The Nordic Hamstring Exercise Cut Hamstring Injuries in Half Across 8,459 Athletes
British Journal of Sports Medicine February 26, 2019
What the researchers wanted to know
The researchers wanted to answer one question: does the Nordic hamstring exercise prevent hamstring injuries when it is part of an injury prevention program?
Why it matters
A hamstring injury is the most common muscle injury in many sports. Earlier summaries of the research left out a lot of studies. One counted only four studies. Another looked only at football (soccer) teams that tracked playing hours. Leaving studies out can give a skewed picture, so these researchers set out to include every study with a comparison group, whatever the sport, sex or age of the athletes.
Your hamstrings are the muscles running down the back of your thigh. They are often strained during sprinting, which is why hamstring injuries are so common in sports like football (soccer) and rugby.
In the Nordic hamstring exercise, you kneel on the ground while a partner holds your ankles down. Keeping your body straight from knees to head, you lean forward as slowly as you can, using the backs of your thighs as brakes, until you catch yourself with your hands. Then you push back up and repeat. It needs no equipment.
This paper did not run a new experiment. It gathered every earlier study on the question and combined their numbers into one overall result. A combined result from many studies is usually more trustworthy than any single study.
The researchers searched three research databases, from their earliest records up to August 2018, with no limit on language. They also checked the reference lists of relevant papers.
A study was included if it:
- involved athletes in any sport, of any age, sex or level
- had one group doing the Nordic hamstring exercise, either by itself or as part of a larger program
- had a comparison group doing usual training or a program without the exercise
- counted hamstring injuries
The search turned up 1,590 papers. 15 studies made the final list, covering 8,459 athletes.
- Type: 8 were controlled trials (7 of them decided by chance who did the exercise) and 7 followed teams that had chosen their own training.
- Sport: 12 in football (soccer), and 1 each in rugby, baseball and Australian football.
- Sex: 13 in men, 2 in women.
- Age and level: players were 18 to 40, apart from one study of youth players aged 13 to 18. Levels ran from youth and amateur to professional.
- Program: 6 studies used the Nordic hamstring exercise by itself. 4 used it as part of the FIFA 11+ warm-up. The rest combined it with other strength, stretching or warm-up exercises.
- Length: 1 to 4 seasons.
The amount of exercise differed between studies. A common plan started with 2 sets of 5 once a week and built up over about 10 weeks to 3 sets of 12, 10 and 8, two or three times a week.
Two researchers separately graded each study for six kinds of weakness, with a third settling disagreements. They then combined the injury numbers from all 15 studies. To test how solid the result was, they repeated the calculation three more ways: with only the trials, with the weakest studies removed, and with each study left out in turn.
Programs that included the Nordic hamstring exercise had 51% fewer hamstring injuries than the comparison groups. Across the 15 studies there were 525 hamstring injuries in total.
The researchers' range for the true figure runs from 26% fewer to 68% fewer.
The result held up each time it was checked:
- Only the trials: 48% fewer injuries
- Weakest studies removed (8 studies taken out): 45% fewer injuries
- Each study left out in turn: the overall result barely moved, so no single study was driving it
Nine studies tracked playing and training time. In those, players doing the exercise had about 0.1 hamstring injuries per 1,000 hours, compared with about 0.2 in players doing their usual training.
Results differed a lot from one study to the next. The two studies in women, and the one in Australian football, did not show a clear drop in injuries when looked at alone.
The drop was larger in the four studies that counted repeat hamstring injuries. Seven studies did not say whether repeat injuries were counted, so the researchers could not draw a firm conclusion about first-time versus repeat injuries.
On the quality grading, most studies had two weak points: players knew whether they were doing the exercise, and the people recording injuries usually knew too. The researchers note that hiding the exercise from players is not really possible. They found no clear sign that studies with disappointing results had gone unpublished.
It is still not clear what the best amount of the exercise is, or exactly how it protects the muscle.
Conclusion
Injury prevention programs that include the Nordic hamstring exercise cut hamstring injuries roughly in half. This held across different sports and different athletes.
Therefore
Athletes may be able to lower their risk of a hamstring injury by adding the exercise, and the researchers encourage coaches and clinicians to include it in their prevention programs, whatever the sport, sex or age.
How much can you trust this study?
Two studies can say the same thing and deserve very different amounts of trust. LayMed scores every study out of 100 on:
- Study design
- Bias Control & Transparency
- Size and precision
- Measurement
LayMed Premium members see the Study Quality score for every study, with the reason behind each part.
Get LayMed Premium$7.99 a month or $79 a year
How far does this apply to you personally?
A study can earn a high quality score and still not apply well to you. How much its results carry over to you can change a lot depending on your sex, age, race or ethnicity, body weight, genes, hormones, blood pressure and resting heart rate, blood sugar and other health conditions, medications, activity level, training experience, diet, sleep, smoking and drinking, job and gut bacteria.
Hover over or tap any of these to see a real study where it changed the results.
LayMed Premium members get a personal Relevance score for every study. It weighs all of these factors to estimate how well the results apply to you and your life.
Get LayMed Premium$7.99 a month or $79 a year
Important new studies, explained in plain English, sent straight to your inbox.
Almost done. Please check your email for a confirmation sent from "laymed@dr-gains.com".
Keywords: Football (soccer), Hamstring injury, Injury prevention, Nordic hamstring exercise
Last checked against the source: November 14, 2026
LayMed articles are plain-English summaries of published research, written for education. They are not medical advice. Always read the original study and talk to a qualified professional about your own situation.