High-Speed Exposure in Football, Part 1: Hamstring Injury Risk, Rehabilitation and Return to Play
Hamstring injuries are the most frequent muscle injury in professional football. Over 21 seasons of the UEFA Elite Club Injury Study their share of all injuries doubled, from 12% in 2001/02 to 24% in 2021/22, and between 2014/15 and 2021/22 incidence rose by about 4% per year in matches and about 7% per year in training (Ekstrand et al., 2023). Most of them occur during sprinting or high-speed running, and the usual response in many clubs has been to limit exposure to those actions. The reasoning is understandable, since a tissue that is not loaded cannot be overloaded. It leaves part of the problem unaddressed, however, because the capacity of the hamstrings to tolerate high-speed running depends on the high-speed running that has previously been performed. Reducing exposure lowers the demand and the tolerance together, and the balance between the two can shift in either direction depending on how the change is applied.
In practice this is difficult to manage. Matches provide intermittent and unpredictable exposure to high speeds, the training week is organised around tactical content and recovery, and players differ widely in how many minutes they play. A starter who completes ninety minutes every weekend and a substitute who rarely leaves the bench arrive at the same training session with very different running histories, and a plan that treats them identically will tend to under-prepare one and over-load the other.
This first part examines the mechanical and epidemiological basis for treating high-speed exposure as a modifiable component of hamstring risk. It then describes how exposure can be programmed in the competitive microcycle and rebuilt after injury. The second part addresses the healthy player and the development of speed.
Hamstring Loading During Sprinting
Musculoskeletal modelling of overground sprinting shows that hamstring force and musculotendon length both reach their peak in terminal swing, when the thigh is flexed and the knee is extending rapidly ahead of foot contact, and that the load in this phase increases steeply with running speed (Schache et al., 2010). Electromyographic recordings are consistent with this, with hamstring activity rising as speed increases (Higashihara et al., 2010). Because the relationship between speed and hamstring demand is not linear, a player who runs regularly at 85% of maximal speed may be less prepared for a single run at 100% than the volume of running would suggest. Much of the additional demand occurs in the last 10 to 15% of speed, a range that is often not reached in football training.
The same muscles contribute to the quality of acceleration. In a treadmill study of young men familiar with sprinting, the participants who produced the greatest horizontal ground reaction force combined high biceps femoris activation at the end of swing with high eccentric knee flexor torque (Morin et al., 2015). Hamstring capacity and sprint performance therefore overlap, and the qualities that make a player fast may also contribute to how well the tissue tolerates fast running. Prospective data in football point in the same direction. In a cohort followed through a season, players with a lower capacity to produce horizontal force at low velocity had a higher hazard of subsequent hamstring injury (HR 2.67, 95% CI 1.51 to 4.73) (Edouard et al., 2021), and in 126 elite English players, sprint running kinematics were associated with later sprint-related injury (Bramah et al., 2025). Mechanical output and injury risk thus seem to share some of their determinants, which is one reason why speed development and injury reduction are better planned together than separately.
Running Workload and Injury
The earliest prospective evidence on running load came from Australian football. In a single AFL club followed over two seasons, high-speed running distances in the preceding week that were above a player's two-year average were associated with markedly higher odds of injury (OR 6.44 for week minus one), whereas total distance and session RPE differed little between injured and uninjured players (Duhig et al., 2016). A multi-club study found that weekly distance above 24 km/h exceeding 653 m was associated with an increased risk in the following week (RR 3.4), although the predictive value for individual players was limited (Ruddy et al., 2018). In a later two-season cohort, roughly 80% of the variance remained unexplained even after combining load, strength and muscle architecture (Breed et al., 2025). Rapid and unaccustomed increases appear to be the more consistent signal, which fits the view that the relationship between load and injury depends on how well prepared the athlete is for that load (Gabbett, 2016). A high weekly volume that has been built gradually is probably not equivalent to the same volume reached after three weeks of low exposure.
Data on near-maximal speed add a second element. In elite Gaelic footballers, players who reached at least 95% of their maximal velocity on at least one occasion in training had lower odds of injury than those who reached only 85% (OR 0.12), and both very low and very high numbers of maximal velocity exposures were associated with higher risk, which produced a U-shaped relationship (Malone et al., 2017). Players with higher chronic training loads tolerated more maximal velocity running at lower risk. A subsequent analysis in professional soccer reported that rapid increases in high-speed running and sprint distances raised the odds of injury, and that higher chronic loads and better intermittent aerobic fitness offset part of that risk (Malone et al., 2018).
Football adds a practical complication, which is that matches supply little exposure at the top of the speed range. In 35 professional players tracked over four seasons, players did not reach 90% of their maximal sprinting speed at all in 35% (attackers) to 65% (midfielders) of matches (Buchheit et al., 2021). The timing of exposure within the week may also matter. In 36 team-seasons from 16 elite clubs, no match hamstring injuries occurred in turnarounds where players had been exposed to runs above 95% of maximal speed two days before the match, whereas injuries continued to occur when that exposure was absent or took place earlier in the microcycle (Buchheit et al., 2023).
"The capacity of the hamstrings to tolerate high-speed running depends on the high-speed running that has previously been performed. Reducing exposure lowers the demand and the tolerance together, and the balance between the two can shift in either direction depending on how the change is applied."
Interpreting the Evidence
Players with more exposure to high speed may differ in fitness, role, availability or injury history, so these associations leave room for alternative explanations. The findings also depend on the thresholds used, since absolute speed zones classify players with different maximal speeds differently, and percentages of individual maximal speed are a more consistent reference.
The most direct test of a programme built around these ideas is a Finnish cohort study of a multifactorial and individualised intervention that included maximal velocity exposure. The primary analysis did not show a significant reduction in hamstring injury risk (HR 0.77, 95% CI 0.39 to 1.51). Secondary analyses in the 31 players present in both seasons showed a lower injury burden (RR 0.67), and higher compliance with maximal velocity exposure and knee flexor strength training was associated with lower injury incidence (Edouard et al., 2024). Because the intervention combined several components, the contribution of sprinting cannot be isolated. Sprinting as a protective stimulus has been described as a potential immunisation process (Edouard et al., 2019), and trials that test sprint exposure alone are still needed.
Taken together, the data support four working assumptions. Regular near-maximal exposure is likely to be part of preparing the hamstrings for football, speed should be referenced to the individual player, rapid increases after periods of low exposure are probably the scenario with the higher risk, and excessive exposure may also increase risk. These assumptions are enough to build a weekly structure, and the next sections turn them into practice.
Programming High-Speed Exposure in the Week
Programming starts with knowing each player's maximal sprinting speed. Peak velocity is better measured by asking players to sprint than by inferring it from matches (Kyprianou et al., 2022), and a standard approach uses three or four flying sprints of 20 to 30 m, often performed in competition against a teammate (Buchheit et al., 2021). Radar, laser or GPS devices then allow percentages of that value to be applied. The value is updated several times during the season, since it changes with fitness, with the surface and with the time elapsed since the last maximal effort.
Near-maximal exposure appears to be useful at modest volumes and at regular intervals. In a narrative review of sprint training in the professional microcycle, Gómez-Piqueras and Alcaraz (2024) proposed practical schemes in which short sprint exposures are placed within the competitive week. Following the association described by Buchheit and colleagues (2023), a session two days before the match is a reasonable position, because fatigue from the previous match has dissipated and the next one is still far enough away for recovery. A typical content in applied settings is three to five flying sprints of 20 to 30 m with an adequate build-up and full recovery, reaching 95% or more of maximal speed. The whole block takes ten to fifteen minutes and can follow the warm-up of a regular session, which makes it easier to include than a dedicated speed day. Players who played few minutes at the weekend receive the same stimulus, whereas players who played the full match may need it reduced, as the match itself contributes some high-speed running.
Progression across the season requires attention at transitions. In preseason the target is a gradual increase of near-maximal exposures across several weeks, from submaximal runs at around 85 to 90% toward maximal efforts. After lay-offs of any cause, players are rebuilt along a similar path, since the high-risk scenario described by Duhig and colleagues (2016) is a sudden return to an unaccustomed level. A weekly record of exposures above 90% and above 95% for each player, with an estimate of chronic exposure over three to four weeks, makes gaps visible, particularly in players who are rarely in the starting team. Staff who track this routinely tend to find that a few players account for most of the missing exposure, and that these are usually the ones coming back from minor knocks or international breaks.
Exposure sits alongside the other components of preparation. Strength work that includes hip-dominant and knee-flexor exercises contributes to the capacity to tolerate speed, and horizontal force capacity seems to matter as well (Edouard et al., 2021; Edouard et al., 2024). In the weekly structure, sprint exposure and strength work are usually separated by a day, so that residual soreness does not reduce the quality of the sprints.
Rebuilding Sprint Exposure After Hamstring Injury
Recurrence is frequent, with 12 to 33% of footballers reinjuring within a year and more than half of recurrences occurring within the first month after return (van der Horst et al., 2017). In the UEFA study, about 18% of hamstring injuries were recurrences, and 69% of these occurred within two months of return to play (Ekstrand et al., 2023). When running is added late in rehabilitation, the capacity to tolerate speed may not have been rebuilt, and the injured tissue may meet its first high-speed exposure in competition. A more coherent approach treats running progression as part of rehabilitation from the early stages, with criteria determining advancement.
A trial of 48 footballers compared a standard protocol with an individualised, criteria-based algorithm that included performance-oriented training from the early stages. Six reinjuries occurred in the standard group and one in the algorithm group (RR 6, 90% CI 1 to 35), return to sport was about two days slower (25.5 versus 23.2 days), and the algorithm group had better 10 m time and maximal speed at return (Mendiguchia et al., 2017). The London consensus panel recommended that rehabilitation progress according to capacity and symptoms, that running and sprinting be prescribed as key components of late rehabilitation and as criteria for return to sport, and that sprinting be pain-free (Paton et al., 2023). A Delphi study of English professional clubs listed progressive running plans, GPS targets for sprints, accelerations and maximal speed, and football-specific testing under fatigue as criteria (Zambaldi, Beasley and Rushton, 2017).
A progression consistent with these sources can be described in five stages, each advanced by criteria rather than dates. Table 1 summarises the content of each stage, the criteria used to move on and the rationale behind them. Loads in the later stages are referenced to the player's own pre-injury GPS data, and the progression is shared between physiotherapist, strength and conditioning coach and head coach, with the criteria agreed before the player reaches the stage in which they apply.
The stages are not a fixed sequence of sessions. A player may need several exposures at 90% before 95% is tolerated, whereas another may move through the second stage within a few days, and the time spent in each stage depends on the severity and location of the injury and on the player's own capacity. Stages 3 and 4 need particular attention in football, since they are the point at which the muscle meets the speeds at which most injuries occur, and since they are often shortened by the pressure of the fixture calendar.
Measurement supports each decision to advance. The next-morning response is particularly informative, and a player who reports stiffness or shows a drop in hamstring strength after a stage usually repeats that stage before moving on.
Return to team training does not complete the process. The exposures above 90 and 95% established in rehabilitation continue in the microcycle, and since reinjury risk is concentrated in the first weeks, the period after return is the point at which maintaining exposure may matter most.
Conclusion
High-speed exposure appears to have two roles in hamstring management in football. Sudden and unaccustomed increases in high-speed running are associated with injury, while regular exposure to near-maximal speed seems associated with lower risk, and the relationship between exposure and risk may follow a U-shaped pattern at the level of the individual. Programmes that include sprinting have so far been tested as part of multifactorial interventions. Applying relative speed thresholds, placing exposure in the microcycle at a modest dose, and rebuilding it progressively after lay-offs and injuries follow from the mechanical and epidemiological data.
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Frequently Asked Questions
Q: Should high-speed running be reduced in players at risk of hamstring injury?
Reductions in high-speed running lower the demand and may also lower the tolerance of the tissue. The data suggest that sudden increases above the level a player is accustomed to carry the largest risk (Duhig et al., 2016; Ruddy et al., 2018), whereas regular near-maximal exposure appears to be associated with lower risk (Malone et al., 2017). A more consistent approach seems to be maintaining a regular and individualised exposure, with reductions applied to fatigue and to unaccustomed spikes.
Q: What speed qualifies as a protective exposure?
No threshold has been validated. Studies have used runs above 90 or 95% of the player's maximal sprinting speed, and the association with lower injury risk has been described mainly at 95% and above (Malone et al., 2017; Buchheit et al., 2023). Because absolute thresholds classify players differently, percentages of individually measured maximal speed are preferable, with the measurement repeated during the season.
Q: When in the week should maximal-speed exposure be programmed?
In a retrospective analysis of elite clubs, no match hamstring injuries occurred when runs above 95% of maximal speed took place two days before the match (Buchheit et al., 2023). This is an association, and the position also allows recovery from the previous match. Fixture congestion and travel may require adjustments.
Q: How is sprinting reintroduced after a hamstring injury?
Through criteria-based progressions in which running is part of rehabilitation from the early stages, moving from submaximal runs and short accelerations to flying sprints at increasing percentages of maximal speed, and then to football-specific actions (Mendiguchia et al., 2017; Paton et al., 2023). Progression depends on symptoms, strength, running performance and the response in the following days.
Q: Does sprint exposure replace hamstring strength training?
Current evidence does not support replacing one with the other. Sprinting exposes the hamstrings to speed-specific loading, and strength training builds capacity at joint angles and loads that sprinting reaches less often. The Finnish multifactorial programme combined both, and compliance with each was associated with lower injury incidence (Edouard et al., 2024).
References
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Antonio Robustelli is the founder of Omniathlete. He is an international high performance consultant and sought-after speaker in the area of Sport Science and Sports Medicine, working all over the world with individual athletes (including participation in the last 5 Olympics) as well as professional teams in soccer, basketball, rugby, baseball since 24 years. Currently serving as Faculty Member and Programme Leader at the National Institute of Sports in India (SAI-NSNIS).
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