Efficacy of Eccentric Over Concentric Hamstring Exercises in Elite Male Footballers for Preventing Non-Contact Hamstring Injuries: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 发起方
- 入组人数
- 275
- 试验地点
- 1
- 主要终点
- Incidence of non-contact hamstring injuries
研究概览
简要总结
Football is a sport with a high risk of injury, and hamstring muscle injuries are among the most common problems faced by players. These injuries can reduce a player's performance, cause time away from training and matches, and place a burden on medical teams and clubs. Many training programs recommend eccentric hamstring exercises to prevent these injuries, but there is limited evidence comparing eccentric exercises with concentric exercises or a combination of both, especially in elite male football players.
The purpose of this study is to compare the long-term effects of three different hamstring strengthening programs-eccentric training, concentric training, and a combination of both-on preventing non-contact hamstring injuries in elite male footballers. Each training program will last for three months, and the players will be followed for a total period of 12 months. The study will look at how these programs affect hamstring injury prevention, muscle strength and performance, flexibility, recurrence of injuries, and players' psychological satisfaction.
The study is based on the following expectations:
A three-month eccentric hamstring strengthening program will lead to long-term improvements in reducing hamstring injuries, improving muscle performance and flexibility, lowering injury recurrence, and increasing psychological satisfaction over a 12-month period.
A three-month concentric hamstring strengthening program will also result in long-term improvements in injury prevention, muscle performance, flexibility, injury recurrence, and psychological satisfaction.
A combined program of eccentric and concentric hamstring strengthening over three months will produce significant long-term benefits in injury prevention, muscle performance, flexibility, injury recurrence, and psychological satisfaction.
There will be clear differences in outcomes between the eccentric, concentric, combined, and control groups over the 12-month follow-up period.
Participants will be divided into four groups (A, B, C, and D) based on the type of training they receive. The study will include young male professional football players aged 18 to 30 years from the UAE who are citizens or permanent residents. All participants must speak English, have at least one year of football playing experience, and must not have had any hamstring injury in the past six months. Players who are interested in participating and provide written informed consent will be included.
Players will be excluded if they have had a hamstring injury in the last six months, are female, are under 18 or over 30 years old, have restrictions in knee movement, have undergone previous hamstring surgery, are currently enrolled in another official rehabilitation program, or do not agree to participate in the study.
Group A participants will perform eccentric hamstring exercises, including Nordic hamstring curls, dumbbell stiff-leg deadlifts, and barbell Romanian deadlifts. Group B participants will perform concentric hamstring exercises such as seated leg curls, lying leg curls, and prone hamstring curls using resistance bands. Group C participants will perform a combination of both eccentric and concentric hamstring exercises. Group D participants will continue with their usual football training only and will not perform any additional hamstring-specific exercises.
Before each training session, all participants in Groups A, B, and C will complete a 10-minute warm-up, consisting of five minutes of cycling, three minutes of stretching, and two minutes of rope jumping. Each training session will last at least 30 minutes. The exercise groups will complete three additional training sessions per week alongside their regular football training for a total of 12 weeks.
The results of this study will help determine which type of hamstring training program is most effective in preventing non-contact hamstring injuries and improving physical and psychological outcomes in elite male football players.
详细描述
Background and Rationale Football is associated with one of the highest injury rates among competitive sports, with hamstring muscle injuries representing a major cause of time loss, reduced performance, and increased medical burden. Epidemiological evidence indicates that approximately 80% of hamstring injuries in football occur without direct contact, most commonly during high-speed running, sprinting, acceleration, deceleration, and sudden changes of direction. These injuries are associated with high recurrence rates and may significantly impact player availability and long-term athletic performance.
Hamstring muscle function plays a critical role in knee and hip stability, particularly during the terminal swing phase of sprinting when the hamstrings are subjected to high eccentric loads. Muscle weakness, fatigue, reduced flexibility, and imbalances between concentric and eccentric strength have been identified as key intrinsic risk factors for hamstring strain injuries in footballers.
Eccentric hamstring strengthening exercises-such as the Nordic hamstring exercise-are widely advocated for injury prevention due to their ability to increase muscle strength, fascicle length, and neuromuscular control. However, emerging evidence suggests that concentric strengthening and combined eccentric-concentric programs may also contribute to improved muscle performance and fatigue resistance. Despite extensive research on eccentric training, direct comparisons between eccentric, concentric, and combined hamstring strengthening programs in elite male football players remain limited, particularly with long-term follow-up across an entire competitive season.
Therefore, this randomized controlled trial aims to systematically evaluate and compare the long-term effectiveness of eccentric, concentric, and combined hamstring strengthening programs in preventing non-contact hamstring injuries, improving muscle performance and flexibility, reducing injury recurrence, and enhancing psychological satisfaction in elite male footballers.
Aim of the Study To compare the long-term effects of eccentric, concentric, and combined hamstring strengthening programs-each conducted over a three-month intervention period-on non-contact hamstring injury prevention, muscle performance, flexibility, injury recurrence, and psychological satisfaction in elite male football players over a 12-month follow-up period.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 30 Years（Adult）
- 性别
- Male
- 接受健康志愿者
- 是
入选标准
- •Players without any recent hamstring injuries (within the last 6 months) from certain clubs will be asked to join the trial.
- •The trial will include young male professional football players aged 18-30 from the UAE who are citizens or permanent residents, English speaking, with no hamstring injuries in the last six months.
- •Participants must have at least one year of experience playing football and be interested in participating in the study.
排除标准
- •Players who have had hamstring injuries within the last 6 months, women, individuals under 18 and over 30 years old will be disqualified.
- •Individuals who have any restrictions in exercising the knee, have undergone prior surgery on their hamstring, or decline to give written informed consent for the study are not eligible.
- •Furthermore, we will not include player who are currently enrolled in other official rehabilitation programs.
研究组 & 干预措施
CONTROL GROUP
Control (regular football training only)
ECCENTRIC HAMSTRING TRAINING
Eccentric Training
Barbell Romanian Deadlift:
Stand hip-width apart with a slight knee bend. Hold the barbell shoulder-width apart, keep the spine neutral, and hinge at the hips to lower the barbell toward the shins. Engage the core, hamstrings, and glutes to return to standing. 3 sets × 10-12 reps.
Nordic Hamstring Curl:
Kneel with feet secured. Maintain a straight line from shoulders to knees and slowly lower the body under hamstring control. Use hands for support if needed and assist returning to start. 3 sets × 10-12 reps.
Dumbbell Stiff-Leg Deadlift:
Hold 10 kg dumbbells at the sides with minimal knee bend. Hinge at the hips, lowering the weights until a hamstring stretch is felt. Engage hamstrings and glutes to stand upright. 3 sets × 10-12 reps.
干预措施: Eccentric training + regular football practice (Other)
CONCENTRIC HAMSTRING TRAINING
Concentric Training
Seated Leg Curl:
Sit on the leg curl machine with feet shoulder-width apart and knees aligned with the machine hinge. Place the pad on the lower calf, engage the core, and keep the spine neutral. Pull the toes upward and curl the heels toward the glutes without arching the lower back. Slowly return to the starting position. 3 sets × 10-12 reps.
Lying Leg Curl:
Lie prone on the machine with feet hip-width apart and knees aligned with the hinge. Keep the core and glutes engaged, head neutral, and shoulder blades retracted. Curl the heels toward the glutes without lifting the hips or arching the back, then return slowly. 3 sets × 10-12 reps.
Prone Hamstring Curl with Resistance Band:
Lie prone with one end of a resistance band secured and the other around the ankle. Start with the knee extended and bend the knee against resistance, then return slowly. 3 sets × 10-12 reps.
Along with regular football training.
干预措施: Concentric training + regular football practice (Other)
COMBINED CONCENTRIC AND ECCENTRIC HAMSTRING TRAINING
Barbell Romanian Deadlift: Stand hip-width with a slight knee bend, bar shoulder-width. Keep spine neutral, hinge at hips to lower the bar, then return using hamstrings and glutes. 3×10-12.
Nordic Hamstring Curl: Kneel with feet secured, body straight. Slowly lower under control and assist back if needed. 3×10-12.
Dumbbell Stiff-Leg Deadlift: Hold 10 kg dumbbells, minimal knee bend. Hinge at hips, lower until hamstrings stretch, then stand tall. 3×10-12.
Seated Leg Curl: Sit with knees aligned, core engaged. Curl heels toward glutes and return slowly. 3×10-12.
Lying Leg Curl: Lie prone with hips down and core tight. Curl heels toward glutes, then lower with control. 3×10-12.
Prone Band Curl: Lie prone, band around ankle. Bend knee against resistance and return slowly. 3×10-12.
Performed alongside regular football training.
干预措施: Eccentric training + regular football practice (Other)
COMBINED CONCENTRIC AND ECCENTRIC HAMSTRING TRAINING
Barbell Romanian Deadlift: Stand hip-width with a slight knee bend, bar shoulder-width. Keep spine neutral, hinge at hips to lower the bar, then return using hamstrings and glutes. 3×10-12.
Nordic Hamstring Curl: Kneel with feet secured, body straight. Slowly lower under control and assist back if needed. 3×10-12.
Dumbbell Stiff-Leg Deadlift: Hold 10 kg dumbbells, minimal knee bend. Hinge at hips, lower until hamstrings stretch, then stand tall. 3×10-12.
Seated Leg Curl: Sit with knees aligned, core engaged. Curl heels toward glutes and return slowly. 3×10-12.
Lying Leg Curl: Lie prone with hips down and core tight. Curl heels toward glutes, then lower with control. 3×10-12.
Prone Band Curl: Lie prone, band around ankle. Bend knee against resistance and return slowly. 3×10-12.
Performed alongside regular football training.
干预措施: Concentric training + regular football practice (Other)
结局指标
主要结局
Incidence of non-contact hamstring injuries
时间窗: 12 Months
The incidence of non-contact hamstring strain injuries will be systematically monitored using a prospective time-loss injury surveillance model, ensuring consistent and accurate tracking throughout the study period. All reported injuries will undergo comprehensive clinical assessment and verification, after which they will be categorized according to their mechanism, with specific identification of non-contact injuries. To facilitate objective and reliable comparison across the four intervention groups, injury incidence will be standardized and expressed per 1,000 player-hours of exposure, providing a uniform metric that accounts for variations in individual training and match participation.
次要结局
- Hamstring flexibility: Active Knee Extension(12 Months)
- Athletic Performance Assessment: 30-meter sprint test(12 Months)
- Recurrence Rates of Hamstring Injury(12 Months)
- Subjective Sports Performance Satisfaction(12 Months)
- Hamstring flexibility: Sit-and-Reach test(12 Months)
- Athletic Performance Assessment: Vertical jump(12 Months)
研究者
Gulab Kappattakath
Senior Physiotherapist
Emirates Health Services (EHS)