TY - JOUR
T1 - Hamstring Injuries in Major League Soccer
T2 - A 10-Year Analysis of Injury Rate, Return to Play, and Performance Metrics by Player Position
AU - Forsythe, Brian
AU - Bohn, Camden
AU - Hand, Catherine
AU - Hand, Francis
AU - Khazi-Syed, Daanish
AU - Chang, Joshua
AU - Singh, Harmanjeet
AU - Savoia, Andrew
AU - Spaan, Jonathan
AU - Borque, Kyle
AU - Frank, Rachel
N1 - Publisher Copyright:
© The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
PY - 2025/8
Y1 - 2025/8
N2 - Background: Hamstring injuries are common in athletes performing high-intensity sports, such as soccer, impacting performance and return to play (RTP) times. This study aimed to evaluate the effect of hamstring injuries on RTP and performance among Major League Soccer (MLS) players over 10 years. Purpose: To evaluate the effect of hamstring injuries on RTP times and performance metrics among MLS players over 10 years, with a focus on injury characteristics, rehabilitation practices, and positional differences. Study Design: Cohort study; Level of evidence, 3. Methods: From 2010 to 2021, 2715 MLS players with hamstring injuries were identified by the MLS Injury Surveillance Database and analyzed. RTP times, injury rates, and reinjury rates were compared between the 2010-2015 and 2016-2021 cohorts. Performance metrics (games, minutes, goals, and assists) were extracted. Uninjured controls were matched 2 to1 by position, age, and experience. T tests were used to assess postinjury performance differences. Results: Game-related injuries required longer RTP than practice injuries (27.8 vs 21.9 days; P = .023), and acute noncontact injuries took more time to recover than chronic injuries (24.9 vs 13.2 days; P < .0001). RTP times increased in the 2016-2021 cohort compared with the 2010-2015 cohort for minimal/first-degree injuries (15.09 ± 31.29 vs 10.13 ± 28.53 days; P = .018) and overall (20.26 vs 13.60 days; P = .002), despite stable injury rates (P = .405). Reinjury rates decreased nonsignificantly (P = .603); however, RTP after reinjury was longer in the 2016-2021 cohort (25.05 vs 10.03 days; P = .025). Defenders saw reduced minutes played 2 years after injury compared with controls (–221.60 ± 833.66 vs −34.80 ± 792.11; P = .007). RTP times were unaffected by playing surface grass versus turf (P = .620) or player position (forward, midfielder, defender, and goalkeeper) (P = .900). Conclusion: Injury rates were unchanged in the 2010-2015 and 2016-2021cohorts; however, RTP times increased in the latter cohort, especially for recurrent injuries. Game-related and acute noncontact injuries required longer RTP, and defenders showed the greatest performance decline. Future studies are needed to further highlight mechanisms of injury and treatment for preventative protocols.
AB - Background: Hamstring injuries are common in athletes performing high-intensity sports, such as soccer, impacting performance and return to play (RTP) times. This study aimed to evaluate the effect of hamstring injuries on RTP and performance among Major League Soccer (MLS) players over 10 years. Purpose: To evaluate the effect of hamstring injuries on RTP times and performance metrics among MLS players over 10 years, with a focus on injury characteristics, rehabilitation practices, and positional differences. Study Design: Cohort study; Level of evidence, 3. Methods: From 2010 to 2021, 2715 MLS players with hamstring injuries were identified by the MLS Injury Surveillance Database and analyzed. RTP times, injury rates, and reinjury rates were compared between the 2010-2015 and 2016-2021 cohorts. Performance metrics (games, minutes, goals, and assists) were extracted. Uninjured controls were matched 2 to1 by position, age, and experience. T tests were used to assess postinjury performance differences. Results: Game-related injuries required longer RTP than practice injuries (27.8 vs 21.9 days; P = .023), and acute noncontact injuries took more time to recover than chronic injuries (24.9 vs 13.2 days; P < .0001). RTP times increased in the 2016-2021 cohort compared with the 2010-2015 cohort for minimal/first-degree injuries (15.09 ± 31.29 vs 10.13 ± 28.53 days; P = .018) and overall (20.26 vs 13.60 days; P = .002), despite stable injury rates (P = .405). Reinjury rates decreased nonsignificantly (P = .603); however, RTP after reinjury was longer in the 2016-2021 cohort (25.05 vs 10.03 days; P = .025). Defenders saw reduced minutes played 2 years after injury compared with controls (–221.60 ± 833.66 vs −34.80 ± 792.11; P = .007). RTP times were unaffected by playing surface grass versus turf (P = .620) or player position (forward, midfielder, defender, and goalkeeper) (P = .900). Conclusion: Injury rates were unchanged in the 2010-2015 and 2016-2021cohorts; however, RTP times increased in the latter cohort, especially for recurrent injuries. Game-related and acute noncontact injuries required longer RTP, and defenders showed the greatest performance decline. Future studies are needed to further highlight mechanisms of injury and treatment for preventative protocols.
KW - hamstring injury
KW - player performance
KW - reinjury
KW - return to play
KW - soccer
UR - https://www.scopus.com/pages/publications/105014189630
UR - https://www.scopus.com/inward/citedby.url?scp=105014189630&partnerID=8YFLogxK
U2 - 10.1177/23259671251360422
DO - 10.1177/23259671251360422
M3 - Article
AN - SCOPUS:105014189630
SN - 2325-9671
VL - 13
JO - Orthopaedic Journal of Sports Medicine
JF - Orthopaedic Journal of Sports Medicine
IS - 8
M1 - 23259671251360422
ER -