{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:03:16Z","timestamp":1794013396783,"version":"4.8.0"},"reference-count":79,"publisher":"BMJ","issue":"15","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2016,3,19]]},"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To systematically review the evidence base related to hamstring strength and flexibility in previously injured hamstrings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Systematic review and meta-analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data sources<\/jats:title><jats:p>A systematic literature search was conducted of PubMed, CINAHL, SPORTDiscus, Cochrane Library, Web of Science and EMBASE from inception to August 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Inclusion criteria<\/jats:title><jats:p>Full-text English articles which included studies which assessed at least one measure of hamstring strength or flexibility in men and women with prior hamstring strain injury within 24\u2005months of the testing date.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-eight studies were included in the review. Previously injured legs demonstrated deficits across several variables. Lower isometric strength was found &lt;7\u2005days postinjury (d=\u22121.72), but this did not persist beyond 7\u2005days after injury. The passive straight leg raise was restricted at multiple time points after injury (&lt;10\u2005days, d=\u22121.12; 10\u201320\u2005days, d=\u22120.74; 20\u201330\u2005days, d=\u22120.40), but not after 40\u201350\u2005days postinjury. Deficits remained after return to play in isokinetically measured concentric (60\u00b0\/s, d=\u22120.33) and Nordic eccentric knee flexor strength (d=\u22120.39). The conventional hamstring to quadricep strength ratios were also reduced well after return to play (60:60\u00b0\/s, d=\u22120.32; 240:240\u00b0\/s, d=\u22120.43) and functional (30:240\u00b0\/s, d=\u22120.88), but these effects were inconsistent across measurement methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>After hamstring strain, acute isometric and passive straight leg raise deficits resolve within 20\u201350\u2005days. Deficits in eccentric and concentric strength and strength ratios persist after return to play, but this effect was inconsistent across measurement methods. Flexibility and isometric strength should be monitored throughout rehabilitation, but dynamic strength should be assessed at and following return to play.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjsports-2015-095311","type":"journal-article","created":{"date-parts":[[2016,4,14]],"date-time":"2016-04-14T04:48:57Z","timestamp":1460609337000},"page":"909-920","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":116,"title":["Hamstring strength and flexibility after hamstring strain injury: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"50","author":[{"given":"Nirav","family":"Maniar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J","family":"Shield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan D","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan G","family":"Timmins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A","family":"Opar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,4,13]]},"reference":[{"key":"2024051410544989000_50.15.909.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1440-2440(02)80036-6"},{"key":"2024051410544989000_50.15.909.2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.36.1.39"},{"key":"2024051410544989000_50.15.909.3","first-page":"10","article-title":"Injury report 2009: Australian football league","volume":"28","author":"Orchard","year":"2010","journal-title":"Sport Health"},{"key":"2024051410544989000_50.15.909.4","first-page":"29","article-title":"Injury Report 2008: Australian Football League","volume":"27","author":"Orchard","year":"2009","journal-title":"Sport Health"},{"key":"2024051410544989000_50.15.909.5","doi-asserted-by":"crossref","first-page":"298","DOI":"10.5694\/j.1326-5377.1993.tb137863.x","article-title":"Football injuries in Australia at the elite level","volume":"159","author":"Seward","year":"1993","journal-title":"Med J Aust"},{"key":"2024051410544989000_50.15.909.6","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-198315030-00014"},{"key":"2024051410544989000_50.15.909.7","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2009.060582"},{"key":"2024051410544989000_50.15.909.8","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.35.1.43"},{"key":"2024051410544989000_50.15.909.9","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.36.6.436"},{"key":"2024051410544989000_50.15.909.10","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2002.002352"},{"key":"2024051410544989000_50.15.909.11","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2005.018135"},{"key":"2024051410544989000_50.15.909.12","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2005.018408"},{"key":"2024051410544989000_50.15.909.13","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2004.013391"},{"key":"2024051410544989000_50.15.909.14","doi-asserted-by":"publisher","DOI":"10.1177\/0363546505286022"},{"key":"2024051410544989000_50.15.909.15","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2008.2575"},{"key":"2024051410544989000_50.15.909.16","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2008.056283"},{"key":"2024051410544989000_50.15.909.17","first-page":"69","article-title":"Musculoskeletal injuries in track and field: incidence, distribution and risk factors","volume":"28","author":"Bennell","year":"1996","journal-title":"Aust J Sci Med Sport"},{"key":"2024051410544989000_50.15.909.18","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508316021"},{"key":"2024051410544989000_50.15.909.19","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092884"},{"key":"2024051410544989000_50.15.909.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsams.2006.03.007"},{"key":"2024051410544989000_50.15.909.21","doi-asserted-by":"publisher","DOI":"10.1177\/0363546503258912"},{"key":"2024051410544989000_50.15.909.22","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1177\/03635465010290030801","article-title":"Intrinsic and Extrinsic Risk Factors for Muscle Strains in Australian Football Neither the author nor the related institution has received any financial benefit from research in this study","volume":"29","author":"Orchard","year":"2001","journal-title":"Am J Sports Med"},{"key":"2024051410544989000_50.15.909.23","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2006.026609"},{"key":"2024051410544989000_50.15.909.24","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.35.6.435"},{"key":"2024051410544989000_50.15.909.25","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.183.4.1830975"},{"key":"2024051410544989000_50.15.909.26","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2013.4452"},{"key":"2024051410544989000_50.15.909.27","doi-asserted-by":"publisher","DOI":"10.1097\/00042752-200201000-00004"},{"key":"2024051410544989000_50.15.909.28","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2005.018879"},{"key":"2024051410544989000_50.15.909.29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2012.11.004"},{"key":"2024051410544989000_50.15.909.30","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512462809"},{"key":"2024051410544989000_50.15.909.31","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-008-0546-0"},{"key":"2024051410544989000_50.15.909.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2010.02.038"},{"key":"2024051410544989000_50.15.909.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2010.04.015"},{"key":"2024051410544989000_50.15.909.34","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000000507"},{"key":"2024051410544989000_50.15.909.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2012.12.006"},{"key":"2024051410544989000_50.15.909.36","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3233\/IES-2000-0048","article-title":"Hamstring muscle tear with recurrent complaints: an isokinetic profile","volume":"8","author":"Croisier","year":"2000","journal-title":"Isokinet Exerc Sci"},{"key":"2024051410544989000_50.15.909.37","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1177\/03635465020300020901","article-title":"Hamstring muscle strain recurrence and strength performance disorders","volume":"30","author":"Croisier","year":"2002","journal-title":"Am J Sports Med"},{"key":"2024051410544989000_50.15.909.38","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092356"},{"key":"2024051410544989000_50.15.909.39","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e3181a55200"},{"key":"2024051410544989000_50.15.909.40","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-9-30"},{"key":"2024051410544989000_50.15.909.41","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2013.4837"},{"key":"2024051410544989000_50.15.909.42","doi-asserted-by":"publisher","DOI":"10.1177\/036354659402200218"},{"key":"2024051410544989000_50.15.909.43","doi-asserted-by":"crossref","first-page":"139","DOI":"10.3233\/IES-2003-0140","article-title":"Identification of previous hamstring muscle injury by isokinetic concentric and eccentric torque measurement in elite soccer player","volume":"11","author":"Dauty","year":"2003","journal-title":"Isokinet Exerc Sci"},{"key":"2024051410544989000_50.15.909.44","doi-asserted-by":"crossref","first-page":"213","DOI":"10.3233\/IES-2009-0356","article-title":"Validity of isokinetic testing for previous hamstring injury detection in soccer players","volume":"17","author":"Houweling","year":"2009","journal-title":"Isokinet Exerc Sci"},{"key":"2024051410544989000_50.15.909.45","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.27.4.243"},{"key":"2024051410544989000_50.15.909.46","first-page":"22","article-title":"The relationship between lower limb flexibility and hamstring injury in Male Gaelic footballers","volume":"33","author":"Lowther","year":"2012","journal-title":"Physiother Ireland"},{"key":"2024051410544989000_50.15.909.47","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-10-37"},{"key":"2024051410544989000_50.15.909.48","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2011.3268"},{"key":"2024051410544989000_50.15.909.49","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.1991.13.3.118"},{"key":"2024051410544989000_50.15.909.50","doi-asserted-by":"publisher","DOI":"10.1136\/jech.52.6.377"},{"key":"2024051410544989000_50.15.909.51","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jsams.2006.02.004","article-title":"Factors associated with chronic plantar heel pain: a systematic review","volume":"9","author":"Irving","year":"2006","journal-title":"J Sci Med Sport"},{"key":"2024051410544989000_50.15.909.52","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2011-090664"},{"key":"2024051410544989000_50.15.909.53","doi-asserted-by":"crossref","unstructured":"Schwarzer G . Meta: general package for meta-analysis. 2015.","DOI":"10.1007\/978-3-319-21416-0_8"},{"key":"2024051410544989000_50.15.909.54","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v036.i03","article-title":"Conducting meta-analyses in R with the metafor package","volume":"36","author":"Viechtbauer","year":"2010","journal-title":"J Stat Softw"},{"key":"2024051410544989000_50.15.909.55","doi-asserted-by":"crossref","unstructured":"Wickham H . ggplot2: elegant graphics for data analysis. Springer Science & Business Media, 2009.","DOI":"10.1007\/978-0-387-98141-3"},{"key":"2024051410544989000_50.15.909.56","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.112.1.155"},{"key":"2024051410544989000_50.15.909.57","unstructured":"Higgins J , Green S . Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011."},{"key":"2024051410544989000_50.15.909.58","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(94)00097-A"},{"key":"2024051410544989000_50.15.909.59","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2011-090317"},{"key":"2024051410544989000_50.15.909.60","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-094256"},{"key":"2024051410544989000_50.15.909.61","doi-asserted-by":"crossref","first-page":"47","DOI":"10.3233\/IES-2011-0396","article-title":"Altered hamstring strength profile in Gaelic footballers with a previous hamstring injury","volume":"19","author":"Mackey","year":"2011","journal-title":"Isokinetics Exerc Sci"},{"key":"2024051410544989000_50.15.909.62","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-093016"},{"key":"2024051410544989000_50.15.909.63","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsams.2014.05.009"},{"key":"2024051410544989000_50.15.909.64","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514556638"},{"key":"2024051410544989000_50.15.909.65","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-010-1265-3"},{"key":"2024051410544989000_50.15.909.66","doi-asserted-by":"publisher","DOI":"10.1249\/01.MSS.0000117165.75832.05"},{"key":"2024051410544989000_50.15.909.67","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e3182776eff"},{"key":"2024051410544989000_50.15.909.68","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-094250"},{"key":"2024051410544989000_50.15.909.69","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513490650"},{"key":"2024051410544989000_50.15.909.70","doi-asserted-by":"publisher","DOI":"10.3928\/19425864-20110415-01"},{"key":"2024051410544989000_50.15.909.71","first-page":"39","article-title":"Comparing concentric isokinetic thigh muscle strength in female gaelic football players with and without previous hamstring injury","volume":"30","author":"O'Sullivan","year":"2009","journal-title":"Physiother Ireland"},{"key":"2024051410544989000_50.15.909.72","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2010.3047"},{"key":"2024051410544989000_50.15.909.73","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-093737"},{"key":"2024051410544989000_50.15.909.74","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200434100-00005"},{"key":"2024051410544989000_50.15.909.75","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000000465"},{"key":"2024051410544989000_50.15.909.76","doi-asserted-by":"crossref","unstructured":"Bourne MN , Opar DA , Williams MD , et al . Muscle activation patterns in the Nordic hamstring exercise: impact of prior strain injury. Scand J Med Sci Sports 2015. doi:10.1111\/sms.12494","DOI":"10.1111\/sms.12494"},{"key":"2024051410544989000_50.15.909.77","doi-asserted-by":"publisher","DOI":"10.1016\/j.ptsp.2010.07.003"},{"key":"2024051410544989000_50.15.909.78","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0838.2003.00312.x"},{"key":"2024051410544989000_50.15.909.79","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511419277"}],"container-title":["British Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjsports-2015-095311","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T18:14:01Z","timestamp":1715710441000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjsm.bmj.com\/lookup\/doi\/10.1136\/bjsports-2015-095311"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,4,13]]},"references-count":79,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2016,7,15]]},"published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1136\/bjsports-2015-095311"],"URL":"https:\/\/doi.org\/10.1136\/bjsports-2015-095311","relation":{},"ISSN":["0306-3674","1473-0480"],"issn-type":[{"value":"0306-3674","type":"print"},{"value":"1473-0480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,4,13]]}}}