Practices and perceptions in hamstring training for injury risk mitigation: A survey-based mixed-methods analysis

In this study, the practices and perceptions of sport and exercise practitioners regarding hamstring training for injury risk mitigation were investigated. Hamstring strain injuries (HSIs) remain a prevalent issue across sports, despite extensive research. An anonymous survey was conducted to assess how practitioners integrate evidence-based strategies, such as the Nordic hamstring exercise (NHE) and high-speed running (HSR), into their training programmes. The survey included both fixed-response and open-ended questions, enabling a mixed-methods analysis of training approaches. A total of 47 practitioners responded, revealing that most incorporate the NHE and HSR into both in-season and off-season training. However, there were notable differences in volume, with higher HSR distances and NHE volumes programmed in the off-season. Despite widespread adoption of the NHE, practitioners indicated that the volumes of NHE used are still likely higher than the smallest effective dosages reported in the literature. Thematic analyses highlighted several key challenges practitioners face, including athlete compliance with training programmes, multi-disciplinary team coordination, and time limitations. Practitioners emphasised the importance of exposing athletes to maximal running efforts to reduce HSI risk, while also integrating strength training exercises that target the hamstrings. The study serves to highlight a need for further improvements in communication among teams and better athlete education which could enhance the effectiveness of hamstring training programmes. Additionally, the findings of the current study indicate a need for future studies that explore the combined effects of resistance training and HSR, as well as how scientific recommendations can be more effectively implemented in practical settings.