Introduction:
Although eccentric hamstring training is widely recommended for injury prevention, existing evidence remains fragmented across diverse sports, intervention protocols and study designs, limiting clear conclusions and highlighting the need for a comprehensive systematic synthesis.

Methods:
The review included 41 peer-reviewed articles identified through searches of the databases from their inception to 10 December 2024. These include randomised and cluster-randomised trials, prospective cohort studies, and systematic reviews or meta-analyses. The research involved athletes who played recreational and professional soccer, rugby, basketball, handball, futsal, sprinting, and other multi-sport disciplines. The study included five intervention types: standalone Nordic hamstring exercise (NHE) protocols; exercise combinations with eccentric and plyometric training; the International Federation of Association Football (FIFA) 11+ warm-up programmes; high-intensity interval training with NHE; and remote eccentric training programmes. The research data included participant information, training methods, injury rates, strength measurements, fascicle structure, and athletic performance metrics.

Results:
The Eccentric hamstring training programmes achieved a 50% decrease in hamstring injuries while simultaneously reducing total lower-extremity and knee injuries and improving both strength and fascicle length. Combining NHE with neuromuscular or adductor exercises improved sprint speed, jump height, and dynamic balance. The FIFA 11+ warm-up routine helped prevent injuries among athletes, with a 33% success rate.

Conclusions:
Eccentric hamstring training, particularly the Nordic hamstring exercise (NHE), is an effective way to reduce hamstring injuries and improve strength and performance. Coaches and trainers should include NHE in warm-ups, combine it with neuromuscular or adductor exercises, and consider remote training options to help athletes stay on track.