Abstract Information 
Abstract ID
20260131
Category
Sports Medicine: Epidemiology and Injury Prevention
Preferable Presentation
Both
Title
THE RELATIONSHIP BETWEEN HIGH METABOLIC LOAD (HML) DISTANCE AND HAMSTRING INJURY SEVERITY IN ELITE ATHLETES
Author
  • Full Name: PUWAPONG NIMKINGRATANA
  • Affiliation/Institution: Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Country: Thailand

  • Full Name: WORRAWAT THANANCHAI
  • Affiliation/Institution: Medical Department, Lamphun Warrior Football Club, Lamphun, Thailand
  • Country: Thailand

  • Full Name: GAN GITILUE
  • Affiliation/Institution: Medical Department, Lamphun Warrior Football Club, Lamphun, Thailand
  • Country: Thailand

  • Full Name: NONTAPAT KHAMPIN
  • Affiliation/Institution: Medical Department, Lamphun Warrior Football Club, Lamphun, Thailand
  • Country: Thailand

  • Full Name: NATTAPONG PONGNIKORN
  • Affiliation/Institution: Medical Department, Lamphun Warrior Football Club, Lamphun, Thailand
  • Country: Thailand

  • Full Name: TANACHOTE CHUMCHUEN
  • Affiliation/Institution: Medical Department, Lamphun Warrior Football Club, Lamphun, Thailand
  • Country: Thailand

  • Full Name: NUTTASIT CHAISANG
  • Affiliation/Institution: Medical Department, Lamphun Warrior Football Club, Lamphun, Thailand
  • Country: Thailand

  • Full Name: NUTTAYA PATTAMAPASPONG
  • Affiliation/Institution: Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Country: Thailand

  • Full Name: THANAT KANTHAWANG
  • Affiliation/Institution: Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Country: Thailand

  • Full Name: PICHITCHAI ATTHAKOMOL
  • Affiliation/Institution: Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Country: Thailand
Presenter
Worrawat Thananchai
Abstract
Background: Hamstring strain injuries (HSIs) remain a significant burden in elite sports, often categorized by clinical grading via imaging. While GPS-derived workload monitoring is standard practice for injury prevention, the specific relationship between metabolic loading intensities and the resulting clinical severity (Grade I vs. Grade II) is not fully established.

Objective: To investigate the differences in absolute metabolic volume and relative workload distribution between Grade I and Grade II hamstring injuries in professional athletes.
Study Design & Methods: A retrospective longitudinal analysis was conducted on 28 professional athletes (Grade I: n=15; Grade II: n=13). GPS-derived metrics, including High Metabolic Load (HML) distance, sprint counts, and the Acute:Chronic Workload Ratio (ACWR), were analyzed for the session in which the injury occurred. Statistical analysis utilized independent t-tests to compare means across grades and Cohen’s d to determine effect sizes.

Results: A statistically significant difference in absolute HML distance was observed between injury grades (593.6m vs 756.1m, p < 0.01). This represents a large effect size (d = 1.05), indicating that Grade II injuries are associated with significantly higher metabolic demands. In contrast, the number of absolute sprints did not significantly differentiate between Grade I and Grade II injuries (p = 0.36). Longitudinal analysis of the lead-up to injury revealed that Grade I injuries were more frequently associated with a "Taper Failure" on the day before injury (MD-1), characterized by a peak ACWR of 1.41 ± 0.85, whereas Grade II injuries were characterized by sustained exposure to high absolute HML volumes.

Conclusions: High Metabolic Load (HML) distance is a superior marker for differentiating hamstring injury severity compared to traditional sprint counting. These findings suggest two distinct mechanical paradigms: Grade II injuries are driven by high absolute metabolic volume (Mechanical Overload), while Grade I injuries are more closely linked to relative loading errors and insufficient tapering. Practitioners should prioritize position-specific HML thresholds over sprint counts to more accurately assess the risk of high-grade structural failure.