Objective: To estimate the incidence and recurrence rate of acute hamstring injuries in all levels of soccer. Design: Epidemiology systematic review. Literature Search: We searched the PubMed (including Medline), CINAHL, SPORTDiscus, Embase and CENTRAL electronic databases. Study Selection Criteria: We included prospective studies of all levels of adult soccer players that registered acute hamstring injuries and provided a description of incidence of acute hamstring injuries in n/1000 playing hours (or available data to calculate this). Data Synthesis: Due to heterogeneity, we synthesised the data descriptively. Results: Thirteen studies including 3868 players met the inclusion criteria. Two of thirteen included studies reported on hamstring injuries in women and thirteen on men. The incidence of acute hamstring injury ranged from 0.3 to 0.5 per 1000 exposure hours in women and 0.3 to 1.9 per 1000 exposure hours in men. Hamstring injuries accounted for 5% to 15% of all soccer-related injuries. Hamstring injury recurrence rates ranged from 4% to 68%, depending on the injury definition. Certainty of the evidence ranged from moderate to very low. Conclusion: The incidence of acute hamstring injury in soccer was 0.3 to 1.9 per 1000 exposure hours. The recurrence rate was 4-68%. Certainty of the evidence ranged from moderate to very low.
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