Prediction of hamstring injury in professional soccer players by isokinetic measurements

Objectives: previous studies investigating the ability of isokinetic strength ratios to predict hamstring injuries in soccer players have reported conflicting results. Hypothesis: to determine if isokinetic ratios are able to predict hamstring injury occurring during the season in professional soccer players. Study Design: case-control study; Level of evidence: 3. Methods: from 2001 to 2011, 350 isokinetic tests were performed in 136 professional soccer players at the beginning of the soccer season. Fifty-seven players suffered hamstring injury during the season that followed the isokinetic tests. These players were compared with the 79 uninjured players. The bilateral concentric ratio (hamstring-to-hamstring), ipsilateral concentric ratio (hamstring-to-quadriceps), and mixed ratio (eccentric/concentric hamstring-to-quadriceps) were studied. The predictive ability of each ratio was established based on the likelihood ratio and post-test probability. Results: the mixed ratio (30 eccentric/240 concentric hamstring-to-quadriceps) <0.8, ipsilateral ratio (180 concentric hamstring-to-quadriceps) <0.47, and bilateral ratio (60 concentric hamstring-to-hamstring) <0.85 were the most predictive of hamstring injury. The ipsilateral ratio <0.47 allowed prediction of the severity of the hamstring injury, and was also influenced by the length of time since administration of the isokinetic tests. Conclusion: isokinetic ratios are useful for predicting the likelihood of hamstring injury in professional soccer players during the competitive season.