Systematic video analysis of 57 hamstring injuries in women's football (soccer): injury mechanisms, situational patterns and biomechanics

Objective: To investigate the occurrence and inciting events of hamstring injuries (HSIs) in elite women's football through video analysis, describing the mechanism, situational patterns and biomechanics of the sport-specific activities performed before and at the time of injury. Methods: A descriptive observational study was conducted using video analysis of HSIs from top national and international women's football competitions across seven seasons (2017/2018 to 2023/2024). Three raters independently categorised HSIs following the Football Injury Inciting Circumstances Classification System and analysed joint and trunk kinematics. Results: Among 109 identified HSIs, 57 (52%) were eligible for analysis. Most injuries (74%) were non-contact, with 51% occurring during running and 49% during stretch-type movements, including kicking and duelling. These patterns involved ball interaction in 68% and duels in 51% of cases. Injuries predominantly occurred in offensive situations (72%), with moderate to high horizontal speed and minimal vertical movement. Biomechanical analysis indicated frequent knee extension and hip flexion. Conclusion: HSIs in women's football predominantly occur during movements with high eccentric demand of the hamstring muscles, with non-contact mechanisms being most common. HSIs are not solely linked to high-speed running but can also occur during propulsion and braking phases, or overstretching activities with an open or closed kinetic chain. HSIs often resulted from complex movements involving multiple tasks simultaneously under high physical and mental demands, in unpredictable and evolving scenarios.