The prevalence and risk factors for hamstring injuries among field hockey players at a hockey club in Pretoria, South Africa

Abstract

Background: Hockey is a growing sport worldwide, including in South Africa. Like other sports, field hockey players are susceptible to musculoskeletal injuries, with hamstring strains being common. Even though a high prevalence of hamstring injuries are reported among field hockey players, there is little to no evidence concerning the prevalence of hamstring injuries, their intrinsic risk factors and how they relate to hamstring strain management among such players. Aim: To determine the prevalence and intrinsic risk factors for hamstring injuries among field hockey players at a hockey club in Pretoria, South Africa. Methodology: This study was cross-sectional in nature. The population consisted of 40 high-performance players from the University of Pretoria’s field hockey club. A convenient sample of 33 field hockey players (15 males and 18 females) took part in this research. All those who participated were ≥18 years old and gave their informed written consent. Ethical clearance was obtained prior to the data collection process. Participants completed a questionnaire covering demographic information, injury status and the Hamstring Outcome Score (HaOS). Musculoskeletal tests (the “single leg hamstring bridge”, “modified Thomas test”, “passive straight leg raise”, “ankle range of motion” and “Star Excursion Balance Test”) were conducted to screen for intrinsic risk for injuries. Descriptive statistics were obtained to report on the demographics, hamstring injury prevalence, and the associated intrinsic risk factors. Inferential statistics were used to compare the variables, using the Independent-measures t-test and the Chi-square test. A p-value of ≤ 0.05 was set to determine the level of significance. Results: None of the participants suffered from hamstring injuries at the time of data collection. The participating field hockey players had a highly prevalent history of hamstring strains (45.5%), decreased hamstring function (48.5% left; 51.5% right), decreased hamstring strength (84% left; 87.9% right), decreased hamstring flexibility (75.8% left; 75.8% right) and decreased hip flexor flexibility (48.5% left; 39.4% right). Significantly lower HaOS was found with history of left hamstring strains (p = 0.006; p = 0.028). The HaOS sub-scores of “pain” (p = 0.014; p = 0.029) and “function in daily living and sport” (p = 0.001; p = 0.026) were significant legdependent indicators. Significantly decreased hamstring flexibility on the right was found with left hamstring strains (p = 0.050). No association were found between the other risk factors, demographics and hamstring injury prevalence. Conclusion: History of hamstring strains was prevalent among high-performance field hockey players. Although field hockey players presented with similar intrinsic risk factors as those manifesting in other sports (decreased hamstring function, strength, hip flexor and hamstring flexibility), field hockey

players also presented with uniquely less strength and flexibility, as well as asymmetries in their flexibility measures. Prospective aetiological studies are required to confirm the association between these risks and hamstring strains. The HaOS might be used to help clinicians to make return-to-play decisions.