Recurrent hamstring injury is a very common problem in rugby union, but has been largely ignored in the literature. It is concluded that a multifactorial aetiology may be present, and that these symptoms may be part of a continuum of symptoms that may lead to more serious injuries. Effective management needs to focus not just locally, but include proximal issues such as lumbo-pelvic stability and correcting lumbar spine dysfunction. The factors addressed in a prevention programme are likely to contribute to performance gains.