 2013;41(4):742-748. doi:10.1177/0363546513475342
Larruskain J, Lekue JA, Diaz N, Odriozola A, Gil SM. A comparison of injuries in elite male and female football players: A five-season prospective study. Scand J Med Sci Sport. 2018;28(1):237-245. doi:10.1111/sms.12860
O’Sullivan, Lucy; Tanaka M. Sex-based differences in hamstring injury risk factors. J Women’s Sport Med. 2021;1(1).
Pacey V, Nicholson LL, Adams RD, Munn J, Munns CF. Winner of the 2009 systematic review competition: Generalized joint hypermobility and risk of lower limb joint injury during sport: A systematic review with meta-analysis. Am J Sports Med. 2010;38(7):1487-1497. doi:10.1177/0363546510364838
Knapik JJ, Bauman CL, Jones BH, Harris JM, Vaughan L. Preseason strength and flexibility imbalances associated with athletic injuries in female collegiate athletes. Am J Sports Med. 1991;19(1):76-81. doi:10.1177/036354659101900113
Huston LJ, Wojtys EM. Neuromuscular performance characteristics in elite female athletes. Am J Sports Med. 1996;24(4):427-436. doi:10.1177/036354659602400405
Nadler SF, Malanga GA, DePrince M, Stitik TP, Feinberg JH. The relationship between lower extremity injury, low back pain, and hip muscle strength in male and female collegiate athletes. Clin J Sport Med. 2000;10(2):89-97. doi:10.1097/00042752-200004000-00002
Vannatta CN, Kernozek TW. Sex differences in gluteal muscle forces during running. Sport Biomech. 2021;20(3):319-329. doi:10.1080/14763141.2018.1548641
Nyland J, Kuzemchek S, Parks M, Caborn DNM. Femoral anteversion influences vastus medialis and gluteus medius EMG amplitude: Composite hip abductor EMG amplitude ratios during isometric combined hip abduction-external rotation. J Electromyogr Kinesiol. 2004;14(2):255-261. doi:10.1016/S1050-6411(03)00078-6
Downloads
Published
Issue
Section
License
Copyright (c) 2021 Journal of Women's Sports Medicine
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.