51
|
Vianna KB, Rodrigues LG, Oliveira NT, Ribeiro-Alvares JB, Baroni BM. A Preseason Training Program With the Nordic Hamstring Exercise Increases Eccentric Knee Flexor Strength and Fascicle Length in Professional Female Soccer Players. Int J Sports Phys Ther 2021; 16:459-467. [PMID: 33842041 PMCID: PMC8016438 DOI: 10.26603/001c.19452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/04/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Training programs that include the Nordic hamstring exercise (NHE) have been shown to increase eccentric knee flexor strength and biceps femoris fascicle length in male athletes. However, the effect of NHE on female athletes remains unknown. PURPOSE To investigate the collective and individual responses of professional female soccer players engaged in a preseason training program with the NHE regarding eccentric knee flexor strength and biceps femoris long head fascicle length. STUDY DESIGN Quasi-experimental study. METHODS Sixteen amateur female soccer players (without a NHE training routine) were evaluated 8-weeks apart to: (1) assess reliability of eccentric knee flexor strength and biceps femoris fascicle length measures; and (2) determine the typical error of measures that would be used to discriminate training responders and non-responders. The NHE training group had 17 professional female soccer players who performed an 8-week training program with the NHE during preseason. Within-group analysis was performed with paired sample t-tests (pre- vs. post-training), and individual responses were determined using the typical error criteria. RESULTS The non-trained group's data demonstrated that measures of strength (ICC=0.82-0.87, typical error = 12-13 N) and fascicle length (ICC=0.92-0.97; typical error = 0.19-0.38 cm) were reliable. In the NHE training group, both limbs increased the eccentric knee flexor strength (~13%; ES=0.74-0.82) and the biceps femoris fascicle length (~6%; ES=0.44-0.65). Twelve players (~71%) were considered responders to the NHE training program for the eccentric knee flexor strength, while eight athletes (~47%) were responders for the biceps femoris fascicle length. CONCLUSION The 8-week preseason training program with the NHE increased both eccentric knee flexor strength and biceps femoris fascicle length in professional female soccer players. More than two-thirds of players demonstrated a meaningful increase in eccentric strength, while nearly half achieved consistent fascicle length increases with the NHE training.
Collapse
|
52
|
Implementing Strength Training Strategies for Injury Prevention in Soccer: Scientific Rationale and Methodological Recommendations. Int J Sports Physiol Perform 2021; 16:456-461. [DOI: 10.1123/ijspp.2020-0862] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 11/18/2022]
Abstract
Due to the negative effects that injuries have on performance, club finances, and long-term player health (permanent disability after a severe injury), prevention strategies are an essential part of both sports medicine and performance. Purpose: To summarize the current evidence regarding strength training for injury prevention in soccer and to inform its evidence-based implementation in research and applied settings. Conclusions: The contemporary literature suggests that strength training, proposed as traditional resistance, eccentric, and flywheel training, may be a valid method to reduce injury risk in soccer players. Training strategies involving multiple components (eg, a combination of strength, balance, plyometrics) that include strength exercises are effective at reducing noncontact injuries in female soccer players. In addition, the body of research currently published supports the use of eccentric training in sports, which offers unique physiological responses compared with other resistance exercise modalities. It seems that the Nordic hamstring exercise, in particular, is a viable option for the reduction of hamstring injuries in soccer players. Moreover, flywheel training has specific training peculiarities and advantages that are related to the combination of both concentric and eccentric contraction, which may play an important role in injury prevention. It is the authors’ opinion that strength and conditioning coaches should integrate the strength training methods proposed here in their weekly training routine to reduce the likelihood of injuries in their players; however, further research is needed to verify the advantages and disadvantages of these training methods to injury prevention using specific cohorts of soccer players.
Collapse
|
53
|
Short SM, MacDonald CW, Strack D. Hip and Groin Injury Prevention in Elite Athletes and Team Sport - Current Challenges and Opportunities. Int J Sports Phys Ther 2021; 16:270-281. [PMID: 33604155 PMCID: PMC7872466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 04/21/2020] [Indexed: 11/12/2023] Open
Abstract
Hip and groin injury (HAGI) has been reported as a source of significant time loss in elite sport. Field and court-based sports such as basketball, football, hockey, soccer, among others, require explosive multiplanar movement in single stance and high-speed change of direction. Often situations arise where sub-optimal pre-season training has occurred or congested in-season competition minimizes physiologic recovery periods between bouts of physical activity, both of which could magnify concomitant existing risk factors and increase injury risk. Identification and management of HAGI can be challenging as numerous structures within the region can be drivers of pain and injury, especially when considering the likelihood of concurrent pathology and injury reoccurrence. Focused prevention strategies have been suggested, but their practical clinical implementation has not been heavily investigated across the sporting spectrum. The purpose of this commentary is to review the historical and current state of HAGI, while focusing on applying evidence and clinical experience towards the development of future risk reduction strategies. Level of evidence: 5.
Collapse
|
54
|
Suarez-Arrones L, Nakamura FY, Maldonado RA, Torreno N, Di Salvo V, Mendez-Villanueva A. Applying a holistic hamstring injury prevention approach in elite football: 12 seasons, single club study. Scand J Med Sci Sports 2021; 31:861-874. [PMID: 33382128 DOI: 10.1111/sms.13913] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 12/15/2020] [Accepted: 12/22/2020] [Indexed: 12/15/2022]
Abstract
The aim was to investigate the preventive effect of a complex training program based on holistic hamstring health understanding in elite professional soccer players. This study involved an elite club in Europe and was conducted over 12 seasons. The last 2 seasons were the intervention period, and the others were the control seasons. During the intervention period, players performed a complex program organized into different interventions throughout the week having as a priority the player health. Hamstring injuries, absenteeism, injury rates, and injury burden between the control and intervention seasons were compared using a rate ratio (RR) with 95% CI. Players had a mean exposure of 333.5 ± 18.6 hours per season with no significant differences between the intervention and control seasons. The overall injury rate was 3 times lower during the two intervention seasons than during the previous seasons (P < .01); the match injury rate was 2.7 times lower (P < .01) and the training rate 4.3 times (P < .01). Injury burden was almost 4 times lower during the two intervention seasons than during the previous seasons (P < .01), and recurrences in the control group were 10% vs 0% in the intervention group. Hamstring injuries were reduced ~3 times during the seasons in which elite football players were exposed to multicomponent, complex prevention training with individual approaches based on player needs, management of training load, individualized physiotherapy treatment, and planned staff communication, in comparison to the control seasons without a clearly defined and structured injury prevention intervention.
Collapse
Affiliation(s)
- Luis Suarez-Arrones
- Department of Sport and Informatics, Section of Physical Education and Sport, Pablo de Olavide University, Sevilla, Spain.,Performance and Health Department, Basel, Switzerland
| | - Fábio Yuzo Nakamura
- Associate Graduate Program in Physical Education UPE/UFPB, João Pessoa, Brazil.,Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI, Maia, Portugal
| | | | - Nacho Torreno
- Performance and Health Department, Basel, Switzerland
| | - Valter Di Salvo
- Football Performance & Science Department, ASPIRE Academy, Doha, Qatar.,Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | | |
Collapse
|
55
|
Recommendations for Hamstring Function Recovery After ACL Reconstruction. Sports Med 2020; 51:607-624. [PMID: 33332017 DOI: 10.1007/s40279-020-01400-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2020] [Indexed: 01/09/2023]
Abstract
It is important to optimise the functional recovery process to enhance patient outcomes after major injury such as anterior cruciate ligament reconstruction (ACLR). This requires in part more high-quality original research, but also an approach to translate existing research into practice to overcome the research to implementation barriers. This includes research on ACLR athletes, but also research on other pathologies, which with some modification can be valuable to the ACLR patient. One important consideration after ACLR is the recovery of hamstring muscle function, particularly when using ipsilateral hamstring autograft. Deficits in knee flexor function after ACLR are associated with increased risk of knee osteoarthritis, altered gait and sport-type movement quality, and elevated risk of re-injury upon return to sport. After ACLR and the early post-operative period, there are often considerable deficits in hamstring function which need to be overcome as part of the functional recovery process. To achieve this requires consideration of many factors including the types of strength to recover (e.g., maximal and explosive, multiplanar not just uniplanar), specific programming principles (e.g., periodised resistance programme) and exercise selection. There is a need to know how to train the hamstrings, but also apply this to the ACLR athlete. In this paper, the authors discuss the deficits in hamstring function after ACLR, the considerations on how to restore these deficits and align this information to the ACLR functional recovery process, providing recommendation on how to recover hamstring function after ACLR.
Collapse
|
56
|
Beato M, Drust B, Iacono AD. Implementing High-speed Running and Sprinting Training in Professional Soccer. Int J Sports Med 2020; 42:295-299. [PMID: 33291180 DOI: 10.1055/a-1302-7968] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
High-speed running and sprinting training play an important role in the development of physical capabilities, sport-specific performance and injury prevention among soccer players. This commentary aims to summarize the current evidence regarding high-speed running and sprinting training in professional soccer and to inform its implementation in research and applied settings. It is structured into four sections: 1) Evidence-based high-speed running and sprinting conditioning methodologies; 2) Monitoring of high-speed running and sprinting performance in soccer 3) Recommendations for effective implementation of high-speed running and sprinting training in applied soccer settings; 4) Limitations and future directions. The contemporary literature provides preliminary methodological guidelines for coaches and practitioners. The recommended methods to ensure high-speed running and sprinting exposure for both conditioning purposes and injury prevention strategies among soccer players are: high-intensity running training, field-based drills and ball-drills in the form of medium- and large-sided games. Global navigation satellite systems are valid and reliable technologies for high-speed running and sprinting monitoring practice. Future research is required to refine, and advance training practices aimed at optimizing individual high-speed running and sprinting training responses and associated long-term effects.
Collapse
Affiliation(s)
- Marco Beato
- School of Health and Sports Science, University of Suffolk, Ipswich, United Kingdom of Great Britain and Northern Ireland
| | - Barry Drust
- School of Health and Sports Sciences, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - Antonio Dello Iacono
- School of Health and Life Sciences, University of the West of Scotland, Paisley, United Kingdom of Great Britain and Northern Ireland
| |
Collapse
|
57
|
Bueno CA, de Araujo Ribeiro-Alvares JB, Oliveira GDS, Grazioli R, Veeck F, Pinto RS, Cadore EL, Baroni BM. Post-match recovery of eccentric knee flexor strength in male professional football players. Phys Ther Sport 2020; 47:140-146. [PMID: 33279801 DOI: 10.1016/j.ptsp.2020.11.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed at verifying the effect of a football match on the eccentric knee flexor strength of male professional players along a 72-h period. STUDY DESIGN Quasi-experimental study. SETTING Football club facilities. PARTICIPANTS Fifteen players were assessed in four timepoints: 24 h before, immediately after, 48 h and 72 h after the match. MAIN OUTCOME MEASURES The eccentric knee flexor strength was assessed during the Nordic hamstring exercise execution. RESULTS Players presented a significant strength reduction immediately after match (Δ = 12%; p = 0.001; large effect size, d = 1.10), and did not recover their strength capacity within a 48 h-period (Δ = 6%; p = 0.011; moderate effect size, d = 0.57). At 72 h after the match, strength was similar to baseline levels (Δ = 3.5%; p = 0.122; small effect size, d = 0.34). Secondarily, individual response analysis considered a player 'fully recovered' when his strength deficit compared to the baseline measure was lower than the measurement coefficient of variation (i.e., <5%). Only 6 (40%) and 9 (60%) players were 'fully recovered' at 48 h and 72 h after the match, respectively. CONCLUSION Professional football players experienced an immediately post-match drop on the eccentric knee flexor strength, and significant strength deficits persisted for a 48-h period. Some players were not recovered at 72 h after the match.
Collapse
Affiliation(s)
- César Augusto Bueno
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | | | | | - Rafael Grazioli
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Filipe Veeck
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | | |
Collapse
|
58
|
Kaneda H, Takahira N, Tsuda K, Tozaki K, Kudo S, Takahashi Y, Sasaki S, Kenmoku T. Effects of Tissue Flossing and Dynamic Stretching on Hamstring Muscles Function. J Sports Sci Med 2020; 19:681-689. [PMID: 33239941 PMCID: PMC7675630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023]
Abstract
Tissue flossing aims to improve range of motion (ROM), reduce pain, and enhance injury prevention. However, evidence is lacking regarding its effects. Therefore, this study examined the effects of flossing on hamstring muscles function in comparison to dynamic stretching (DS). Seventeen healthy young men ([mean ± SD] age, 23.2 ± 1.1 years; height, 1.72 ± 0.08 m; body mass, 63.5 ± 9.3 kg) volunteered as subjects in this randomized crossover trial. The subjects received flossing, DS, and control interventions in random order at least 1 week apart to eliminate the influence of the previous intervention. Flossing involved passive twisting and active movement using a floss band (Sanctband COMPRE Floss Blueberry, Sanct Japan Co., Ltd.). DS was performed for 4 minutes in 30-second sets consisting of 15 repetitions of 2 seconds stretching. The following were measured before and after each intervention: straight leg raise (SLR) test, passive knee extension (KE) test, passive torque, passive stiffness, fascicle length in the biceps femoris long head as an indication of hamstring muscles flexibility, and maximal isometric knee flexion contraction, maximal eccentric knee extension/flexion contraction, rate of force development, and muscle activity. Flossing yielded significant improvements in the SLR test (mean difference in post-intervention changes between interventions: 5.4°, percentage change from pre- to post-value: 13.4%, p = 0.004), passive KE test (6.2°, 4.5%, p < 0.001), passive torque at end-ROM (3.8 Nm, 4.7%, p = 0.03), and maximal eccentric knee flexion contraction (14.9% body weight, 8.2%, p = 0.03) than control. Moreover, flossing yielded 2.1-fold greater improvements in the passive KE test (3.8°, 4.5%, p = 0.03) and yielded significant improvements in the maximal eccentric knee extension contraction (29.9% body weight, 13.8%, p = 0.02) than DS. Therefore, flossing on hamstring muscles is more beneficial than DS with respect to increasing ROM and muscle exertion.
Collapse
Affiliation(s)
- Hiroaki Kaneda
- Sensory and Motor Control, Graduate School of Medical Sciences, Kitasato 1-15-1, Minami, Sagamihara, Kanagawa 252-0374, Japan
| | - Naonobu Takahira
- Sensory and Motor Control, Graduate School of Medical Sciences, Kitasato 1-15-1, Minami, Sagamihara, Kanagawa 252-0374, Japan
- Physical Therapy Course, Department of Rehabilitation, School of Allied Health Sciences, Kitasato 1-15-1, Minami, Sagamihara, Kanagawa 252-0374, Japan
| | - Kouji Tsuda
- Sensory and Motor Control, Graduate School of Medical Sciences, Kitasato 1-15-1, Minami, Sagamihara, Kanagawa 252-0374, Japan
| | - Kiyoshi Tozaki
- Sensory and Motor Control, Graduate School of Medical Sciences, Kitasato 1-15-1, Minami, Sagamihara, Kanagawa 252-0374, Japan
| | - Sho Kudo
- Sensory and Motor Control, Graduate School of Medical Sciences, Kitasato 1-15-1, Minami, Sagamihara, Kanagawa 252-0374, Japan
| | - Yoshiki Takahashi
- Sensory and Motor Control, Graduate School of Medical Sciences, Kitasato 1-15-1, Minami, Sagamihara, Kanagawa 252-0374, Japan
| | - Shuichi Sasaki
- Sensory and Motor Control, Graduate School of Medical Sciences, Kitasato 1-15-1, Minami, Sagamihara, Kanagawa 252-0374, Japan
- Department of Rehabilitation, Kitasato University Hospital, Kitasato 1-15-1, Minami, Sagamihara, Kanagawa 252-0374, Japan
| | - Tomonori Kenmoku
- Department of Orthopaedic Surgery, School of Medicine, Kitasato University, Kitasato 1-15-1, Minami, Sagamihara, Kanagawa 252-0374, Japan
| |
Collapse
|
59
|
THE GAP BETWEEN RESEARCH AND CLINICAL PRACTICE FOR INJURY PREVENTION IN ELITE SPORT: A CLINICAL COMMENTARY. Int J Sports Phys Ther 2020; 15:1229-1234. [PMID: 33344038 DOI: 10.26603/ijspt20201229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
As clinicians strive to apply evidence-based principles, team-based practitioners have identified a large gap as it relates to published research, ideal applications of evidence-based practice, and actual clinical practice related to injury prevention in elite sport within the United States. For rehabilitation professionals, especially those intimately involved in the research of injury prevention, the solution often seems quite clear and defined. However, preventing injury by implementing the latest recommendation from the most recent prospective study on the using the FIFA 11 + warm-up, a Copenhagen Adduction exercise, or a plyometric drill with elite athletes may not be as effective as was seen among the cohort used in the study. In addition to extrapolating research, clinicians face additional challenges such as variance among professions, schedule density, and off-season contacts with athletes. There is an inherent difficulty in the application of research to practice in elite sport as it relies on the teamwork of not only the practitioner and athlete, but the entire sporting organizational structure and those involved in athlete participation. The purpose of this clinical commentary is to explore the difficulty with application of research in clinical practice and to discuss potential strategies for improving carry over from research to clinical practice.
Collapse
|
60
|
Chesterton P, Evans W, Wright M, Lolli L, Richardson M, Atkinson G. Influence of Lumbar Mobilizations During the Nordic Hamstring Exercise on Hamstring Measures of Knee Flexor Strength, Failure Point, and Muscle Activity: A Randomized Crossover Trial. J Manipulative Physiol Ther 2020; 44:1-13. [PMID: 33248746 DOI: 10.1016/j.jmpt.2020.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 09/11/2020] [Accepted: 09/11/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aims of this study were to quantify the effects of spinal mobilization on force production, failure point, and muscle activity of the hamstrings during the Nordic hamstring exercise (NHE), and to explore individual differences in responses. METHODS In a replicated randomized crossover trial, 24 asymptomatic, recreationally active men (age [mean ± standard deviation]: 27 ± 6 years; body mass: 82 ± 17 kg; height: 181 ± 8 cm) completed 2 standardized intervention trials (L4/5 zygapophyseal mobilizations) and 2 control trials. The failure point of the NHE was determined with 3D motion capture. Peak force, knee flexor torque, and electromyography (EMG) of the biceps femoris were measured. Data analyses were undertaken to quantify mean intervention response and explore any individual response heterogeneity. RESULTS Mean (95% confidence interval) left-limb force was higher in intervention than in control trials by 18.7 (4.6-32) N. Similarly, right-limb force was higher by 22.0 (3.4-40.6) N, left peak torque by 0.14 (0.06-0.22) N • m, and right peak torque by 0.14 (0.05-0.23) N • m/kg. Downward force angle was decreased in intervention vs control trials by 4.1° (0.5°-7.6°) on the side of application. Both peak EMG activity (P = .002), and EMG at the downward force (right; P = .020) increased in the intervention condition by 16.8 (7.1-26.4) and 8.8 (1.5-16.1) mV, respectively. Mean downward acceleration angle changed by only 0.3° (-8.9° to 9.4°) in intervention vs control trials. A clear response heterogeneity was indicated only for right force (Participant × Intervention interaction: P = .044; response heterogeneity standard deviation = 34.5 [5.7-48.4] N). Individual response heterogeneity was small for all other outcomes. CONCLUSION After spinal mobilization, immediate changes in bilateral hamstring force production and peak torque occurred during the NHE. The effect on the NHE failure point was unclear. Electromyographic activity increased on the ipsilateral side. Response heterogeneity was generally similar to the random trial-to-trial variability inherent in the measurement of the outcomes.
Collapse
Affiliation(s)
- Paul Chesterton
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom.
| | - Will Evans
- Faculty of Health Sciences and Wellbeing, Sunderland University, Sunderland, United Kingdom
| | - Matthew Wright
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Lorenzo Lolli
- Football Exchange, Research Institute of Sport Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Mark Richardson
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Greg Atkinson
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| |
Collapse
|
61
|
Silvers-Granelli HJ, Cohen M, Espregueira-Mendes J, Mandelbaum B. Hamstring muscle injury in the athlete: state of the art. J ISAKOS 2020; 6:170-181. [PMID: 34006581 DOI: 10.1136/jisakos-2017-000145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 08/16/2020] [Accepted: 09/26/2020] [Indexed: 11/03/2022]
Abstract
Hamstring injuries (HSI) are the source of significant impairment and disability for both professional and recreational athletes. The incidence and prevalence of HSIs has been well documented in the literature, as they are among the most common soft tissue injuries reported. The significant time loss due to injury and the inherent risk of reinjury pose a significant issue to the athlete, their career longevity and the success of their respective team. This review will deal predominantly with describing the prevalence and incidence of HSI in athletes, discuss risk factors and the mechanisms of injury for HSI, how to properly diagnose, image and prognosticate appropriate return to sport (RTS) for individuals who have sustained an HSI, prescribe treatment and prevention strategies and to discuss relevant options to decrease overall risk of primary and secondary recurrence of HSI.Current treatments of acute HSI necessitate a thorough understanding of the mechanism of injury, identifying muscle imbalances and/or weakness, inclusion of eccentric and concentric hamstring (HS) and hip extension (HE) exercises, evaluation of pathokinematic movement patterns and use non-surgical methods to promote healing and RTS. This methodology can be used prospectively to mitigate the overall risk of HSI. Injection therapies for HSI, including ultrasound-guided platelet-rich plasma and corticosteroids, may impart some short-term benefit, but the existing literature is largely inconclusive with respect to long-term functional outcomes. Future directions should prioritise injury prevention, early diagnosis and targeted interventions that combine both non-surgical and minimally invasive orthobiological approaches and identifying biomechanical risk factors prospectively to mitigate risk.
Collapse
Affiliation(s)
- Holly J Silvers-Granelli
- Musculoskeletal Research Center, Velocity Physical Therapy, Santa Monica, California, USA .,Medical Assessment Research Committee, Major League Soccer, New York, New York, USA
| | - Moises Cohen
- Orthopedic Department, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - João Espregueira-Mendes
- Dom Research Center, Clinica Espregueira Mendes, FIFA Medical Centre of Excellence, Porto, Portugal
| | - Bert Mandelbaum
- Medical Assessment Research Committee, Major League Soccer, New York, New York, USA.,Sports Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| |
Collapse
|
62
|
Chesterton P, Tears C, Wright M, Portas M. Hamstring injury prevention practices and compliance of the Nordic hamstring program in English professional football. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.209] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Paul Chesterton
- School of Health and Life Sciences Teesside University Tees Valley UK
| | - Craig Tears
- School of Health and Life Sciences Teesside University Tees Valley UK
| | - Matthew Wright
- School of Health and Life Sciences Teesside University Tees Valley UK
| | - Matthew Portas
- School of Health and Life Sciences Teesside University Tees Valley UK
- St. George's Park Burton‐Upon Trent Staffordshire UK
| |
Collapse
|
63
|
Buckthorpe M, Wright S, Virgile A, Gimpel M. Infographic. Recommendations for hamstring injury prevention in elite football: translating research into practice. Br J Sports Med 2020; 55:699-700. [PMID: 33077480 DOI: 10.1136/bjsports-2020-103455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Matthew Buckthorpe
- Faculty of Sport, Health and Applied Science, St Mary's University, Twickenham, London, UK .,Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy.,Isokinetic Medical Group, FIFA Medical Centre of Excellence, London, UK
| | | | - Adam Virgile
- College of Nursing and Health Sciences, University of Vermont, Burlington, Vermont, USA
| | - Mo Gimpel
- Southampton Football Club, Southampton, UK
| |
Collapse
|
64
|
Hills SP, Barrett S, Busby M, Kilduff LP, Barwood MJ, Radcliffe JN, Cooke CB, Russell M. Profiling the Post-match Top-up Conditioning Practices of Professional Soccer Substitutes: An Analysis of Contextual Influences. J Strength Cond Res 2020; 34:2805-2814. [PMID: 32986393 DOI: 10.1519/jsc.0000000000003721] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hills, SP, Barrett, S, Busby, M, Kilduff, LP, Barwood, MJ, Radcliffe, JN, Cooke, CB, and Russell, M. Profiling the post-match top-up conditioning practices of professional soccer substitutes: An analysis of contextual influences. J Strength Cond Res 34(10): 2805-2814, 2020-Soccer practitioners implement "top-up" conditioning sessions to compensate for substitutes' limited match-play exposure. Although perceived to be valuable for reducing injury risk and augmenting positive physical adaptations, little research has considered the demands of post-match top-up training. To quantify post-match top-up responses, 31 professional soccer players wore 10 Hz microelectromechanical systems after 37 matches whereby they were selected in the match-day squad as substitutes (184 observations; 6 ± 5 observations·player). Linear mixed models and effect sizes (ES) assessed the influence of contextual factors on 23 physical performance variables. Top-ups lasted 17.13 ± 7.44 minutes, eliciting total and high-speed distances of 1.7 ± 6.2 km and 0.4 ± 1.7 km, respectively. Each contextual factor (i.e., position, substitution timing, match location, result, time of day, stage of the season, and fixture density) influenced at least 4 of the dependent variables profiled (p ≤ 0.05). Top-up duration; total, moderate-speed, and low-speed distance; and the number of repeated high-intensity efforts were greater for unused vs. used substitutes (ES: 0.38-0.73, small to moderate). Relative to away matches, home top-ups elicited heightened total, low-speed, and high-speed distances, alongside more moderate-speed accelerations and decelerations, and repeated high-intensity efforts (ES: 0.25-0.89, small to moderate). Although absolute and relative running distances were generally the highest when the fixture density was low, the greatest acceleration and deceleration demands were observed during the most congested fixture periods. Late-season top-ups typically elicited lower absolute physical responses than early and mid-season sessions. These data provide important information for practitioners when considering the aims and design of substitute top-up conditioning sessions, particularly with reference to contextual influences.
Collapse
Affiliation(s)
- Samuel P Hills
- School of Social and Health Sciences, Leeds Trinity University, Leeds, United Kingdom
| | | | - Matt Busby
- Sport Medicine and Science Department, Hull City Tigers FC, Kingston Upon Hull, United Kingdom
| | - Liam P Kilduff
- Applied Sports Technology, Exercise Medicine Research Center (A-STEM), Swansea University, Swansea, United Kingdom; and.,Welsh Institute of Performance Science, College of Engineering, Swansea University, Swansea, United Kingdom
| | - Martin J Barwood
- School of Social and Health Sciences, Leeds Trinity University, Leeds, United Kingdom
| | - Jon N Radcliffe
- School of Social and Health Sciences, Leeds Trinity University, Leeds, United Kingdom
| | - Carlton B Cooke
- School of Social and Health Sciences, Leeds Trinity University, Leeds, United Kingdom
| | - Mark Russell
- School of Social and Health Sciences, Leeds Trinity University, Leeds, United Kingdom
| |
Collapse
|
65
|
Lahti J, Mendiguchia J, Ahtiainen J, Anula L, Kononen T, Kujala M, Matinlauri A, Peltonen V, Thibault M, Toivonen RM, Edouard P, Morin JB. Multifactorial individualised programme for hamstring muscle injury risk reduction in professional football: protocol for a prospective cohort study. BMJ Open Sport Exerc Med 2020. [DOI: 10.1136/bmjsem-2020-000758] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
IntroductionHamstring muscle injuries (HMI) continue to plague professional football. Several scientific publications have encouraged a multifactorial approach; however, no multifactorial HMI risk reduction studies have been conducted in professional football. Furthermore, individualisation of HMI management programmes has only been researched in a rehabilitation setting. Therefore, this study aims to determine if a specific multifactorial and individualised programme can reduce HMI occurrence in professional football.Methods and analysisWe conducted a prospective cohort study over two seasons within the Finnish Premier League and compare the amount of HMI sustained during a control season to an intervention season. Injury data and sport exposure were collected during the two seasons (2019–2020), and a multifactorial and individualised HMI risk reduction programme will be implemented during intervention season (2020). After a hamstring screening protocol is completed, individual training will be defined for each player within several categories: lumbo-pelvic control, range of motion, posterior chain strength, sprint mechanical output and an additional non-individualised ‘training for all players’ category. Screening and respective updates to training programmes were conducted three times during the season. The outcome will be to compare if there is a significant effect of the intervention on the HMI occurrence using Cox regression analysis.Ethics and disseminationApproval for the injury and sport exposure data collection was obtained by the Saint-Etienne University Hospital Ethics Committee (request number: IORG0007394; record number IRBN322016/CHUSTE). Approval for the intervention season was obtained from the Central Finland healthcare District (request and record number: U6/2019).
Collapse
|
66
|
Ferioli D, La Torre A, Tibiletti E, Dotto A, Rampinini E. Determining the relationship between load markers and non-contact injuries during the competitive season among professional and semi-professional basketball players. Res Sports Med 2020; 29:265-276. [PMID: 32812787 DOI: 10.1080/15438627.2020.1808980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This study examined the association and predictive ability of internal load markers (based on rating of perceived exertion, RPE) with non-contact injuries in basketball. 35 basketball players (age: 24 ± 6 years, stature: 196 ± 9 cm, body mass: 91 ± 12 kg) were prospectively followed during 1 or 2 seasons, during which non-contact injuries were recorded. Markers examined were: mean weekly RPE, weekly load, exposure, week-to-week load change, acute:chronic 1:2, 1:3, 1:4 load ratio. A generalized estimating equations analysis was used to determine association with non-contact injury in the subsequent week. Prediction was examined with receiver operating characteristic curve, area under the curve (AUC) and Youden index. No associations were found between load markers and non-contact injuries (all p > 0.05); load markers showed no injury predictive ability (AUC range: 0.468-537; Youden index range: 0.019-132). In conclusion, the load markers selected are not associated with non-contact injuries and they cannot be used to predict injuries in basketball.
Collapse
Affiliation(s)
- Davide Ferioli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy.,Human Performance Laboratory, MAPEI Sport Research Centre, Olgiate Olona, Varese, Italy
| | - Antonio La Torre
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | | | | | - Ermanno Rampinini
- Human Performance Laboratory, MAPEI Sport Research Centre, Olgiate Olona, Varese, Italy
| |
Collapse
|
67
|
Buchheit M, Simpson BM, Hader K, Lacome M. Occurrences of near-to-maximal speed-running bouts in elite soccer: insights for training prescription and injury mitigation. SCI MED FOOTBALL 2020; 5:105-110. [DOI: 10.1080/24733938.2020.1802058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Martin Buchheit
- Performance Department, Saint-Germain-en-Laye, France
- French Institute of Sport (INSEP), Research Department, Laboratory Sport, Expertise and Performance, Paris, France
| | | | - Karim Hader
- Performance Department, Saint-Germain-en-Laye, France
| | - Mathieu Lacome
- Performance Department, Saint-Germain-en-Laye, France
- French Institute of Sport (INSEP), Research Department, Laboratory Sport, Expertise and Performance, Paris, France
| |
Collapse
|
68
|
Edouard P, Ford KR. Great Challenges Toward Sports Injury Prevention and Rehabilitation. Front Sports Act Living 2020; 2:80. [PMID: 33345071 PMCID: PMC7739591 DOI: 10.3389/fspor.2020.00080] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 12/26/2022] Open
Affiliation(s)
- Pascal Edouard
- Inter-university Laboratory of Human Movement Science (LIBM EA 7424), University of Lyon, University Jean Monnet, Saint Etienne, France.,Faculty of Medicine, Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Kevin R Ford
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, United States
| |
Collapse
|
69
|
Fritsch CG, Dornelles MP, Oliveira GDS, Baroni BM. Poor hamstrings-to-quadriceps torque ratios in male soccer players: weak hamstrings, strong quadriceps, or both? Sports Biomech 2020:1-11. [PMID: 32508266 DOI: 10.1080/14763141.2020.1766100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study aimed to evaluate the influence of hamstrings and quadriceps strength on the hamstrings-to-quadriceps conventional (H:Qcon) and functional (H:Qfun) ratios in male soccer players. Quadriceps concentric peak torque (PT) and hamstrings concentric and eccentric PT were assessed with isokinetic dynamometry at 60°/s in 101 players (202 legs). The cut-points of 0.50, 0.55 and 0.60 were used to assess muscle imbalance through the H:Qcon ratio, while 0.80, 0.85 and 0.90 were used for H:Qfun ratio. Legs with lower H:Qcon ratio had decreased hamstrings concentric PT (p < 0.01; moderate and large effect sizes) and increased quadriceps concentric PT (p < 0.01; moderate effect sizes) in all cut-points. Legs with lower H:Qfun ratio had decreased hamstrings eccentric PT (p < 0.01; large effect sizes) for all cut-points, and controversial results for quadriceps concentric PT (p < 0.01 only for 0.80 cut-point; small effect sizes). H:Qcon ratio presented only weak correlations with quadriceps (r = -0.37) and hamstrings (r = 0.45) concentric PT, while H:Qfun ratio had a negligible correlation with quadriceps concentric PT (r = -0.30) and a moderate correlation with hamstrings eccentric PT (r = 0.66). In conclusion, our findings support that hamstrings strength deficit is the key factor for low H:Q ratios in male soccer players, especially those with poor H:Qfun ratio.
Collapse
Affiliation(s)
- Carolina G Fritsch
- Department of Physiotherapy, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Maurício P Dornelles
- Department of Physiotherapy, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Gabriel Dos S Oliveira
- Department of Physiotherapy, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Bruno M Baroni
- Department of Physiotherapy, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| |
Collapse
|
70
|
Abstract
The COVID-19 pandemic in 2020 has resulted in widespread training disruption in many sports. Some athletes have access to facilities and equipment, while others have limited or no access, severely limiting their training practices. A primary concern is that the maintenance of key physical qualities (e. g. strength, power, high-speed running ability, acceleration, deceleration and change of direction), game-specific contact skills (e. g. tackling) and decision-making ability, are challenged, impacting performance and injury risk on resumption of training and competition. In extended periods of reduced training, without targeted intervention, changes in body composition and function can be profound. However, there are strategies that can dramatically mitigate potential losses, including resistance training to failure with lighter loads, plyometric training, exposure to high-speed running to ensure appropriate hamstring conditioning, and nutritional intervention. Athletes may require psychological support given the challenges associated with isolation and a change in regular training routine. While training restrictions may result in a decrease in some physical and psychological qualities, athletes can return in a positive state following an enforced period of rest and recovery. On return to training, the focus should be on progression of all aspects of training, taking into account the status of individual athletes.
Collapse
|
71
|
Gualtieri A, Rampinini E, Sassi R, Beato M. Workload Monitoring in Top-level Soccer Players During Congested Fixture Periods. Int J Sports Med 2020; 41:677-681. [PMID: 32455455 DOI: 10.1055/a-1171-1865] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This study assessed the internal and external workload of starters and non-starters in a professional top-level soccer team during a congested fixture period. Twenty Serie A soccer players were monitored in this study during two mesocycles of 21 days each. Starters and non-starters were divided based on the match time played in each mesocycle. The following metrics were recorded: exposure time, total distance, relative total distance, high-speed running distance over 20 km·h-1, very high-speed running distance over 25 km·h-1, individual very high-speed distance over 80% of maximum peak speed, and rating of perceived exertion. Differences between starters and non-starters were found for: exposure time (effect size=large to very large), rating of perceived exertion (large to very large), total distance (large to very large), and individual very high-speed distance over 80% of maximum peak speed (moderate to large). Furthermore, differences for relative total distance, high-speed running distance over 20 km·h-1 and very high-speed running distance over 25 km·h-1 were small to moderate, but not significant. This study reports that during congested fixture periods, starters had higher exposure time, rating of perceived exertion, total distance, and individual very high-speed distance over 80% of maximum peak speed than non-starters.
Collapse
Affiliation(s)
| | - Ermanno Rampinini
- MAPEI Sport Research Centre, Human Performance Laboratory, Varese, Italy
| | | | - Marco Beato
- School of Health and Sports Sciences, University of Suffolk, Ipswich, United Kingdom of Great Britain and Northern Ireland
| |
Collapse
|
72
|
Mechanisms of Hamstring Strain Injury: Interactions between Fatigue, Muscle Activation and Function. Sports (Basel) 2020; 8:sports8050065. [PMID: 32443515 PMCID: PMC7281534 DOI: 10.3390/sports8050065] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/04/2020] [Accepted: 05/12/2020] [Indexed: 12/19/2022] Open
Abstract
Isolated injury to the long head of biceps femoris is the most common type of acute hamstring strain injury (HSI). However, the precise hamstring injury mechanism (i.e., sprint-type) is still not well understood, and research is inconclusive as to which phase in the running cycle HSI risk is the greatest. Since detailed information relating to hamstring muscle function during sprint running cannot be obtained in vivo in humans, the findings of studies investigating HSI mechanisms are based on modeling that requires assumptions to be made based on extrapolations from anatomical and biomechanical investigations. As it is extremely difficult to account for all aspects of muscle-tendon tissues that influence function during high-intensity running actions, much of this complexity is not included in these models. Furthermore, the majority of analyses do not consider the influence of prior activity or muscular fatigue on kinematics, kinetics and muscle activation during sprinting. Yet, it has been shown that fatigue can lead to alterations in neuromuscular coordination patterns that could potentially increase injury risk. The present critical review will evaluate the current evidence on hamstring injury mechanism(s) during high-intensity running and discuss the interactions between fatigue and hamstring muscle activation and function.
Collapse
|
73
|
Green B, Bourne MN, van Dyk N, Pizzari T. Recalibrating the risk of hamstring strain injury (HSI): A 2020 systematic review and meta-analysis of risk factors for index and recurrent hamstring strain injury in sport. Br J Sports Med 2020; 54:1081-1088. [PMID: 32299793 DOI: 10.1136/bjsports-2019-100983] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2020] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To systematically review risk factors for hamstring strain injury (HSI). DESIGN Systematic review update. DATA SOURCES Database searches: (1) inception to 2011 (original), and (2) 2011 to December 2018 (update). Citation tracking, manual reference and ahead of press searches. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies presenting prospective data evaluating factors associated with the risk of index and/or recurrent HSI. METHOD Search result screening and risk of bias assessment. A best evidence synthesis for each factor and meta-analysis, where possible, to determine the association with risk of HSI. RESULTS The 78 studies captured 8,319 total HSIs, including 967 recurrences, in 71,324 athletes. Older age (standardised mean difference=1.6, p=0.002), any history of HSI (risk ratio (RR)=2.7, p<0.001), a recent HSI (RR=4.8, p<0.001), previous anterior cruciate ligament (ACL) injury (RR=1.7, p=0.002) and previous calf strain injury (RR=1.5, p<0.001) were significant risk factors for HSI. From the best evidence synthesis, factors relating to sports performance and match play, running and hamstring strength were most consistently associated with HSI risk. The risk of recurrent HSI is best evaluated using clinical data and not the MRI characteristics of the index injury. SUMMARY/CONCLUSION Older age and a history of HSI are the strongest risk factors for HSI. Future research may be directed towards exploring the interaction of risk factors and how these relationships fluctuate over time given the occurrence of index and recurrent HSI in sport is multifactorial.
Collapse
Affiliation(s)
- Brady Green
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Matthew N Bourne
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.,School of Allied Health Sciences, Griffith University, Gold Coast Campus, Queensland, Australia
| | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland
| | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| |
Collapse
|
74
|
Ribeiro-Alvares JB, Oliveira GDS, De Lima-E-Silva FX, Baroni BM. Eccentric knee flexor strength of professional football players with and without hamstring injury in the prior season. Eur J Sport Sci 2020; 21:131-139. [DOI: 10.1080/17461391.2020.1743766] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- João Breno Ribeiro-Alvares
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Gabriel Dos Santos Oliveira
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Felipe Xavier De Lima-E-Silva
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Bruno Manfredini Baroni
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| |
Collapse
|
75
|
Koumantakis GA, Roussou E, Angoules GA, Angoules NA, Alexandropoulos T, Mavrokosta G, Nikolaou P, Karathanassi F, Papadopoulou M. The immediate effect of IASTM vs. Vibration vs. Light Hand Massage on knee angle repositioning accuracy and hamstrings flexibility: A pilot study. J Bodyw Mov Ther 2020; 24:96-104. [PMID: 32826015 DOI: 10.1016/j.jbmt.2020.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 02/03/2020] [Accepted: 02/17/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The effectiveness of novel soft-tissue interventions relative to traditional ones requires further exploration. The purpose of this pilot study was to evaluate the immediate effect of Instrument Assisted Soft Tissue Mobilization (IASTM) compared to Vibration Massage or Light Hand Massage on hamstrings' flexibility and knee proprioception. METHODS 16 healthy non-injured male participants (mean age 23.7 years, height 1.80 cms and body mass 77.7 kg) were randomly assigned to the following interventions: (a) 5min IASTM, (b) 5min Vibration Massage and (c) 8min Light Hand-Massage, sequentially delivered to all participants with an in-between 1-week time interval. A single application of each intervention was given over the hamstrings of their dominant leg (repeated measures under 3 different experimental conditions). An active knee angle reproduction proprioception test and the back-saver sit and reach flexibility test were performed before and immediately after each intervention. Reliability of outcomes was also assessed. RESULTS Reliability for flexibility (ICC3,1 = 0.97-0.99/SEM = 0.83-1.52 cm) and proprioception (ICC3,1 = 0.83-0.88/SEM = 1.63-2.02°) was very good. For flexibility, statistically significant immediate improvement (p < 0.001) was noted in all 3 groups (1.61-3.23 cm), with no between-group differences. For proprioception, improvement in the IASTM (2.12°), Vibration Massage (0.32°) and Light Hand-Massage (1.17°) conditions was not statistically significant; no between-group differences were also evident. CONCLUSIONS Our findings indicate that muscle flexibility was positively influenced immediately after a single intervention of IASTM, Vibration Massage or Light Hand Massage. Proprioception changes were not statistically significant either within or between groups. Further evaluation of those interventions in a larger population with hamstrings pathology is required.
Collapse
Affiliation(s)
- George A Koumantakis
- 401 General Army Hospital of Athens, Physiotherapy Department, Pan. Kanellopoulou 1, Athens, Greece; Metropolitan College, Health Sciences Faculty, School of Physiotherapy, Athens, Greece - Affiliated Institution with Queen Margaret University, Edinburgh, UK.
| | - Eleonora Roussou
- Metropolitan College, Health Sciences Faculty, School of Physiotherapy, Athens, Greece - Affiliated Institution with Queen Margaret University, Edinburgh, UK
| | - Georgios A Angoules
- Metropolitan College, Health Sciences Faculty, School of Physiotherapy, Athens, Greece - Affiliated Institution with Queen Margaret University, Edinburgh, UK
| | - Nikolaos A Angoules
- Metropolitan College, Health Sciences Faculty, School of Physiotherapy, Athens, Greece - Affiliated Institution with Queen Margaret University, Edinburgh, UK
| | - Theodoros Alexandropoulos
- Metropolitan College, Health Sciences Faculty, School of Physiotherapy, Athens, Greece - Affiliated Institution with Queen Margaret University, Edinburgh, UK
| | - Georgia Mavrokosta
- Metropolitan College, Health Sciences Faculty, School of Physiotherapy, Athens, Greece - Affiliated Institution with Queen Margaret University, Edinburgh, UK
| | - Prokopios Nikolaou
- Metropolitan College, Health Sciences Faculty, School of Physiotherapy, Athens, Greece - Affiliated Institution with Queen Margaret University, Edinburgh, UK
| | - Filippi Karathanassi
- Metropolitan College, Health Sciences Faculty, School of Physiotherapy, Athens, Greece - Affiliated Institution with Queen Margaret University, Edinburgh, UK
| | - Maria Papadopoulou
- Metropolitan College, Health Sciences Faculty, School of Physiotherapy, Athens, Greece - Affiliated Institution with Queen Margaret University, Edinburgh, UK
| |
Collapse
|
76
|
Practitioner perceptions regarding the practices of soccer substitutes. PLoS One 2020; 15:e0228790. [PMID: 32032369 PMCID: PMC7006909 DOI: 10.1371/journal.pone.0228790] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 12/24/2019] [Indexed: 11/21/2022] Open
Abstract
Despite empirical observations suggesting that practitioners value the use of substitutions during soccer match-play, limited research has sought to substantiate such claims. This study used online surveys to assess the perceptions of practitioners within professional soccer about the use and practices of substitutes. Thirty-three practitioners completed one of two surveys (each requiring both open and closed questions to be answered), depending upon whether their primary role related mostly to tactical (‘tactical practitioners’; n = 7) or physical (‘physical practitioners’; n = 26) aspects of player/team management. Thematic content analysis of responses identified four higher-order themes: ‘impact of substitutions’, ‘planning and communication’, ‘player preparation and recovery’ and ‘regulations’. Eighty-five percent of practitioners believed that substitutes are important in determining success during soccer match-play, with the primary justification being the perceived ability of such players to provide a physical and/or tactical impact. However, contextual factors such as the match situation, timing of introduction, and players undergoing adequate pre-pitch-entry preparation, may be important for realising such aims. Although many practitioners believed that there was a need for substitutes to engage in bespoke non-match-day preparations and recovery strategies that differ from starting players, logistical considerations, such as scarcity of resources, often limit their scope. Notwithstanding, 96% of respondents indicated that substitutes frequently perform extra conditioning sessions to account for deficits in high-speed running loads compared with players exposed to a longer period of match-play. Substitutes’ pre-match warm-ups are typically led by team staff, however practitioners reported providing varying levels of input with regards to the practices adopted between kick-off and pitch-entry. Uncertainty exists as to the efficacy of current pre-pitch-entry practices, and 100% of practitioners highlighted ‘preparatory strategies’ as at least a ‘moderately important’ direction for future research. This study presents novel insights and highlights areas that are considered future research priorities amongst those working in the field.
Collapse
|
77
|
Effects of low-level laser therapy on hamstring strain injury rehabilitation: A randomized controlled trial. Phys Ther Sport 2020; 42:124-130. [PMID: 31991284 DOI: 10.1016/j.ptsp.2020.01.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/07/2020] [Accepted: 01/07/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To evaluate the effects of low-level laser therapy (LLLT) on functional rehabilitation following hamstring strain injury (HSI) in amateur athletes treated with an exercise-based rehabilitation program. DESIGN Randomized controlled trial. METHODS Male athletes (18-40 years old) who sustained HSI were randomized in LLLT or placebo groups. All patients were engaged in the same exercise-based rehabilitation program until they met specific criteria to return to sport. Hamstring muscles were treated with LLLT or placebo immediately after each rehabilitation session. The primary outcome was time-to-return to sport. Secondary outcomes were the number of rehabilitation sessions, hamstring flexibility, hamstring strength, and re-injury rate. RESULTS Twenty-four athletes began rehabilitation, and 22 (11 per group) completed the study schedule. Participants of LLLT and placebo groups had similar age, body size, injury characteristics, and baseline levels of hamstring flexibility and strength. The two groups increased flexibility and strength similarly throughout the rehabilitation program. Time-to-return to sport was the same for athletes treated with LLLT (23 ± 9 days) and placebo (24 ± 13 days). There were no re-injuries within 6 months after return to sport. CONCLUSION LLLT, as used in this study, did not optimize functional rehabilitation following HSI in amateur athletes treated with an exercise-based rehabilitation program.
Collapse
|
78
|
Menager E, Dauty M. Profil musculaire isocinétique des athlètes de haut niveau en fonction de la pratique de sports différents : le football, le basketball, le handball, le volleyball, et le cyclisme. Sci Sports 2019. [DOI: 10.1016/j.scispo.2019.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
79
|
Milanese S, Eston R. Hamstring injuries and Australian Rules football: over-reliance on Nordic hamstring exercises as a preventive measure? Open Access J Sports Med 2019; 10:99-105. [PMID: 31413646 PMCID: PMC6662172 DOI: 10.2147/oajsm.s212008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 06/06/2019] [Indexed: 12/19/2022] Open
Abstract
Nordic hamstring exercises (NHE) are promoted as an evidence-based strategy for reducing the prevalence of hamstring injuries in football, with a number of studies showing a significant reduction in hamstring injury rates following implementation of a NHE-based program. However, most of the research to date has been undertaken in soccer with less research carried out in other football codes. Despite this lack of relevant evidence, NHE has recently become popular as a preventative measure in Australian Rules football (ARF) teams; however, hamstring injuries remain high. This paper reviews the literature associated with the use of NHE for ARF players and questions the appropriateness of this exercise approach as a preventative measure for hamstring injuries in this sport. When considering the use of a preventative exercise program, such as the NHE, the specific risks associated with the sporting activity should be considered and the evidence reviewed in light of this. Whilst NHE provides an easy way to do eccentric exercises, the movement does not replicate what is needed in the real world for ARF and should therefore be included in a hamstring injury prevention program in this code with caution.
Collapse
Affiliation(s)
- Steve Milanese
- International Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, Australia
| | - Roger Eston
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| |
Collapse
|
80
|
Macdonald B, McAleer S, Kelly S, Chakraverty R, Johnston M, Pollock N. Hamstring rehabilitation in elite track and field athletes: applying the British Athletics Muscle Injury Classification in clinical practice. Br J Sports Med 2019; 53:1464-1473. [DOI: 10.1136/bjsports-2017-098971] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2019] [Indexed: 12/31/2022]
Abstract
RationaleHamstring injuries are common in elite sports. Muscle injury classification systems aim to provide a framework for diagnosis. The British Athletics Muscle Injury Classification (BAMIC) describes an MRI classification system with clearly defined, anatomically focused classes based on the site of injury: (a) myofascial, (b) muscle–tendon junction or (c) intratendinous; and the extent of the injury, graded from 0 to 4. However, there are no clinical guidelines that link the specific diagnosis (as above) with a focused rehabilitation plan.ObjectiveWe present an overview of the general principles of, and rationale for, exercise-based hamstring injury rehabilitation in British Athletics. We describe how British Athletics clinicians use the BAMIC to help manage elite track and field athletes with hamstring injury. Within each class of injury, we discuss four topics: clinical presentation, healing physiology, how we prescribe and progress rehabilitation and how we make the shared decision to return to full training. We recommend a structured and targeted diagnostic and rehabilitation approach to improve outcomes after hamstring injury.
Collapse
|
81
|
Buckthorpe M, Stride M, Villa FD. ASSESSING AND TREATING GLUTEUS MAXIMUS WEAKNESS - A CLINICAL COMMENTARY. Int J Sports Phys Ther 2019; 14:655-669. [PMID: 31440415 PMCID: PMC6670060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
The Gluteus Maximus (GM) muscle is the largest and most powerful in the human body. It plays an important role in optimal functioning of the human movement system as well as athletic performance. It is however, prone to inhibition and weakness which contributes to chronic pain, injury and athletic under-performance. As such, understanding how to assess and treat GM dysfunction is an important aspect of sports science and medicine, as it has relevance for injury prevention, rehabilitation and performance enhancement. Despite GMs considerable importance there is little research attempting to translate evidence into practice to support practitioners when faced with 'sleepy glutes'. This clinical commentary discusses the importance of GM for athletic performance and injury risk; factors which contribute to GM dysfunction and then provides evidenced informed approaches to assess and treat GM dysfunction. This can be used as part of rehabilitation or injury prevention practices as well as athletic performance training. LEVEL OF EVIDENCE 5.
Collapse
Affiliation(s)
| | - Matthew Stride
- Isokinetic Medical Group, FIFA Medical Centre of Excellence, London, UK
| | - Francesco Della Villa
- Isokinetic Medical Group, FIFA Medical Centre of Excellence, Education & Research Department, Bologna, Italy
| |
Collapse
|
82
|
Ménard M, Sorel A, Boumpoutou R, Kerhervé H, Kulpa R, Bideau B. A musculoskeletal modelling approach of the assessment of the risk of hamstring injuries in professional soccer players: a pilot study. Comput Methods Biomech Biomed Engin 2019. [DOI: 10.1080/10255842.2020.1714913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- M. Ménard
- Univ Rennes, Rennes, France
- Institut d’Ostéopathie de Rennes, Rennes, France
| | | | - R. Boumpoutou
- Univ Rennes, Rennes, France
- Stade Rennais FC - La Piverdière - Chemin de la Taupinais, Rennes, France
| | | | | | | |
Collapse
|
83
|
Assessing the Return on Investment of Injury Prevention Procedures in Professional Football. Sports Med 2019; 49:621-629. [PMID: 30838519 DOI: 10.1007/s40279-019-01083-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The aim of this study was to develop a quick and simple screening procedure for evaluating the return on investment provided by injury prevention programmes in professional football. Injury prevention in sport has usually been considered in isolation of other management responsibilities, and interventions are published irrespective of whether their impact is worthwhile and irrespective of the return on players' time investment in the programme. This approach is naive from a business perspective and is not an approach normally adopted by commercial organisations. METHODS In professional football, the overwhelming cost associated with implementing an injury prevention programme is the players' time commitment, and the major benefit is the players' increased availability, achieved through the reduction in the number of injuries. A comparison of these time-based costs and benefits provides the basis for the evaluation process presented. RESULTS Applying the evaluation process to a number of published injury prevention programmes recommended for football demonstrates that they are unlikely to provide an adequate return on investment. CONCLUSIONS Researchers should focus on developing injury prevention programmes that provide an adequate return on players' time investment, otherwise there is no incentive for clubs to implement the programmes. Reporting that an injury prevention programme produces a statistically significant reduction in the incidence of injury, for example, is insufficient information. Injury prevention programmes should focus on 'at risk' players to increase the return on investment, and researchers should evaluate and report on the utility of prevention programmes within the intended sports setting.
Collapse
|