Hamstring muscle injury rehabilitation in sports: a scoping review

What do published rehabilitation programmes for acute hamstring muscle injury actually contain, and how well are they reported?

137 articles on non-surgically managed acute hamstring muscle injury in humans (English-language); athlete populations varied and were often narrowly represented

Scoping review of MEDLINE (PubMed), Scopus and Web of Science searched through October 2024, charting methodological quality and rehabilitation content

• 43.1% (n=59) were primary studies, mostly cohorts and RCTs — what this means; 54.0% (n=74) were secondary, mainly narrative reviews
• 54.7% of included articles were judged low level of evidence
• Only 44.2% of primary studies actually centred on rehabilitation programmes, and 47.8% of those were RCTs — what this means
• In subacute/functional phases, strengthening was reported in 78.3% and stretching in 55.6%
• Return-to-sport criteria appeared in just 43.5% of primary research, commonly resting on resolution of pain
• 40 distinct rehabilitation strategies were catalogued, most often eccentric — what this means strengthening, flexibility work, progressive running and agility drills

Hamstring injury rehabilitation content in the literature is highly heterogeneous and poorly reported, so clinicians should recognize that no single standardized, well-evidenced protocol currently dominates the evidence base.