The hamstring paradox

This is from the 2018 AFL Injury Report produced in collaboration with AFL Doctors Association, AFL Physiotherapists Association, and AFL Football Operations Department. “Hamstring strains remain the most common injury, with an incidence of 6.3 new injuries per club and are the most common cause of matches missed (25.2 matches missed per club), with a recurrence rate of 20%. These are the highest rates we have seen for a number of years.”

This is in the hamstring paradox: we have more research, more data, and more experience. Yet we continue to injure hamstrings at high and higher rates.

Ever since my first trip to Australia in 1996 I have followed the AFL. The sport is one of the most demanding in the world. I thought their approach was systematic and progressive, so it appealed to me. They were the first league in the world to embrace sports science and came to be looked upon as the global model. They were the first league to allow in-game GPS monitors. In short, they are very progressive except one area: hamstring injury prevention. On a visit to OZ in 1999 some of my Australian colleagues and I started brainstorming on this because hamstring injuries have always been a problem. We offered solutions which eventually were published a couple of years later in an article that Dean Benton and I co-authored. You can read that here. There are some changes I would make today in exercise selection which I will go over either on a podcast or another post.

The only result of that article was abuse I received for listing Nordic Hamstring Curl as a contraindicated exercise. But nearly 20 years later I stand by that. Why? Just look at the statistics. No one does more NHC and measures the movement more than AFL teams. So why the continued increase in hamstring injuries? I would suggest they need to rethink their approach; injury avoidance is not a good strategy. They need to look at teams and systems that do not have hamstring injuries and see what they are doing and what they are not doing. If they keep doing the same thing, the problem will only continue to grow more.