Match high-speed running distances are often suppressed after return from hamstring strain injury in professional footballers

Key points

1. 01High-speed running is commonly implicated in causing hamstring injuries, yet return-to-play success is usually judged only by time lost and reinjury, not by performance.
2. 02Of 15 players, 7 showed a sustained drop in high-speed running distance after returning, 7 showed no change, and 1 increased.
3. 03Post-injury high-speed running distance varied significantly more than pre-injury, indicating suppression after returning from injury.
4. 04The group showed a typical suppression of roughly 1000 m of high-speed running after injury.
5. 05Return to play does not necessarily equal return to performance, suggesting success metrics should include performance, not just time and recurrence.

How it was conducted

Design

Non-randomized cohort, Level 3 evidence

Participants

15 professional players (highest-level football: soccer, Rugby League, Rugby Union, Australian Rules) with 22 hamstring strain injuries including 7 reinjuries; data from 5 of 10 invited teams

Data

Routinely collected match high-speed running distance, minimum 5 complete matches before and after each verified injury

Analysis

Linear regression models comparing actual versus predicted high-speed running distance for each individual before and after injury

Primary outcome

Change in match high-speed running distance after return to play

What they found

• Pre-injury cumulative high-speed running distances were strongly correlated for each individual (r2 = 0.92-1.0; P < 0.0001).
• Pre- and post-injury high-speed running data were available for a median of 15 matches (range, 6-15).
• Variance from the pre-injury high-speed running distance was significantly less than post-injury values (P = 0.0005), indicating suppression after returning from injury.
• On return to play, 7 of 15 players showed a sustained absolute reduction in high-speed running distance, 7 showed no change, and 1 increased.
• The group mean showed a typical suppression of approximately 1000 m in high-speed running post-injury.
• Analysis of second and third injury return to play showed no differences compared with return from the index injury.

Limitations

• Small sample: only 5 of 10 invited organizations provided usable data, leaving 22 injuries in 15 players and reduced statistical power.
• The authors describe the work as best considered a proof of concept.
• Observational, non-randomized cohort (Level 3) so it cannot establish cause.
• Reasons for the high-speed running suppression (tactical, fitness, fear of reinjury, or true physical deficit) were not determined.

Why it matters

For patients

If you return to sport after a hamstring injury, you may find your sprinting output in games stays lower than before for the rest of the season, even once you are cleared to play.

For clinicians

Judge hamstring rehab success by performance measures such as match high-speed running, not just time lost and reinjury, because nearly half of returning players did not regain their prior output.

For readers

This early, small study suggests returning to play often is not the same as returning to performance after a hamstring injury, but its findings are preliminary.