Preventing and managing hamstring strain injuries: the Holy Grail of football medicine

In this podcast, Dr Sean Carmody speaks to Dr Nick van der Horst, who has recently published a paper on decision-making and medical criteria for return to play following hamstring strain injuries. Nick, who is First team physiotherapist at the Go Ahead Eagles in the Dutch Eerst Divisie and holds a PhD in football medicine, provides his thoughts on the controversies around the role of MRI and eccentric strength in determining return to play, and also shares his beliefs about why hamstring strain injuries continue to rise. Finally, Nick closes the podcast with his key tips for clinicians managing hamstring strain injuries. There is lots of research referred to during the podcast, and these are linked below: Return to play after hamstring injuries in football (soccer): a worldwide Delphi procedure regarding definition, medical criteria and decision-making: http://bjsm.bmj.com/content/early/2017/03/30/bjsports-2016-097206 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: http://bjsm.bmj.com/content/early/2016/01/08/bjsports-2015-095359 Evidence-based hamstring injury prevention is not adopted by the majority of Champions League or Norwegian Premier League football teams: the Nordic Hamstring survey: http://bjsm.bmj.com/content/early/2015/05/20/bjsports-2015-094826 Strategic Assessment of Risk and Risk Tolerance (StARRT) framework for return-to-play decision-making: http://bjsm.bmj.com/content/early/2015/06/02/bjsports-2014-094569.short?rss=1 Hamstring injuries and predicting return to play: ‘bye-bye MRI?’ http://bjsm.bmj.com/content/49/18/1162 MRI does not add value over and above patient history and clinical examination in predicting time to return to sport after acute hamstring injuries: a prospective cohort of 180 male athletes: http://bjsm.bmj.com/content/early/2015/08/24/bjsports-2015-094892