The impact of therapeutic exercises and ultrasound therapy on the rehabilitation of partially injured hamstring muscles in elite football players: a randomized controlled trial

Introduction: Hamstring injuries are among the most frequent in sports, especially in high-speed activities such as football, leading to recurrent episodes, prolonged recovery, and significant time lost from competition. Conventional rehabilitation methods like eccentric exercises are effective, yet emerging modalities such as therapeutic ultrasound (TUS) may further accelerate healing and reduce reinjury risk. Objective: This study aimed to evaluate the combined effects of therapeutic ultrasound and therapeutic exercises on the rehabilitation of partially injured hamstring muscles in elite football players, focusing on recovery time, muscle strength, and pain reduction. Methodology: A randomized controlled trial was conducted with 150 professional football players aged 18–35 years from eight clubs. Participants with MRI-confirmed partial hamstring strains were randomly assigned to an intervention group (TUS + therapeutic exercises) or a control group (therapeutic exercises only). Recovery time, pain scores, muscle strength, and MRI tear size were assessed over four weeks. Results: The intervention group achieved significantly faster recovery (18.3 ± 3.6 days vs. 21.7 ± 4.1 days; p < 0.001), greater pain reduction (2 weeks: 3.5 vs. 4.6; 4 weeks: 1.3 vs. 2.7; p < 0.001), and higher muscle strength gains (4 weeks: 264.8 N vs. 246.3 N; p < 0.001). MRI analysis revealed smaller residual tear size (15.1 mm² vs. 19.3 mm²; p < 0.001), and participant satisfaction was greater in the intervention group (50.7% vs. 18.7%; p = 0.02). Conclusion: The combination of therapeutic ultrasound and exercise accelerates recovery, alleviates pain, and enhances muscle repair in elite football players. This integrated approach offers a valuable advancement for optimizing rehabilitation protocols, shortening return-to-play timelines, and minimizing reinjury risk.