Flexibility and Rehab Tips
The Nordic Eccentric
Hamstring Exercise for
Injury Prevention in
Soccer Players
Adam Sayers PhD, CSCS and Brandi-Eveland Sayers, PhD, CSCS
Middle Tennessee State University, Murfreesboro, Tennessee
factors have been identified as potential
causes for the incidence of hamstring
injury in soccer players, including poor
hamstring strength, strength imbalance
between hamstrings and quadriceps,
and previous hamstring injury (3,5,7).
Helen Binkley, PhD, CSCS*D;
NSCA-CPT*D
Column Editor
SUMMARY
ECCENTRIC HAMSTRING MUSCLE
ACTIONS ARE INVOLVED IN SEVERAL MOVEMENTS IN THE GAME
OF SOCCER. RECENT STUDIES
HAVE INDICATED THAT THE
NORDIC HAMSTRING EXERCISE
IS AN EFFECTIVE WAY OF ECCENTRICALLY STRENGTHENING THE
HAMSTRINGS IN SOCCER
PLAYERS, RESULTING IN REDUCED
INJURY RISK AND IMPROVED
PERFORMANCE.
INTRODUCTION
amstring injuries are common
in sports that require repeated
acceleration, deceleration, and
maximal sprinting. Recent studies in
elite level soccer have shown that
hamstring injuries account for up to
17% of all injuries (1,3,6). Several
H
56
REVIEW OF THE RESEARCH
Recent studies have demonstrated that
preventative measures can be implemented in addressing susceptibility to
hamstring injury in soccer players
(2,4,7). A 10-week preseason hamstring strength training program
emphasizing eccentric overload has
been shown to significantly reduce
hamstring injury rate in professional
male soccer players during the following 10-month season (4). Additionally,
the same strength program resulted in
increases in maximal running speed
and isokinetic hamstring muscle
strength. Although it is common to
strengthen the hamstrings concentrically, it is evident that eccentric
strengthening is equally important to
both injury prevention and optimal
performance.
Mjolsnes and colleagues (7) found that
the Nordic hamstring exercise was
more effective in developing maximal
eccentric hamstring strength than the
traditional hamstring curl exercise in
well-trained soccer players. When
athletes performed the Nordic hamstring exercise with a gradual increase
in volume and load during a 10-week
VOLUME 30 | NUMBER 4 | AUGUST 2008
period, the results were greater gains in
eccentric hamstring torque and isometric hamstring strength than the
traditional hamstring curl (7). Eccentric strength training with the use of
the Nordic hamstring exercise was also
found to reduce the risk of hamstring
strains in elite male soccer players (2).
The effect of eccentric strength training when using the Nordic exercise in
addition to a warm-up protocol was
compared with the effect of a flexibility
training program with the same warmup protocol on hamstring strain incidence during a 2-year period in players
from elite Norwegian and Icelandic
soccer teams. Baseline data were collected during the previous 3 years. The
flexibility training program consisted
of a contract–relax method of proprioceptive neuromuscular facilitation
being performed after practice 3 times
per week during the preseason and 1
to 2 times per week during the competitive season. The teams consisting
of participants who used the Nordic
hamstring exercise had a significantly
fewer number of hamstring strains than
did the teams consisting of participants
who used the flexibility program.
Additionally, the teams consisting of
participants who used the Nordic
exercises suffered fewer hamstring
strains than they had during the previous 3 years. However, teams consisting of participants who used the
flexibility training program showed
Ó National Strength and Conditioning Association
no improvement in the amount of
hamstring strains when compared with
the previous 3 years (2).
TECHNIQUE
According to the research previously
discussed, eccentric strength training
of the hamstrings when one uses the
Nordic exercise can both lower the
risk of hamstring strain and improve
performance. The Nordic hamstring
exercise requires the assistance of a
partner. The starting position requires
the athlete to begin on his/her knees,
with knee flexion at 90°, the hips
slightly flexed, and an erect torso. The
partner secures the athlete’s ankles to
the floor throughout the exercise (Figure 1). The athlete then falls forward
from the knees, resisting the fall for as
long as possible with the hamstrings
(Figure 2). As the athlete’s upper body
approaches the ground, the hands must
quickly be turned out to buffer the fall,
letting the chest touch the ground
(Figure 3). The athlete should keep
the hips in a slightly flexed position
throughout the range of motion. Upon
completion of one repetition, the athlete
must immediately return to the starting
position by thrusting themselves back
up using their hands to minimize
loading in the concentric phase (2,4,7).
Figure 1. Nordic hamstring exercise starting position.
motion can be withstood for 12 repetitions, load can be increased by increasing speed at the starting phase of
the motion, and can then be further
increased by the partner pushing at the
back of the shoulders (7). When the
competitive season begins, frequency
should be reduced to one to two times
per week (2). The exercises should be
completed in a non-fatigued state, and
after an appropriate warm-up.
PRECAUTIONS/LIMITATIONS
As previously explained, the Nordic
hamstring exercise requires the
assistance of a partner. Additionally,
the exercise should be performed on a
relatively soft surface. Grass or artificial
turf is suitable, as is a carpeted area of
a strength and conditioning facility.
Concrete or wooden surfaces should
be avoided, unless the athletes have
access to some form of mat or pad.
The role of the Nordic hamstring exercise in injury rehabilitation has yet
to be extensively researched. Therefore, caution must be exerted when
implementing the exercise with athletes who have a history of hamstring or knee injuries. In this case, it
IMPLEMENTATION
Given that no equipment or specific
environment is required to perform the
Nordic hamstring exercise, it can be
easily incorporated into any training
routine. It is also time efficient as
several athletes can perform the exercise simultaneously. As stated earlier,
a 10-week, preseason Nordic hamstring
exercise program can have significant
positive results on both injury prevention and performance (4). Therefore,
when initially incorporating Nordic
eccentric hamstring exercises, the program should begin 10 weeks before the
start of the season. Table 1 displays
recommended frequency, volume, and
time frame for implementation of the
program (7). Load is increased by
attempting to withstand the fall for
longer. When the entire range of
Figure 2. The athlete falls forward from the knees, resisting the fall with the
hamstrings.
Strength and Conditioning Journal | www.nsca-lift.org
57
Flexibility and Rehab Tips
Dr. Adam Sayers is the Assistant
Women’s Soccer Coach at Middle Tennessee State University, Murfreesboro,
Tennessee.
Dr. Brandi-Eveland Sayers is
an Assistant Professor in the Exercise
Science department at Middle Tennessee
State University, Murfreesboro, Tennessee.
REFERENCES
1 Anderson, TE, Larsen, O, Tenga, A,
Engebretsen, L, and Bahr, R. Football
incident analysis (FIA): A new video-based
method to describe injury mechanisms in
professional football. Br. J Sports Med 37:
226–232, 2003.
Figure 3. End position.
is advisable to seek the advice of medical
professionals before implementation.
SUMMARY
The Nordic hamstring exercise is
a beneficial, efficient way to eccentrically strengthen the hamstring muscles
for soccer. Research has suggested
that, when compared with traditional
hamstring strengthening exercises, eccentric strengthening results in fewer
hamstring injuries and greater performance benefits. The role of eccentric
hamstring muscle action in many
soccer-specific movements emphasizes
the importance of implementing eccentric strengthening exercises when
training soccer players.j
TABLE 1
Recommended frequency and volume during the 10-week preseason
period and into the competitive season (week 11 and beyond) (2,7)
Week
Sessions/Week
Sets
Reps
1
1
2
5
2
2
2
6
3
3
3
6–8
4
3
3
8–10
5–10
3
3
12,10,8
1–2
3
12,10,8
11 and beyond
Adapted from Mjolsnes et al. (7).
58
VOLUME 30 | NUMBER 4 | AUGUST 2008
2. Arnason, A, Anderson, TE, Holme, I,
Engebretsen, L, and Bahr R. Prevention of
hamstring strains in elite soccer. Scand J
Med Sci Sports 18: 40–48, 2008.
3. Arnason, A, Sigurdsson, SB, Gudmundsson,
A, Holme, I, Engebretsen, L, and Bahr, R.
Risk factors for injuries in soccer. Am J
Sports Med 32: 5–16, 2004.
4. Askling, C, Karlsson, J, and Thorstensson, A.
Hamstring injury occurrence in elite soccer
players after preseason strength training
with eccentric overload. Scand J Med Sci
Sports 13:244–250, 2003.
5. Croisier, JL, Forthomme, B, Namurois, MH,
Vanderthommen, M, and Crielaard, JM.
Hamstring muscle strain recurrence and
strength performance disorders. Am. J
Sports Med 30: 199–203, 2002.
6. Hawkins, RD, Hulse, MA, Wilkinson, C,
Hodson, A, and Gibson, M. The association
of football medical research programme: An
audit of injuries in professional football. Br J
Sports Med 35: 43–47, 2001.
7. Mjolsnes, R, Arnason, A, Osthagen, T,
Raastad, T, and Bahr, R. A10-week
randomized trial comparing eccentric vs.
concentric hamstring strength training in
well-trained soccer players. Scand J Med
Sci Sports 14: 311–317, 2004.