Hamstring muscle injuries in professional football: the correlation of MRI findings with return to play

Br J Sports Med. 2012 Feb;46(2):112-7. doi: 10.1136/bjsports-2011-090155. Epub 2011 Dec 5.


Background: Hamstring injury is the single most common injury in professional football. MRI is commonly used to confirm the diagnosis and provide a prognosis of lay-off time.

Objective: To evaluate the use of MRI as a prognostic tool for lay-off after hamstring injuries in professional football players and to study the association between MRI findings and injury circumstances.

Methods: Prospective cohort study where 23 European professional teams, were followed between 2007 and 2011. Team medical staffs recorded individual player exposure and time-loss injuries. Radiological grading was performed using a modified Peetrons classification into four grades where grades 2 and 3 represent fibre disruption.

Results: In total, 516 hamstring injuries occurred and 58% of these were examined by MRI. Thirteen per cent were grade 0 injuries, 57% grade 1, 27% of grade 2 and 3% of grade 3. Grade 0 and 1 injuries accounted for 56% (2141/3830 days) of the total lay-off. The lay-off time differed between all four radiological grades of injury (8±3, 17±10, 22±11 and 73±60 days, p<0.0001). Eighty-three per cent of injuries affected the biceps femoris while 11% and 5% occurred to the semimembranosus and semitendinosus, respectively. Re-injuries (N=34/207) constituted 16% of injuries. All re-injuries occurred to the biceps femoris.

Conclusion: MRI can be helpful in verifying the diagnosis of a hamstring injury and to prognosticate lay-off time. Radiological grading is associated with lay-off times after injury. Seventy per cent of hamstring injuries seen in professional football are of radiological grade 0 or 1, meaning no signs of fibre disruption on MRI, but still cause the majority of absence days.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absenteeism
  • Athletic Injuries / etiology
  • Athletic Injuries / pathology
  • Athletic Injuries / rehabilitation
  • Cumulative Trauma Disorders / etiology
  • Cumulative Trauma Disorders / pathology
  • Cumulative Trauma Disorders / rehabilitation
  • Dominance, Cerebral / physiology
  • Humans
  • Leg Injuries / etiology
  • Leg Injuries / pathology*
  • Leg Injuries / rehabilitation
  • Magnetic Resonance Imaging
  • Male
  • Muscle, Skeletal / injuries*
  • Prospective Studies
  • Recovery of Function / physiology
  • Recurrence
  • Running / injuries
  • Soccer / injuries*
  • Thigh / injuries