Hamstring muscle injury rehabilitation in sports: a scoping review.

OBJECTIVE: To describe the methodological characteristics and content of published hamstring muscle injury (HMI) rehabilitation programmes in order to inform clinical practice and guide future research. METHODS: We searched the MEDLINE (PubMed), Scopus and Web of Science electronic databases, on October 2024, using key terms "hamstring" and "rehabilitation", with strategies refined after a preliminary search. Eligible studies included English-language publications involving non-surgically managed acute HMI in humans and reporting rehabilitation protocols. RESULTS: We included 137 articles. Primary research (43.1%, n=59) included mostly cohort and randomised controlled trials (RCTs); secondary research articles (54.0%, n=74) were predominantly narrative reviews. Overall, 54.7% of studies had a low level of evidence. Only 44.2% of primary research focused on HMI rehabilitation programmes of which 47.8% were RCTs. Rehabilitation programme details were often missing. In the subacute/functional phases, strengthening (78.3%) and stretching (55.6%) were most frequently reported. Return-to-sport criteria were reported in only 43.5% of primary research, often based on pain resolution. Across both primary and secondary research, 40 different rehabilitation strategies were identified, with the most frequently reported being eccentric-based strengthening, flexibility exercises, progressive running and agility protocols. Key gaps included lack of standardisation, under-reporting of programme parameters and limited inclusion of diverse sporting populations. CONCLUSIONS: Current scientific literature on HMI rehabilitation programmes shows wide variety, limited high-level evidence primary research and under-reporting of key clinical details. More rigorous and inclusive studies are needed to improve the standardisation and clinical applicability of rehabilitation strategies.