Hamstring injuries receive widespread attention in sports science and medicine due to their impact on athlete performance, health and time loss burden. On the topic of hamstring injury prevention and rehabilitation, ~30 reviews have been published since 2011, alongside clinical practice guidelines (comprehensive list in online supplemental material) and a recent consensus.1–3 The aim of this editorial is to offer a perspective on the existing hamstring injury prevention and rehabilitation literature, highlighting current limitations that could benefit from different research paths in the future.

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Research on hamstring injury risk has provided rich evidence on surrogate outcomes (eg, strength or flexibility), which may deliver valuable information about injury risk factors. Surrogate outcomes are easier to collect, particularly in shorter time frames,4 and may provide important cues for developing larger trials on injury prevention. Injury prevention trials are usually expensive and time-consuming and are less commonly performed. For example, a recent systematic review included 108 published randomised controlled trials (RCTs) on hamstring prevention and risk factor management.5 Only four RCTs (3.7% of all trials) were focused on prevention and assessed injury incidence, all other trials assessed risk factor management (through surrogate outcomes).5 …