As soccer continues to grow in popularity, the need for understanding the science behind injuries, prevention, treatment, and recovery becomes increasingly important. In this article, we will delve into the latest research and expert opinions on how to best approach soccer injuries, particularly hamstring injuries (HSIs), and ensure a safe and effective return to sport (RTS).

Rehabilitation and Return to Sport Decision-Making

When determining the rehabilitation end goal and timing of RTS, experts focus on the demands and capacity required for competition. Athletes are monitored and tested throughout their rehabilitation, using modalities such as global positioning systems to provide sports-specific information on loading/running dosages, speed, and RTS readiness. An integrated assessment of symptoms, strength, and response to previous loading is used as criteria for progressing and dosing exercise, as well as deciding on the safety of return to running (RTR) and RTS.

Early Loading and Contractions

In the early stages of rehabilitation, the types of load and contractions considered appropriate, as well as the order of their application can vary greatly between experts. This highlights the need for further research and consensus on best practices for early loading in soccer injury rehabilitation.

London International Hamstring Injury Consensus Group

In 2020, the London International Hamstring Injury Consensus group was convened to determine the key aspects of rehabilitation and RTS decision-making in the assessment and treatment of HSIs. This group aimed to bridge the gap between research and practice, as current rehabilitation methods do not always follow the research, and there is limited evidence available for elite sports athletes.

Guidelines and Reviews for Return to Sport Criteria

While there are published guidelines and reviews on criteria for RTS after HSI, these often focus on lower-grade injuries and do not accurately mimic specific sporting loads or functional demands. Few studies have examined combined rehabilitation programs for higher-grade tendon HSIs, which require longer rehabilitation and time to RTS. As a result, there is a need for more research and development of guidelines tailored to higher-grade injuries and the unique demands of soccer.