Predisposing factors to hamstring neuromuscular deficits—implications for prevention and rehabilitation of hamstring strain injuries: a narrative review

Background: Scientific knowledge on hamstring strain injuries (HSI) constantly accumulates for the last 100 years. However HSI still exhibit high injury/re-injury rates and new areas of research must be thoroughly explored. Deficiencies that impact the close relationship between the nervous system and muscle functioning constitute a promising research direction, according to existing literature.Objectives: To outline the often-overlooked factors that pre-dispose to hamstring neuromuscular deficits, with a special emphasis on hamstring strain injury and re-injury.Major Findings: Sensory input impairment, neural tension, fatigue, competitive anxiety and lumbar-pelvic motor control deficit can all induce dysregulations of the hamstring neuromuscular functioning that may be detrimental during high-speed running. They constitute therefore serious risk factors for hamstring strain injury and re-injury.Conclusions: We devised an intervention algorithm including both evaluation procedures and hamstring management plan, by compiling and adjusting the most promising doctrines of the literature reviewed. Further research, such as randomized controlled trials, is required to provide evidence of the effectiveness and feasibility of this algorithm for patients in post-HSI recovery or as a preventive approach in the event of high suspicion of re-injury.