Implementing hamstring injury prevention programmes remotely: a randomised proof of concept trial
Fearghal P Behan, Nicol van Dyk, Lance Rane, Emma Thorne, Alexa Banaghan, Kevin Gilsenan, Enda Francis Whyte
British Medical Journal Open Sport & Exercise Medicine
School of Health and Human Performance

Hamstring injuries continue to be a persistent problem for athletes, with little change in incidence rates over time. These injuries account for 24% of all injuries in elite European men’s football, with similar hamstring injury rates in females and males in field sports.

The Nordic hamstring exercise (NHE) can reduce hamstring injury incidence by up to 51%. However, this exercise is poorly adopted and adhered to across elite football, as it is deemed to cause muscle soreness. Therefore, the pursuit of potential alternative exercises seems prudent.

The deadlift is a staple of hamstring strengthening routines, and of its variations, the single-leg Romanian deadlift (SLRDL) offers specific benefits. As a single-leg exercise, the SLRDL adds an extra balance requirement by reducing the base of support while also increasing eccentric biceps femoris activation over its bilateral equivalent. Additionally, the SLRDL targets the hamstrings more specifically, as evidenced by a higher ratio of biceps femoris and semitendinosus to erector spinae activation, compared with other deadlift variations. The SLRDL may present an alternative to the NHE.

This study included several aim: to compare the effectiveness of a Nordic hamstring exercise (NHE) versus single-leg Romanian deadlift (SLRDL) exercise programme; to compare the muscle soreness experienced by both exercise programmes; and to assess compliance to remote injury prevention exercise protocols when they are delivered remotely in video format.

Both the NHE and SLRDL are equally effective in increasing SLHB performance and demonstrate a similar level of muscle soreness. This suggests that SLRDL may be a viable option as a preventative exercise to mitigate the risk of hamstring injury. Finally, implementing injury prevention programmes remotely has the potential to enhance adherence.