Thigh Muscle Injuries

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11 Lessons

Thigh muscle injuries occur frequently as a result of contusions, and as muscle strains due to repeated maximal sprints and acceleration. Because football combines maximal sprints with frequent player-to-player contact, it is not surprising that up to 30% of all football injuries are thigh muscle injuries. In fact, results from the elite leagues in England, Iceland and Norway show that hamstring strains are the most common type of injury in men’s football, accounting for between 13% and 17% of all acute injuries. Other studies have shown that muscle contusion injuries to the thigh account for up to 16% of all acute football injuries at the elite level. F-MARC studies have revealed similar results. On average, a male elite-level football team with a squad of 25 players can expect around 18 muscle injuries per season. Of these, seven will affect hamstrings and three will affect quadriceps.1

According to our observations (FC Barcelona, unpublished data) in young players, the most common muscle injury is a tear of the rectus femoris, whereas in professional football players it is the hamstring.

Due to the magnitude of the problem, a need for a better understanding of muscle injuries and their prevention has become an emerging challenge for football clubs.

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Learning outcomes

By the end of this topic you should:

  • be aware of the major thigh injuries (including hamstring sprains, rectus femoris muscle tears and contusions) seen in football;
  • be able to diagnose thigh injuries by taking an appropriate history and examination, and order an appropriate investigation (where needed);
  • understand and be able to implement an appropriate rehabilitation programme to treat thigh injuries in football players;
  • understand the potential sequelae following thigh muscle injuries and their treatment;
  • understand the effectiveness and implementation of injury prevention programmes.


  • Read the provided text and review the associated media content
  • Read the provided articles
  • Review the FC Barcelona Muscle Injuries Clinical Guide
  • Complete the case-based assessment task

Suggested Reading

Brukner and Khan’s

Clinical Sports Medicine 4th Edition

Chapters 30 (pages 579-593) and 31 (pages 594-625)


  1. Hagglund M, Walden M, Ekstrand J. Risk factors for lower extremity muscle injury in professional soccer: the UEFA injury study. Am J Sports Med. 2013;41(2):327-335.
  2. Askling CM, Malliaropoulos N, Karlsson J. High-speed running type or stretching-type of hamstring injuries makes a difference to treatment and prognosis. Br J Sports Med. 2012;46(2):86-87.
  3. Ekstrand J, Hagglund M, Walden M. Epidemiology of muscle injuries in professional football (soccer). Am J Sports Med. 2011;39(6):1226-1232.
  4. Ekstrand J, Hagglund M, Walden M. Injury incidence and injury patterns in professional football: the UEFA injury study. Br J Sports Med. 2011;45(7):553-558.
  5. Pruna R, Artells R, Ribas J, et al. Single nucleotide polymorphisms associated with non-contact soft tissue injuries in elite professional soccer players: influence on degree of injury and recovery time. BMC Musculoskelet Disord. 2013;14:221-2474-14-221.
  6. Warren P, Gabbe BJ, Schneider-Kolsky M, Bennell KL. Clinical predictors of time to return to competition and of recurrence following hamstring strain in elite Australian footballers. Br J Sports Med. 2010;44(6):415-419.
  7. Hallen A, Ekstrand J. Return to play following muscle injuries in professional footballers. J Sports Sci. 2014;32(13):1229-1236.
  8. Orchard J, Best TM. The management of muscle strain injuries: an early return versus the risk of recurrence. Clin J Sport Med. 2002;12(1):3-5.
  9. Schneider-Kolsky ME, Hoving JL, Warren P, Connell DA. A comparison between clinical assessment and magnetic resonance imaging of acute hamstring injuries. Am J Sports Med. 2006;34(6):1008-1015.
  10. Orchard J, Best TM, Verrall GM. Return to play following muscle strains. Clin J Sport Med. 2005;15(6):436-441.
  11. Harmon KG. Muscle injuries and PRP: what does the science say? Br J Sports Med. 2010;44(9):616-617.
  12. Reurink G, Goudswaard GJ, Moen MH, et al. Rationale, secondary outcome scores and 1-year follow-up of a randomised trial of platelet-rich plasma injections in acute hamstring muscle injury: the Dutch hamstring injection therapy study. Br J Sports Med. 2015.
  13. Dadebo B, White J, George K. A survey of flexibility training protocols and hamstring strains in professional football clubs in England. Br J Sports Med. 2004;38(4):388-394.
  14. Petersen J, Thorborg K, Nielsen MB, Budtz-Jorgensen E, Holmich P. Preventive effect of eccentric training on acute hamstring injuries in men’s soccer: a cluster-randomized controlled trial. Am J Sports Med. 2011;39(11):2296-2303.
  15. Mendiguchia J, Garrues MA, Cronin JB, et al. Nonuniform changes in MRI measurements of the thigh muscles after two hamstring strengthening exercises. J Strength Cond Res. 2013;27(3):574-581.
  16. Soligard T, Myklebust G, Steffen K, et al. Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial. BMJ. 2008;337:a2469.
  17. Silvers-Granelli H, Mandelbaum B, Adeniji O, et al. Efficacy of the FIFA 11+ injury prevention program in the collegiate male soccer player. Am J Sports Med. 2015.