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Simonsson R, Piussi R, Högberg J, Sundberg A, Hamrin Senorski E. Rehabilitation and Return to Sport After Anterior Cruciate Ligament Reconstruction. Clin Sports Med 2024; 43:513-533. [PMID: 38811125 DOI: 10.1016/j.csm.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
Rehabilitation after an anterior cruciate ligament (ACL) reconstruction requires patience, devotion, and discipline. Rehabilitation should be individualized to each patient's specific need and sport. Return to sport is a continuum throughout the rehabilitation, and patients should not return to performance before passing a battery of muscle function tests and patient-reported outcomes, as well as change of direction-specific tests. Return to full participation should be an agreement between the patient, physical therapist, surgeon, and coach. For minimal risk for second ACL injury, patients should continue with maintenance and prevention training even after returning to sport.
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Affiliation(s)
- Rebecca Simonsson
- Sportrehab Sports Medicine Clinic, Stampgatan 14, Gothenburg SE-411 01, Sweden; Sahlgrenska Sports Medicine Center, Gothenburg, Sweden; Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, Gothenburg SE-405 30, Sweden
| | - Ramana Piussi
- Sportrehab Sports Medicine Clinic, Stampgatan 14, Gothenburg SE-411 01, Sweden; Sahlgrenska Sports Medicine Center, Gothenburg, Sweden; Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, Gothenburg SE-405 30, Sweden
| | - Johan Högberg
- Sportrehab Sports Medicine Clinic, Stampgatan 14, Gothenburg SE-411 01, Sweden; Sahlgrenska Sports Medicine Center, Gothenburg, Sweden; Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, Gothenburg SE-405 30, Sweden
| | - Axel Sundberg
- Sahlgrenska Sports Medicine Center, Gothenburg, Sweden; Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, Gothenburg SE-405 30, Sweden; Capio Ortho Center, Arvid Wallgrens Backe 4a, Gothenburg SE-413 13, Sweden
| | - Eric Hamrin Senorski
- Sportrehab Sports Medicine Clinic, Stampgatan 14, Gothenburg SE-411 01, Sweden; Sahlgrenska Sports Medicine Center, Gothenburg, Sweden; Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 455, Gothenburg SE-405 30, Sweden; Swedish Olympic Committee, Olympiastadion 114 33, Stockholm, Sweden.
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Rubin EB, Schmidt AM, Koff MF, Kogan F, Gao K, Majumdar S, Potter H, Gold GE. Advanced MRI Approaches for Evaluating Common Lower Extremity Injuries in Basketball Players: Current and Emerging Techniques. J Magn Reson Imaging 2024; 59:1902-1913. [PMID: 37854004 DOI: 10.1002/jmri.29019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 10/20/2023] Open
Abstract
Magnetic resonance imaging (MRI) can provide accurate and non-invasive diagnoses of lower extremity injuries in athletes. Sport-related injuries commonly occur in and around the knee and can affect the articular cartilage, patellar tendon, hamstring muscles, and bone. Sports medicine physicians utilize MRI to evaluate and diagnose injury, track recovery, estimate return to sport timelines, and assess the risk of recurrent injury. This article reviews the current literature and describes novel developments of quantitative MRI tools that can further advance our understanding of sports injury diagnosis, prevention, and treatment while minimizing injury risk and rehabilitation time. Innovative approaches for enhancing the early diagnosis and treatment of musculoskeletal injuries in basketball players span a spectrum of techniques. These encompass the utilization of T2, T1ρ, and T2* quantitative MRI, along with dGEMRIC and Na-MRI to assess articular cartilage injuries, 3D-Ultrashort echo time MRI for patellar tendon injuries, diffusion tensor imaging for acute myotendinous injuries, and sagittal short tau inversion recovery and axial long-axis T1-weighted, and 3D Cube sequences for bone stress imaging. Future studies should further refine and validate these MR-based quantitative techniques while exploring the lifelong cumulative impact of basketball on players' knees. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Elka B Rubin
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Andrew M Schmidt
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Matthew F Koff
- Department of Radiology and Imaging, Hospital for Special Surgery, New York City, New York, USA
| | - Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Kenneth Gao
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Hollis Potter
- Department of Radiology and Imaging, Hospital for Special Surgery, New York City, New York, USA
| | - Garry E Gold
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
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Medeiros DM, Lima-E-Silva FXD, Aimi M, Vaz MA, Baroni BM. Do athletes with hamstring strain injury have shorter muscle fascicles in the injured limb? J Bodyw Mov Ther 2024; 38:269-273. [PMID: 38763569 DOI: 10.1016/j.jbmt.2024.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 12/01/2023] [Accepted: 01/25/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION Previous studies have suggested that a reduced length of the biceps femoris long head (BFlh) fascicles may increase the risk of hamstring strain injury (HSI). However, it remains unclear whether the BFlh fascicles of the injured limb are shorter than those of the contralateral limb in athletes with an acute HSI. OBJECTIVE To investigate the between-limb asymmetry of BFlh fascicle length in amateur athletes with an acute HSI. METHODS Male amateur athletes were evaluated using ultrasound scans within five days following an HSI. The BFlh fascicle length was estimated using a validated equation. RESULTS Eighteen injured athletes participated in this study. There was no significant difference (p = 0.27) in the length of BFlh fascicles between the injured limb (9.53 ± 2.55 cm; 95%CI 8.26 to 10.80 cm) and the uninjured limb (10.54 ± 2.87 cm; 95%CI 9.11 to 11.97 cm). Individual analysis revealed high heterogeneity, with between-limb asymmetries (percentage difference of the injured limb compared to the uninjured limb) ranging from -42% to 25%. Nine out of the 18 athletes had a fascicle length that was more than 10% shorter in the injured limb compared to the uninjured limb, five athletes had a difference of less than 10%, and four athletes had a fascicle length that was more than 10% longer in the injured limb compared to the uninjured limb. CONCLUSION The architecture characteristics of injured and uninjured muscles is not consistent among athletes with HSI. Therefore, rehabilitation programs focused on fascicle lengthening should be evaluated on a case-by-case basis.
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Affiliation(s)
| | | | - Mateus Aimi
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Lazarczuk SL, Collings TJ, Hams AH, Timmins RG, Opar DA, Edwards S, Shield AJ, Barrett RS, Bourne MN. Biceps femoris long head muscle and aponeurosis geometry in males with and without a history of hamstring strain injury. Scand J Med Sci Sports 2024; 34:e14619. [PMID: 38572910 DOI: 10.1111/sms.14619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/04/2024] [Accepted: 03/13/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Hamstring strain injuries (HSIs) commonly affect the proximal biceps femoris long head (BFlh) musculotendinous junction. Biomechanical modeling suggests narrow proximal BFlh aponeuroses and large muscle-to-aponeurosis width ratios increase localized tissue strains and presumably risk of HSI. This study aimed to determine if BFlh muscle and proximal aponeurosis geometry differed between limbs with and without a history of HSI. METHODS Twenty-six recreationally active males with (n = 13) and without (n = 13) a history of unilateral HSI in the last 24 months underwent magnetic resonance imaging of both thighs. BFlh muscle and proximal aponeurosis cross-sectional areas, length, volume, and interface area between muscle and aponeurosis were extracted. Previously injured limbs were compared to uninjured contralateral and control limbs for discrete variables and ratios, and along the relative length of tissues using statistical parametric mapping. RESULTS Previously injured limbs displayed significantly smaller muscle-to-aponeurosis volume ratios (p = 0.029, Wilcoxon effect size (ES) = 0.43) and larger proximal BFlh aponeurosis volumes (p = 0.019, ES = 0.46) than control limbs with no history of HSI. No significant differences were found between previously injured and uninjured contralateral limbs for any outcome measure (p = 0.216-1.000, ES = 0.01-0.36). CONCLUSIONS Aponeurosis geometry differed between limbs with and without a history of HSI. The significantly larger BFlh proximal aponeuroses and smaller muscle-to-aponeurosis volume ratios in previously injured limbs could alter the strain experienced in muscle adjacent to the musculotendinous junction during active lengthening. Future research is required to determine if geometric differences influence the risk of re-injury and whether they can be altered via targeted training.
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Affiliation(s)
- Stephanie L Lazarczuk
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Tyler J Collings
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Andrea H Hams
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Ryan G Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | - David A Opar
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Suzi Edwards
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- School of Environmental and Life Sciences, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Anthony J Shield
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Rod S Barrett
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Matthew N Bourne
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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Maroto-Izquierdo S, García-López D, Beato M, Bautista IJ, Hernández-Davó JL, Raya-González J, Martín-Rivera F. Force Production and Electromyographic Activity during Different Flywheel Deadlift Exercises. Sports (Basel) 2024; 12:95. [PMID: 38668563 PMCID: PMC11054580 DOI: 10.3390/sports12040095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/17/2024] [Accepted: 03/28/2024] [Indexed: 04/29/2024] Open
Abstract
This study aimed to characterize and compare force production and muscle activity during four flywheel deadlift exercises (bilateral [Bi] vs. unilateral [Uni]) with different loading conditions (vertical [Ver] vs. horizontal [Hor]). Twenty-three team-sport athletes underwent assessments for exercise kinetics (hand-grip force), along with surface electromyography (sEMG) of the proximal (BFProx) and medial biceps femoris (BFMed), semitendinosus (ST), and gluteus medius (GM). Mean and peak force were highest (p < 0.001) in Bi + Ver compared with Bi + Hor, Uni + Ver, and Uni + Hor. Although no significant differences were observed between Bi + Hor and Uni + Ver, both variants showed higher (p < 0.001) average force and peak eccentric force when compared with Uni + Hor. The presence of eccentric overload was only observed in the vertically loaded variants. Bi + Ver and Uni + Ver showed higher (p < 0.05) sEMG levels in BFProx and BFMed compared with the Uni + Hor variant. In addition, Uni + Ver registered the largest GM and ST sEMG values. In conclusion, the vertical variants of the flywheel deadlift exercise led to higher muscle force production and sEMG compared with their horizontal counterparts. Both Bi + Ver and Uni + Ver may be effective in promoting an increase in hamstring muscles activity and muscle force at long muscle length, while the Uni + Ver variant may be more effective in promoting GM and ST involvement.
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Affiliation(s)
- Sergio Maroto-Izquierdo
- i+HeALTH Strategic Research Group, Department of Health Sciences, European University Miguel de Cervantes, 47012 Valladolid, Spain
- Proporción A, Applied Sports Science Centre, 47015 Valladolid, Spain
| | - David García-López
- Department of Health Sciences, European University Miguel de Cervantes, 47012 Valladolid, Spain
| | - Marco Beato
- School of Health and Sports Sciences, University of Suffolk, Ipswich IP4 1QJ, UK
- Institute of Health and Wellbeing, University of Suffolk, Ipswich IP4 1QJ, UK
| | - Iker J. Bautista
- Institute of Sport and Allied Health, University of Chichester, Chichester PO19 6PE, UK
| | | | | | - Fernando Martín-Rivera
- Prevention and Health in Exercise and Sport, University of Valencia, 46010 Valencia, Spain
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Keerasomboon T, Soga T, Hirose N. The Effect of Variations in Knee and Hip Angles on Electromyographic Activity of the Hamstrings and Related Muscles During the Nordic Hamstring Exercise. Int J Sports Phys Ther 2024; 19:275-283. [PMID: 38439779 PMCID: PMC10909307 DOI: 10.26603/001c.92745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/06/2024] [Indexed: 03/06/2024] Open
Abstract
Background The benefit of performing the Nordic Hamstring Exercise (NHE) on an inclined board has been described, however, isometric hamstring activation in different knee and hip angles has not yet been thoroughly explored. Purpose This study investigated the effect of variations in knee and hip angles during the isometric performance of the NHE on electromyographic activity of the hamstring muscles. Study design Crossover study. Methods Thirteen male volunteers performed isometric contractions during the NHE with the knee (30°, 50°, 60°) and the hip (0°, 30°, and 45°) in various angles of flexion on a leg support platform which was inclined at 30°. An electrical goniometer was used to monitor the knee and hip joint angles during 5-s isometric contractions. A multivariate analysis of variance with repeated measures was used to compare normalized electromyographic values of each muscle across different knee and hip angles, followed by pairwise comparisons. Results The electromyographic activity of the biceps femoris, semitendinosus, and semimembranosus at a knee angle of 30° and hip angle of 0° were significantly higher than those observed with a knee angle of 50° and hip angle of 0°, or a knee angle of 60° and hip angle of 0° (p<0.05). The electromyographic activity of the semimembranosus at a knee angle of 60° and hip angle of 45° was significantly higher than values obtained with knee and hip angles of 60° and 0°, respectively (p<0.05). Conclusions The results indicate that using a knee flexion of 30° and a hip flexion of 0°, while isometrically performing the NHE on a platform inclined at 30°, may optimize electromyographic activity of the hamstrings. Level of Evidence 3.
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Affiliation(s)
| | - Toshiaki Soga
- Graduate School of Sport Sciences, Waseda University, Japan
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Japan
- Research Fellow of Japan Society for the Promotion of Science, Japan
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Jaenada-Carrilero E, Vicente-Mampel J, Baraja-Vegas L, Thorborg K, Valero-Merlos E, Blanco-Gímenez P, Gargallo P, Bautista IJ. Hip adduction and abduction strength profiles in elite and sub-elite female soccer players according to players level and leg limb-dominance. BMC Sports Sci Med Rehabil 2024; 16:53. [PMID: 38383450 PMCID: PMC10882891 DOI: 10.1186/s13102-024-00838-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 02/02/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Understanding the hip adduction and abduction strength in female soccer players is crucial for performance enhancement and injury prevention. This study compares the strength profiles in these muscle groups between elite and sub-elite female soccer players and assesses the impact of leg limb-dominance. METHODS A descriptive-comparative study was employed. Eighty-two female soccer players were evaluated. Isometric hip-adduction and abduction strength were measured using a handheld dynamometer. RESULTS Female elite and sub-elite soccer players displayed a mean and standard deviation (SD) on isometric hip-adductor strength for dominant (3.19 Nm/kg ± 0.69 vs. 2.40 Nm/kg ± 0.67) and non-dominant leg (3.32 Nm/kg ± 0.76 versus 2.42 Nm/kg ± 0.70), respectively. For isometric hip-abductor strength in elite and sub-elite players, a mean and SD of dominant (2.86 Nm/kg ± 0.56 vs. 2.07 Nm/kg ± 0.50) and non-dominant (2.80 Nm/kg ± 0.59 vs. 2.04 Nm/kg ± 0.43). In essence, elite players were stronger than sub-elite players on isometric hip-adduction (mean difference [MD] = 0.82 Nm/kg, CI95% = 0.42-1.12) and abduction (MD = 0.83 Nm/kg, CI95% = 0.54- 1.12) both in dominant and non-dominant, leg, whereas no differences existed for hip adduction:abduction ratios between groups and legs. CONCLUSIONS Elite female athletes exhibited greater strength than sub-elite female players in both hip adduction and abduction, whereas adduction:abduction ratio values did not differ between the two groups or between different legs.
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Affiliation(s)
| | - Juan Vicente-Mampel
- Faculty of Science Health, Catholic University of Valencia, Physiotherapy Department., C/ Ramiro de Maetzu 14, Torrent Valencia, Spain.
| | - Luis Baraja-Vegas
- Faculty of Science Health, Catholic University of Valencia, Physiotherapy Department., C/ Ramiro de Maetzu 14, Torrent Valencia, Spain
| | - Kristian Thorborg
- Department of Sports, Department of Orthopedic Surgery, Orthopedic Research Center-Copenhagen (SORC-C), Amager-Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Eloína Valero-Merlos
- Faculty of Nursing. Campus Jerónimos, Catholic University of Murcia, Murcia, Spain
| | - Paula Blanco-Gímenez
- Faculty of Science Health, Catholic University of Valencia, Physiotherapy Department., C/ Ramiro de Maetzu 14, Torrent Valencia, Spain
| | - Pedro Gargallo
- Faculty of Science Health, Catholic University of Valencia, Physiotherapy Department., C/ Ramiro de Maetzu 14, Torrent Valencia, Spain
| | - Iker J Bautista
- Faculty of Science Health, Catholic University of Valencia, Physiotherapy Department., C/ Ramiro de Maetzu 14, Torrent Valencia, Spain
- Institute of Sport, Nursing and Allied Health, University of Chichester, Chichester, UK
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Edouard P, Lahti J, Fleres L, Ahtiainen J, Ulvila JJ, Lehtinen T, Virtanen N, Taipale T, Bellver M, Peltonen V, Thibault M, Huuhka T, Toivonen RM, Morin JB, Mendiguchia J. A musculoskeletal multifactorial individualised programme for hamstring muscle injury risk reduction in professional football: results of a prospective cohort study. BMJ Open Sport Exerc Med 2024; 10:e001866. [PMID: 38347859 PMCID: PMC10860081 DOI: 10.1136/bmjsem-2023-001866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 02/15/2024] Open
Abstract
Objective To test whether a musculoskeletal multifactorial and individualised hamstring muscle injury (HMI) risk reduction programme could reduce HMI risk in professional football. Methods We conducted a prospective cohort study in Finnish premier football league teams, with the 2019 season used as a control and an intervention conducted in the 2021 season. Screening was conducted to provide individualised programmes and monitor progress. Cox regression with hazard ratio (HR) was used with HMI as outcome and season as explanatory variable, including all players for primary analysis and those who performed the two seasons for secondary analysis. Results 90 players were included in the control and 87 in the intervention seasons; 31 players performed in the 2 seasons. Twenty HMIs were recorded during the control and 16 during the intervention seasons. Cox regression analyses revealed that HMI risk at any given time was not significantly different between control and intervention seasons (for all players: HR 0.77 (95% CI 0.39 to 1.51), p=0.444; for the 31 players: HR 0.32 (95% CI 0.01 to 1.29), p=0.110)). For the 31 players, the HMI burden was significantly reduced in the intervention compared with the control season (RR 0.67 (95% CI 0.53 to 0.85)). Higher compliance with knee strength training, maximal velocity exposure and lower performance reductions in maximal theoretical horizontal force and knee flexor force were associated with lower HMI incidence. Conclusions Although the primary analysis did not reveal any significant effect of the intervention to reduce HMI risk in professional football, the programme was feasible, and additional secondary analyses showed a significant association between the intervention and lower HMI burden, incidence and risk.
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Affiliation(s)
- Pascal Edouard
- Inter‐university Laboratory of Human Movement Science (LIBM EA 7424), Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Saint Etienne, France
- Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France
| | - Johan Lahti
- Department of Strength & Conditioning R5 Athletics & Health Performance center, Helsinki, Finland
| | - Luca Fleres
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, Jyvaskyla, Finland
| | - Juha Ahtiainen
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, Jyvaskyla, Finland
| | | | | | | | | | | | | | | | | | | | - Jean-Benoit Morin
- Inter‐university Laboratory of Human Movement Science (LIBM EA 7424), Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Saint Etienne, France
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Jurdan Mendiguchia
- Department of Physical Therapy, ZENTRUM Rehab and Performance Center, Barañain, Spain
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Behan FP, van Dyk N, Rane L, Thorne E, Banaghan A, Gilsenan K, Whyte EF. Implementing hamstring injury prevention programmes remotely: a randomised proof of concept trial. BMJ Open Sport Exerc Med 2024; 10:e001728. [PMID: 38288272 PMCID: PMC10824055 DOI: 10.1136/bmjsem-2023-001728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2024] [Indexed: 01/31/2024] Open
Abstract
Objectives This study aimed to (1) compare the effectiveness of a Nordic hamstring exercise (NHE) versus single-leg Romanian deadlift (SLRDL) exercise programme on a hamstring injury risk surrogate; (2) compare the muscle soreness experienced by both exercise programmes; and (3) assess compliance to remote injury prevention exercise protocols through video software. Methods Twenty participants (10 women and 10 men: 21.45±1.6 years; 176±23 cm; 70±10 kg) were randomised into an NHE or SLRDL programme for 6 weeks. Single-leg hamstring bridge (SLHB), a hamstring injury surrogate, was the primary outcome for exercise efficacy. Muscle soreness and exercise adherence were also assessed. Significance was set at p<0.05. Results Both exercises increased SLHB performance resulting in an overall effect (p=0.013) with no effect for group (p=0.470) and no interaction effect (p=0.709), indicating both groups improved but there was no difference in improvement between interventions. There was no difference in muscle soreness between groups (p=0.087). Finally, both groups had 100% adherence to the programme. Conclusions Both the NHE and SLRDL are equally effective in increasing SLHB performance and demonstrate a similar level of muscle soreness. This suggests that SLRDL may be a viable option as a preventative exercise to mitigate the risk of hamstring injury. Finally, implementing injury prevention programmes remotely has the potential to enhance adherence.
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Affiliation(s)
- Fearghal P Behan
- Department of Bioengineering, Imperial College London, London, UK
- Discipline of Physiotherapy, Trinity College Dublin, Dublin, Ireland
| | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland
- Faculty of Health Science, University of Pretoria, Section Sports Medicine, Pretoria, Gauteng, South Africa
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Lance Rane
- Department of Bioengineering, Imperial College London, London, UK
| | - Emma Thorne
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Alexa Banaghan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Kevin Gilsenan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Enda Francis Whyte
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
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de Keijzer KL, McErlain-Naylor SA, Beato M. Six Weeks of Unilateral Flywheel Hip-Extension and Leg-Curl Training Improves Flywheel Eccentric Peak Power but Does Not Enhance Hamstring Isokinetic or Isometric Strength. Int J Sports Physiol Perform 2024; 19:34-43. [PMID: 37917962 DOI: 10.1123/ijspp.2023-0035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 08/12/2023] [Accepted: 09/12/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE This preregistered trial investigated how 6 weeks of unilateral flywheel leg-curl and hip-extension training impact isokinetic, isometric, and flywheel strength and power outcomes. METHODS The study involved 11 male university athletes (age 22 [2] y; body mass 77.2 [11.3] kg; height 1.74 [0.09] m) with one leg randomly allocated to flywheel training and one leg to control. Unilateral eccentric and isometric knee-flexion torque and flywheel unilateral leg-curl and hip-extension peak power were tested. Training intensity and volume (3-4 sets of 6 + 2 repetitions) were progressively increased. RESULTS The intervention enhanced hip-extension concentric (P < .01, d = 1.76, large) and eccentric (P < .01, d = 1.33, large) peak power more than the control (significant interaction effect). Similarly, eccentric (P = .023, d = 1.05, moderate) peak power was enhanced for the leg curl. No statistically significant differences between conditions were found for isokinetic eccentric (P = .086, d = 0.77, moderate) and isometric (P = .431, d = 0.36, small) knee-flexor strength or leg-curl concentric peak power (P = .339, d = 0.52, small). Statistical parametric mapping analysis of torque-angle curves also revealed no significant (P > .05) time-limb interaction effect at any joint angle. CONCLUSION Unilateral flywheel hamstring training improved knee-flexor eccentric peak power during unilateral flywheel exercise but not flywheel concentric, isokinetic eccentric, or isometric (long-lever) knee-flexor strength.
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Affiliation(s)
- Kevin L de Keijzer
- School of Health and Sports Sciences, University of Suffolk, Ipswich, United Kingdom
- Institute of Health and Wellbeing, University of Suffolk, Ipswich, United Kingdom
| | - Stuart A McErlain-Naylor
- School of Health and Sports Sciences, University of Suffolk, Ipswich, United Kingdom
- Institute of Health and Wellbeing, University of Suffolk, Ipswich, United Kingdom
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Marco Beato
- School of Health and Sports Sciences, University of Suffolk, Ipswich, United Kingdom
- Institute of Health and Wellbeing, University of Suffolk, Ipswich, United Kingdom
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11
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Scaturro D, de Sire A, Vitagliani F, Lo Nardo D, Tomasello S, Ammendolia A, Letizia Mauro G. Effectiveness of cryo plus ultrasound therapy versus diathermy in combination with high-intensity laser therapy for pain relief in footballers with muscle injuries: A prospective study. J Back Musculoskelet Rehabil 2024; 37:771-780. [PMID: 38160343 DOI: 10.3233/bmr-230265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Muscle injuries are common traumatic events in the clinical practice of the rehabilitation field. There is still a gap in the scientific literature on the effectiveness of physical agent modalities in the management of muscle injuries in athletes. OBJECTIVE The aim of this study was to assess the effectiveness of cryo plus ultrasound therapy com-pared to diathermy in combination with high-intensity laser therapy (HILT) for pain relief in professional footballers with muscle injuries. METHODS A case-control study was conducted on 31 professional footballers with a muscle injury of the lower limbs. Of these, 17 patients, assigned to a Group A (AG), were treated with HILT and cryoultrasound therapy; the remaining 14 patients, assigned to a Group B (BG), underwent HILT and diathermy. We assessed the extent of the pain, the size of the muscle injury, frequency of recurrence and number of days to recovery, at the time of recruitment, at the end of the rehabilitation and 3 months after the injury. RESULTS Group A athletes had a greater benefit on pain (4.65 ± 0.61 vs 3.24 ± 0.63; p< 0.05) and muscle injury recurrence. The return to play in the athletes of group A took place 4.73 days earlier. CONCLUSION HILT and cryo plus ultrasound therapy, in combination with therapeutic exercise, rep-resent a valid strategy in the treatment of muscle injuries in professional footballers.
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Affiliation(s)
- Dalila Scaturro
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Fabio Vitagliani
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Davide Lo Nardo
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Sofia Tomasello
- Faculty of Medicine and Surgery, University of Palermo, Palermo, Italy
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Giulia Letizia Mauro
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy
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12
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Brown R, Greig M. The influence of isokinetic dynamometer configuration on eccentric hamstring strength metrics: implications for testing and training. Res Sports Med 2024; 32:98-106. [PMID: 35638722 DOI: 10.1080/15438627.2022.2079988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
Isokinetic dynamometry is the clinical gold standard for strength assessment but testing protocols and outcome metrics can lack functional relevance. To quantify the influence of dynamometer configuration on eccentric hamstring strength metrics, 23 trained participants completed isokinetic eccentric knee flexor trials at 180°·s-1 in a seated and extended hip position. The extended position elicited a greater peak torque (P = 0.04) which was achieved at a significantly (P < 0.001) greater degree of knee flexion. Isokinetic range and functional range (defined as 85% of peak torque) were consistent at ~44° and ~21°, respectively, across trials, but were achieved with a more flexed knee in the extended hip configuration. Therefore, whilst the extended hip configuration might better reflect the biarticular nature of the hamstring musculature and the mechanism of hamstring strain injury, the sensitivity of strength metrics to configuration has implications for clinical assessment and training adaptations.
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Affiliation(s)
- Rebecca Brown
- Sports Injuries Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk UK
| | - Matt Greig
- Sports Injuries Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk UK
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13
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Murakami Y, Nishida S, Yoshida R, Kasahara K, Kumazaki A, Sakuma H, Fujimoto H, Kaneko Y, Abe O, Nakamura M. Relationship Between Nordic Hamstring Strength and Single Leg Bridge Test in University Soccer Players. J Sport Rehabil 2024; 33:27-32. [PMID: 37917973 DOI: 10.1123/jsr.2022-0451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 08/20/2023] [Accepted: 08/20/2023] [Indexed: 11/04/2023]
Abstract
CONTEXT Nordic hamstring strength (NH strength) and single leg bridge test (SLBT) scores are used to predict the risk of hamstring strain injury. Although NH strength and SLBT scores may be related, the relationship between NH strength and SLBT score remains unknown. OBJECTIVES This study investigated the relationship between NH strength and SLBT scores in university soccer players. DESIGN Cross-sectional study. SETTING Research laboratory. PARTICIPANTS 38 male university soccer players. MAIN OUTCOME MEASURES NH strength and SLBT scores. INTERVENTIONS A participant was instructed to lean forward gradually at the slowest possible speed from a kneeling posture with the knee joint flexed 90° for the NH strength measurement. Participants in the SLBT crossed their arms over their chests, pushed down from their heels, and lifted their hips off the ground as many times as they could until they failed. We investigated the relationship between NH strength and SLBT scores in the left and right sides using Spearman rank correlation coefficient. Additionally, we calculated the percentage of left-right asymmetry in NH strength and SLBT scores and investigated the relationship between these variables using Pearson correlation coefficient. RESULTS There were no significant correlations between NH strength and SLBT scores in the right (rs = .239, P = .16) and left (rs = .311, P = .065) legs. Furthermore, there was no significant relationship between NH strength and SLBT between-limb asymmetry (r = .073, P = .671). CONCLUSIONS NH strength and SLBT scores could be different indexes, indicating either maximal muscle strength or muscle endurance. Thus, the findings suggested that when assessing risk factors for hamstring strain injury, both NH strength and SLBT scores should be measured.
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Affiliation(s)
- Yuta Murakami
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Satoru Nishida
- Faculty of Sports and Health Science, Ryutsu Keizai University, Ryugasaki, Ibaraki, Japan
| | - Riku Yoshida
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Kazuki Kasahara
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Akira Kumazaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Faculty of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Hirokazu Sakuma
- Faculty of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Hirosi Fujimoto
- Faculty of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Yuki Kaneko
- Faculty of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Otoka Abe
- Faculty of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Masatoshi Nakamura
- Faculty of Rehabilitation Sciences, Nishikyushu University, Kanzaki, Saga, Japan
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14
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Siddle J, Weaver K, Greig M, Harper D, Brogden CM. A low-volume Nordic hamstring curl programme improves change of direction ability, despite no architectural, strength or speed adaptations in elite youth soccer players. Res Sports Med 2024; 32:49-60. [PMID: 35642790 DOI: 10.1080/15438627.2022.2079984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/26/2022] [Indexed: 10/18/2022]
Abstract
Nordic hamstring curls (NHC) are a commonly used injury intervention method in amateur team sports. Seventeen elite male academy soccer players performed an 8-week low volume NHC programme. Pre-post intervention measures of isokinetic eccentric knee flexor (KF) strength, linear speed, COD performance, hamstring muscle thickness, pennation angle and fascicle length were recorded. No significant main effects were observed for measures of isokinetic KF strength (P ≥ 0.19), linear sprint speed (P ≥ 0.47) or hamstring muscle architecture (P ≥ 0.30). However, significance was noted for improved COD performance (P < 0.01; mean difference, -0.06, p = 0.001, 95% CI = 0.03 to 0.09; d = 0.80), exceeding the minimal detectable difference (MDD = 0.05 s). A low-volume NHC intervention may contribute to significant improvements in COD ability, independent of no significant changes in eccentric KF strength, linear sprint speed or muscle architectural properties in elite youth soccer players.
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Affiliation(s)
- James Siddle
- Sports Injuries Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk, UK
| | - Kristian Weaver
- Sports Injuries Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk, UK
| | - Matt Greig
- Sports Injuries Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk, UK
| | - Damian Harper
- Institute of Coaching and Performance, University of Central Lancashire, Preston, UK
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15
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McNally T, Edwards S, Halaki M, O'Dwyer N, Pizzari T, Blyton S. Quantifying demands on the hamstrings during high-speed running: A systematic review and meta-analysis. Scand J Med Sci Sports 2023; 33:2423-2443. [PMID: 37668346 DOI: 10.1111/sms.14478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/24/2023] [Accepted: 08/16/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTION Hamstring strain injury (HSI) remains a performance, economic, and player availability burden in sport. High-speed running (HSR) is cited as a common mechanism for HSI. While evidence exists regarding the high physical demands on the hamstring muscles in HSR, meta-analytical synthesis of related activation and kinetic variables is lacking. METHODS A systematic search of Medline, Embase, Scopus, CINAHL, SportDiscus, and Cochrane library databases was conducted in accordance with the PRISMA 2020 guidelines. Studies reporting hamstring activation (electromyographic [EMG]) or hamstring muscle/related joint kinetics were included where healthy adult participants ran at or beyond 60% of maximum speed (activation studies) or 4 m per second (m/s) (kinetic studies). RESULTS A total of 96 studies met the inclusion criteria. Run intensities were categorized as "slow," "moderate," or "fast" in both activation and kinetic based studies with appropriate relative, and raw measures, respectively. Meta-analysis revealed pooled mean lateral hamstring muscle activation levels of 108.1% (95% CI: 84.4%-131.7%) of maximal voluntary isometric contraction (MVIC) during "fast" running. Meta-analysis found swing phase peak knee flexion internal moment and power at 2.2 Newton meters/kilogram (Nm/kg) (95% CI: 1.9-2.5) and 40.3 Watts/kilogram (W/kg) (95% CI: 31.4-49.2), respectively. Hip extension peak moment and power was estimated as 4.8 Nm/kg (95% CI: 3.9-5.7) and 33.1 W/kg (95% CI: 17.4-48.9), respectively. CONCLUSIONS As run intensity/speed increases, so do the activation and kinetic demands on the hamstrings. The presented data will enable clinicians to incorporate more objective measures into the design of injury prevention and return-to-play decision-making strategies.
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Affiliation(s)
- Timothy McNally
- Faculty of Medicine & Health, Sydney School of Health Sciences, Discipline of Exercise & Sport Science, Sydney, New South Wales, Australia
| | - Suzi Edwards
- Faculty of Medicine & Health, Sydney School of Health Sciences, Discipline of Exercise & Sport Science, Sydney, New South Wales, Australia
| | - Mark Halaki
- Faculty of Medicine & Health, Sydney School of Health Sciences, Discipline of Exercise & Sport Science, Sydney, New South Wales, Australia
| | - Nicholas O'Dwyer
- Faculty of Medicine & Health, Sydney School of Health Sciences, Discipline of Exercise & Sport Science, Sydney, New South Wales, Australia
| | - Tania Pizzari
- School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Sarah Blyton
- School of Health Sciences (Physiotherapy), University of Newcastle, Newcastle, New South Wales, Australia
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16
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Lunn DE, Nicholson G, Cooke M, Crespo R, Robinson T, Price RJ, Walker J. Discrete Hamstring: Quadriceps Strength Ratios Do Not Represent Angle-Specific Ratios in Premier League Soccer Players. J Strength Cond Res 2023; 37:2417-2422. [PMID: 37815243 DOI: 10.1519/jsc.0000000000004574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
ABSTRACT Lunn, DE, Nicholson, G, Cooke, M, Crespo, R, Robinson, T, Price, RJ, and Walker, J. Discrete hamstring: quadriceps strength ratios do not represent angle-specific ratios in Premier League soccer players. J Strength Cond Res 37(12): 2417-2422, 2023-This study compared angle-specific hamstring:quadriceps (H:Q) ratios with their discrete counterparts during strength testing in professional male soccer players. Twenty-seven professional English Premier League soccer players were recruited for this study (age: 22 ± 4 years; stature: 1.81 ± 0.08 m; body mass: 74.7 ± 6.5 kg). Isokinetic testing of the knee flexors and extensors was conducted concentrically at two angular velocities (60° and 240°·s -1 ) and eccentrically (for the knee flexors only) at 30°·s -1 . Conventional H:Q ratio was calculated as the ratio between peak joint moment in the flexors and extensors at 60°·s -1 . Functional H:Q ratio was calculated as the peak joint moment in the flexors during the eccentric condition and the extensors at 240°·s -1 . Discrete conventional and functional H:Q ratios were 0.56 ± 0.06 and 1.28 ± 0.22, respectively. The residual differences between discrete values and angle-specific residual values were 13.60 ± 6.56% when normalized to the magnitude of the discrete value. For the functional ratios, the normalized residual was 21.72 ± 5.61%. Therefore, neither discrete ratio was representative of angle-specific ratios, although the conventional ratio had lower error overall. Therefore, practitioners should consider H:Q ratio throughout the full isokinetic range of motion, not just the discrete ratio calculated from peak joint moments, when designing and implementing training programs or monitoring injury risk, recovery from injury, and readiness to return to play.
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Affiliation(s)
- David E Lunn
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom; and
| | - Gareth Nicholson
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom; and
| | - Mark Cooke
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom; and
| | - Rubén Crespo
- Leeds United Football Club, Leeds, United Kingdom
| | - Tom Robinson
- Leeds United Football Club, Leeds, United Kingdom
| | - Rob J Price
- Leeds United Football Club, Leeds, United Kingdom
| | - Josh Walker
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom; and
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17
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Amundsen R, Møller M, Bahr R. Performing Nordic hamstring strength testing with additional weight affects the maximal eccentric force measured: do not compare apples to oranges. BMJ Open Sport Exerc Med 2023; 9:e001699. [PMID: 37953969 PMCID: PMC10632891 DOI: 10.1136/bmjsem-2023-001699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 11/14/2023] Open
Abstract
Background Nordic hamstring test devices are commonly used to measure maximal eccentric hamstring force. The ability to control the final phase of the exercise has been adopted as a criterion to add weight when testing, without substantial evidence. We investigated if adding weight affected the maximal force measured, and if there were differences between players who could and could not control the final phase. Methods Female (n=84) and male (n=56) football players performed a Nordic hamstring strength test with 0, 5 and 10 kg. We used visual inspection to assess the ability to control the final phase (approximately last 20°), as per previously published studies. Results Maximal force was higher when tested with 5 kg (females: +8 N (2%), p<0.001; males: +18 N (4%), p<0.001) and 10 kg (females: +17 N (5%), p<0.001; males: +27 N (6%), p<0.001) compared with 0 kg. This was the case for both groups, those who could control the final phase (5 kg: +16 N (4%), p<0.001; 10 kg: +28 N (7%), p<0.001) and those who could not (5 kg: +9 N (3%), p<0.001; 10 kg: +15 N (4%), p<0.001). Conclusion Both players who could and could not control the final phase of the Nordic hamstring test demonstrated higher maximal force when adding weight to testing. Therefore, this should not be used to decide if players should perform testing with or without weight. Either all participants or none should be tested with weight, and the same approach should be used both for pre-testing and post-testing.
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Affiliation(s)
- Roar Amundsen
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Merete Møller
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
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18
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Crawford SK, Hickey J, Vlisides J, Chambers JS, Mosiman SJ, Heiderscheit BC. The effects of hip- vs. knee-dominant hamstring exercise on biceps femoris morphology, strength, and sprint performance: a randomized intervention trial protocol. BMC Sports Sci Med Rehabil 2023; 15:72. [PMID: 37365624 DOI: 10.1186/s13102-023-00680-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND The hamstrings are an important muscle group that contribute to horizontal force during sprint acceleration and are also the most injured muscle group in running-based sports. Given the significant time loss associated with hamstrings injury and impaired sprinting performance following return to sport, identifying exercises that drive adaptations that are both protective of strain injury and beneficial to sprint performance is important for the strength and conditioning professional. This paper describes the study protocol investigating the effects of a 6-week training program using either the hip-dominant Romanian deadlift (RDL) or the knee-dominant Nordic hamstring exercise (NHE) on hamstring strain injury risk factors and sprint performance. METHODS A permuted block randomized (1:1 allocation) intervention trial will be conducted involving young, physically-active men and women. A target sample size of 32 will be recruited and enrolled participants will undergo baseline testing involving extended-field-of-view ultrasound imaging and shear wave elastography of the biceps femoris long head muscle, maximal hamstrings strength testing in both the RDL and NHE, and on-field sprint performance and biomechanics. Participants will complete the 6-week training intervention using either the RDL or NHE, according to group allocation. Baseline testing will be repeated at the end of the 6-week intervention followed by 2 weeks of detraining and a final testing session. The primary outcome will be regional changes in fascicle length with secondary outcomes including pennation angle, muscle cross sectional area, hamstring strength, and maximal sprint performance and biomechanics. An exploratory aim will determine changes in shear wave velocity. DISCUSSION Despite extensive research showing the benefits of the NHE on reducing hamstring strain injury risk, alternative exercises, such as the RDL, may offer similar or potentially even greater benefits. The findings of this study will aim to inform future researchers and practitioners investigating alternatives to the NHE, such as the RDL, in terms of their effectiveness in reducing rates of hamstring strain injury in larger scale prospective intervention studies. TRIAL REGISTRATION The trial is prospectively registered on ClinicalTrials.gov (NCT05455346; July 15, 2022).
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Affiliation(s)
- Scott K Crawford
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA.
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA.
- Department of Kinesiology, Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, 1300 University Ave, Madison, WI, 53706, USA.
| | - Jack Hickey
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia
- Sports Performance, Recovery, Injury and New Technologies Research Centre, Australian Catholic University, Fitzroy, VIC, Australia
- Department of Sport Science and Nutrition, Maynooth University, County Kildare, Ireland
| | - Jessica Vlisides
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Jennifer S Chambers
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Samuel J Mosiman
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA
| | - Bryan C Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA
- Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI, USA
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19
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Bright TE, Handford MJ, Mundy P, Lake J, Theis N, Hughes JD. Building for the Future: A Systematic Review of the Effects of Eccentric Resistance Training on Measures of Physical Performance in Youth Athletes. Sports Med 2023; 53:1219-1254. [PMID: 37097414 PMCID: PMC10185653 DOI: 10.1007/s40279-023-01843-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Eccentric resistance training is recognised as an effective stimulus for enhancing measures of muscular strength and power in adult populations; however, its value in youth athletes is currently not well understood. OBJECTIVE The aim of this systematic review was to critically appraise the effects of eccentric resistance training on measures of physical performance (i.e. muscular strength, jump, sprint and change of direction) in youth athletes 18 years of age and under. METHODS Original journal articles published between 1950 and June 2022 were retrieved from electronic search engines of PubMed, SPORTDiscus and Google Scholar's advanced search option. Full journal articles investigating the acute and chronic effects of eccentric resistance training on measures of physical performance in youth athletes (i.e. a person 18 years of age or under who competes in sport) were included. The methodological quality and bias of each study were assessed prior to data extraction using a modified Downs and Black checklist. RESULTS The search yielded 749 studies, of which 436 were duplicates. Three-hundred studies were excluded based upon title and abstract review and a further 5 studies were removed following the modified Downs and Black checklist. An additional 14 studies were identified during backward screening. Accordingly, 22 studies were included in our systematic review. The Nordic hamstring exercise and flywheel inertial training were the most frequently used eccentric resistance training methods in youth athletes. Improvements in physical performance following the Nordic hamstring exercise are dependent upon an increase in the breakpoint angle, rather than training volume (sets and repetitions), and are further elevated with the addition of hip extension exercises or high-speed running. A minimum of 3 familiarisation trials is necessary to elicit meaningful adaptations following flywheel inertial training. Furthermore, an emphasis should be placed upon decelerating the rotating flywheel during the final one to two thirds of the eccentric phase, rather than gradually throughout the entire eccentric phase. CONCLUSIONS The findings of this systematic review support the inclusion of eccentric resistance training in youth athletes to improve measures of muscular strength, jump, sprint and change of direction performance. The current eccentric resistance training methods are predominantly limited to the Nordic hamstring exercise and flywheel inertial training; however, the efficacy of accentuated eccentric loading to improve jump performance warrants attention in future investigations.
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Affiliation(s)
- Thomas E. Bright
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
- School of Sport, Health and Wellbeing, Plymouth Marjon University, Derriford Rd, Plymouth, PL6 8BH UK
| | - Matthew J. Handford
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | | | - Jason Lake
- Department of Sport and Exercise Sciences, Chichester University, Chichester, UK
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA Australia
| | - Nicola Theis
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | - Jonathan D. Hughes
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
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20
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Brown M, Buchheit M, Lacome M, Hader K, Guilhem G. Correlations Between Hamstring Muscle Architecture, Maturation, and Anthropometric Measures in Academy Soccer Players. Int J Sports Physiol Perform 2023; 18:615-624. [PMID: 37059426 DOI: 10.1123/ijspp.2022-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 04/16/2023]
Abstract
PURPOSE Muscle architecture is associated with motor performance and muscle injury. While muscle architecture and knee-flexor eccentric strength change with growth, the influence of anthropometric measures on these properties is rarely considered. This study aimed to investigate the relationship between hamstring muscle architecture and knee-flexor eccentric strength with anthropometric measurements. METHODS Sixty male footballers (16.6 [1.05] y) from the U16, U17, and U19 teams of an elite soccer club were included in this study. Fascicle length, pennation angle, and muscle thickness of the biceps femoris long head (BFlh) and semimembranosus muscles were measured in both legs using ultrasound. Knee-flexor eccentric strength, height, body mass, leg length, femur length, and peak height velocity (PHV) were measured within 1 week of the ultrasound images. A stepwise regression and 1-way analysis of variance tests were used to evaluate the effects of age, maturity, and anthropometric measurements on muscle properties. RESULTS Variance within BFlh and semimembranosus muscle thickness (r < .61), semimembranosus pennation angle (r < .58), and knee-flexor eccentric strength (r = .50) were highly related to body mass. We observed no significant correlations between muscle architecture and age (P > .29). However, moderately greater BFlh muscle thickness was shown for the post-PHV compared with the PHV group (effect size ± 90% CI: 0.72 ± 0.49). CONCLUSIONS In conclusion, weak correlations between muscle architecture and anthropometric measurements suggest that other factors (ie, genetics, training regimen) influence muscle architecture. The moderate effect of maturity on BFlh muscle thickness strongly suggests post-PHV hypertrophy of the BFlh muscle. Our results confirmed previous findings that eccentric knee-flexor strength is influenced by body mass.
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Affiliation(s)
- Matthew Brown
- Performance Department, Paris Saint Germain Football Club, Saint Germain-en-Laye,France
- Laboratory of Sport, Expertise and Performance, French Institute of Sport (INSEP), Paris,France
- Playermaker, London,United Kingdom
| | - Martin Buchheit
- Laboratory of Sport, Expertise and Performance, French Institute of Sport (INSEP), Paris,France
- Kitman Labs, Performance Research Intelligence Initiative, Dublin,Ireland
| | - Mathieu Lacome
- Laboratory of Sport, Expertise and Performance, French Institute of Sport (INSEP), Paris,France
- Performance and Analytics Department, Parma Calcio 1913, Parma,Italy
| | - Karim Hader
- Kitman Labs, Performance Research Intelligence Initiative, Dublin,Ireland
| | - Gaël Guilhem
- Laboratory of Sport, Expertise and Performance, French Institute of Sport (INSEP), Paris,France
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21
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Suskens JJM, Secondulfo L, Kiliç Ö, Hooijmans MT, Reurink G, Froeling M, Nederveen AJ, Strijkers GJ, Tol JL. Effect of two eccentric hamstring exercises on muscle architectural characteristics assessed with diffusion tensor MRI. Scand J Med Sci Sports 2023; 33:393-406. [PMID: 36514886 DOI: 10.1111/sms.14283] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 11/08/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To evaluate the effect of a Nordic hamstring exercise or Diver hamstring exercise intervention on biceps femoris long head, semitendinosus and semimembranosus muscle's fascicle length and orientation through diffusion tensor imaging (DTI) with magnetic resonance imaging. METHODS In this three-arm, single-center, randomized controlled trial, injury-free male basketball players were randomly assigned to a Nordic, Diver hamstring exercise intervention or control group. The primary outcome was the DTI-derived fascicle length and orientation of muscles over 12 weeks. RESULTS Fifty-three participants were included for analysis (mean age 22 ± 7 years). Fascicle length in the semitendinosus over 12 weeks significantly increased in the Nordic-group (mean [M]: 20.8 mm, 95% confidence interval [95% CI]: 7.8 to 33.8) compared with the Control-group (M: 0.9 mm, 95% CI: -7.1 to 8.9), mean between-groups difference: 19.9 mm, 95% CI: 1.9 to 37.9, p = 0.026. Fascicle orientation in the biceps femoris long head over 12 weeks significantly decreased in the Diver-group (mean: -2.6°, 95% CI: -4.1 to -1.0) compared with the Control-group (mean: -0.2°, 95% CI: -1.4 to 1.0), mean between-groups difference: -2.4°, 95% CI: -4.7 to -0.1, p = 0.039. CONCLUSION The Nordic hamstring exercise intervention did significantly increase the fascicle length of the semitendinosus and the Diver hamstring exercise intervention did significantly change the orientation of fascicles of the biceps femoris long head. As both exercises are complementary to each other, the combination is relevant for preventing hamstring injuries.
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Affiliation(s)
- Jozef J M Suskens
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, Netherlands
| | - Laura Secondulfo
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,Department of Biomedical Engineering & Physics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Özgür Kiliç
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, Netherlands
| | - Melissa T Hooijmans
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Gustaaf Reurink
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, Netherlands
| | - Martijn Froeling
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Aart J Nederveen
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Gustav J Strijkers
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,Department of Biomedical Engineering & Physics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes L Tol
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, Netherlands.,Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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22
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Behan FP, Opar DA, Vermeulen R, Timmins RG, Whiteley R. The dose-response of pain throughout a Nordic hamstring exercise intervention. Scand J Med Sci Sports 2023; 33:542-546. [PMID: 36651719 DOI: 10.1111/sms.14317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 12/21/2022] [Accepted: 01/11/2023] [Indexed: 01/19/2023]
Abstract
The Nordic hamstring exercise (NHE) reduces hamstring injury incidence. Compliance to large exercise volumes of the NHE is poor, with exercise related soreness often seen as a contributing factor. We investigated the dose-response of NHE exposure with delayed onset muscle soreness (DOMS) and non-DOMS pain. Forty males were randomized to a 6-week intervention of four different NHE dosages: Group 1: very low volume; Group 2: low volume; Group 3: initial high to low volume; Group 4: low to high volume. Group 4 experienced more DOMS (p < 0.05) and non-DOMS pain (p = 0.030) than other groups. High volumes of NHE increase DOMS and non-DOMS pain while lower volume protocols have lesser DOMS and non-DOMS pain responses.
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Affiliation(s)
- Fearghal P Behan
- Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar.,Musculoskeletal Mechanics Group, Imperial College London, London, UK
| | - David A Opar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | - Robin Vermeulen
- Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar.,Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands
| | - Ryan G Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | - Rodney Whiteley
- Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
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23
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Paton BM, Read P, van Dyk N, Wilson MG, Pollock N, Court N, Giakoumis M, Head P, Kayani B, Kelly S, Kerkhoffs GMMJ, Moore J, Moriarty P, Murphy S, Plastow R, Stirling B, Tulloch L, Wood D, Haddad F. London International Consensus and Delphi study on hamstring injuries part 3: rehabilitation, running and return to sport. Br J Sports Med 2023; 57:278-291. [PMID: 36650032 DOI: 10.1136/bjsports-2021-105384] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/19/2023]
Abstract
Hamstring injuries (HSIs) are the most common athletic injury in running and pivoting sports, but despite large amounts of research, injury rates have not declined in the last 2 decades. HSI often recur and many areas are lacking evidence and guidance for optimal rehabilitation. This study aimed to develop an international expert consensus for the management of HSI. A modified Delphi methodology and consensus process was used with an international expert panel, involving two rounds of online questionnaires and an intermediate round involving a consensus meeting. The initial information gathering round questionnaire was sent to 46 international experts, which comprised open-ended questions covering decision-making domains in HSI. Thematic analysis of responses outlined key domains, which were evaluated by a smaller international subgroup (n=15), comprising clinical academic sports medicine physicians, physiotherapists and orthopaedic surgeons in a consensus meeting. After group discussion around each domain, a series of consensus statements were prepared, debated and refined. A round 2 questionnaire was sent to 112 international hamstring experts to vote on these statements and determine level of agreement. Consensus threshold was set a priori at 70%. Expert response rates were 35/46 (76%) (first round), 15/35 (attendees/invitees to meeting day) and 99/112 (88.2%) for final survey round. Statements on rehabilitation reaching consensus centred around: exercise selection and dosage (78.8%-96.3% agreement), impact of the kinetic chain (95%), criteria to progress exercise (73%-92.7%), running and sprinting (83%-100%) in rehabilitation and criteria for return to sport (RTS) (78.3%-98.3%). Benchmarks for flexibility (40%) and strength (66.1%) and adjuncts to rehabilitation (68.9%) did not reach agreement. This consensus panel recommends individualised rehabilitation based on the athlete, sporting demands, involved muscle(s) and injury type and severity (89.8%). Early-stage rehab should avoid high strain loads and rates. Loading is important but with less consensus on optimum progression and dosage. This panel recommends rehabilitation progress based on capacity and symptoms, with pain thresholds dependent on activity, except pain-free criteria supported for sprinting (85.5%). Experts focus on the demands and capacity required for match play when deciding the rehabilitation end goal and timing of RTS (89.8%). The expert panellists in this study followed evidence on aspects of rehabilitation after HSI, suggesting rehabilitation prescription should be individualised, but clarified areas where evidence was lacking. Additional research is required to determine the optimal load dose, timing and criteria for HSI rehabilitation and the monitoring and testing metrics to determine safe rapid progression in rehabilitation and safe RTS. Further research would benefit optimising: prescription of running and sprinting, the application of adjuncts in rehabilitation and treatment of kinetic chain HSI factors.
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Affiliation(s)
- Bruce M Paton
- Institute of Sport Exercise and Health (ISEH), University College London, London, UK .,Physiotherapy Department, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Surgery and Intervention Science, University College London, London, UK
| | - Paul Read
- Institute of Sport Exercise and Health (ISEH), University College London, London, UK.,Division of Surgery and Intervention Science, University College London, London, UK.,School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.,Section Sports Medicine, University of Pretoria, Pretoria, South Africa
| | - Mathew G Wilson
- Division of Surgery and Intervention Science, University College London, London, UK.,Princess Grace Hospital, London, UK
| | - Noel Pollock
- Institute of Sport Exercise and Health (ISEH), University College London, London, UK.,British Athletics, London, UK
| | | | | | - Paul Head
- School of Sport, Health and Applied Science, St. Mary's University, London, UK
| | - Babar Kayani
- Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Sam Kelly
- Salford City Football Club, Salford, UK.,Blackburn Rovers Football Club, Blackburn, UK
| | - Gino M M J Kerkhoffs
- Orthopaedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Amsterdam IOC Research Center, Amsterdam, The Netherlands
| | - James Moore
- Sports & Exercise Medicine, Centre for Human Health and Performance, London, UK
| | - Peter Moriarty
- Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Simon Murphy
- Medical Services, Arsenal Football Club, London, UK
| | - Ricci Plastow
- Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | - David Wood
- Trauma & Orthopaedic Surgery, North Sydney Orthopaedic and Sports Medicine Centre, Sydney, New South Wales, Australia
| | - Fares Haddad
- Institute of Sport Exercise and Health (ISEH), University College London, London, UK.,Division of Surgery and Intervention Science, University College London, London, UK.,Princess Grace Hospital, London, UK.,Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK
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24
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Does an Adjusted Kinematic Model Predict the Relative Eccentric Force During Nordic Curl? J Sport Rehabil 2023; 32:151-157. [PMID: 35894874 DOI: 10.1123/jsr.2022-0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 02/07/2023]
Abstract
This study aimed to assess the combination of video-based kinematic variables adjusted by intrinsic covariates to predict the relative eccentric force (RelF) during the Nordic curl. The participants (n = 21) performed Nordic curls (3 trials; 3-min rest) on a device measuring the eccentric force. The peaks were normalized by body weight. Kinovea software was used to track angular and linear velocity and acceleration from recorded videos. Two prediction models with multiple linear regression equations associated kinematic, anthropometric, and age variables to adjust the actual RelF. The equations obtained the predicted RelF. The actual RelF was inversely correlated with height (r = -.52), tangential (r = -.50) and centripetal accelerations (r = -.715), and angular velocity (r = -.70). The best prediction models combined angular velocity with age (F2,18 = 15.1, P = .001, r = .792, r2 = .627) and with height (F2,18 = 14.5, P = .001, r = .785, r2 = .616). No differences were observed between actual and predicted values (P = .993-.994), with good levels of agreement and consistency (intraclass correlation coefficient = .77-.78; Cronbach α = .86-.87). Bland-Altman results showed high levels of agreement and low biases. The standard error of measurement and minimal detectable change ranges were 0.46 to 0.49 N/kg and 1.28 to 1.36 N/kg, respectively. Also, the percentage of standard error of measurement was below 10% (7.92%-8.35%). The coefficient of variation analysis returned a 14.54% and 15.13% for each model, respectively. Kinematic analysis offers portability and low cost to current expensive or technical impaired dynamometry-based techniques to assess the RelF.
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25
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Cronin K, Foley S, Cournane S, De Vito G, Kerin F, Farrell G, Delahunt E. The architectural characteristics of the hamstring muscles do not differ between male and female elite-level rugby union players. Front Physiol 2023; 14:1129061. [PMID: 36776970 PMCID: PMC9911870 DOI: 10.3389/fphys.2023.1129061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/18/2023] [Indexed: 01/28/2023] Open
Abstract
Purpose: To determine whether differences exist in the architectural characteristics of the hamstring muscles of elite-level male and female rugby union players. Methods: Forty elite-level rugby union players (male n = 20, female n = 20) participated in this cross-sectional study. A sonographer acquired static ultrasound images using a 92 mm linear transducer to quantify (via a semi-automated tracing software tool) the architectural characteristics (muscle length, fascicle length, pennation angle, and muscle thickness) of the biceps femoris long head and semimembranosus muscles of participants' left limb. Muscle length and muscle thickness of the biceps femoris short head and semitendinosus muscles of participants' left limb were also quantified. Bonferroni adjusted independent samples t-tests were performed to evaluate whether differences exist in the architectural characteristics of the hamstring muscles of elite-level male and female rugby union players. Results: There were no significant differences in fascicle length or pennation angle of the hamstring muscles of elite-level male and female rugby union players. Some significant differences in muscle thickness (biceps femoris short head, and semimembranosus) and muscle length (biceps femoris short head, biceps femoris long head, semitendinosus, and semimembranosus) were observed; in all cases the male players had thicker and longer muscles. Conclusion: At a group level, hamstring muscle fascicle length and pennation angle are unlikely to be a sex-specific intrinsic risk factor for Hamstring strain injuries.
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Affiliation(s)
- Kevin Cronin
- School of Medicine, University College Dublin, Dublin, Ireland,*Correspondence: Kevin Cronin,
| | - Shane Foley
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Seán Cournane
- School of Physics, University College Dublin, Dublin, Ireland
| | - Giuseppe De Vito
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Fearghal Kerin
- Leinster Rugby, Dublin, Ireland,School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | | | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland,Institute for Sport and Health, University College Dublin, Dublin, Ireland
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26
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Activity Distribution Among the Hamstring Muscles During the Nordic Hamstring Exercise: A Multichannel Surface Electromyography Study. J Appl Biomech 2023; 39:69-79. [PMID: 36791725 DOI: 10.1123/jab.2022-0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 12/01/2022] [Accepted: 12/15/2022] [Indexed: 02/17/2023]
Abstract
This study assessed activity distribution among the hamstring muscles during the Nordic hamstring exercise (NHE). The objective was to compare muscle activity between and within muscles during the NHE to add insights in its underlying protective mechanism. Through multichannel electromyography, we measured muscle activity in male basketball players during the NHE. Electromyography was assessed at 15 locations: 5 for biceps femoris long head, 4 for semitendinosus, and 6 for semimembranosus. For each percent of the eccentric phase of the NHE, muscle activity was calculated for each electrode location within each hamstring muscle individually. To quantify whole muscle head activity, means and variances across electrodes within each muscle were calculated. Thirty-five noninjured participants were included (mean age, 18 [2] y; mass, 87 [12] kg; height, 192 [9] cm). Heterogeneous muscle activity was found between 38% and 62% and over the whole eccentric contraction phase within the semitendinosus and the semimembranosus, respectively. Muscle activity of the semitendinosus was significantly higher than that of the biceps femoris long head. During the NHE, the relative contribution of the semitendinosus is the highest among hamstring muscles. Its strong contribution may compensate for the biceps femoris long head, the most commonly injured hamstring muscle head.
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27
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Ripley NJ, Cuthbert M, Comfort P, McMahon JJ. Effect of additional Nordic hamstring exercise or sprint training on the modifiable risk factors of hamstring strain injuries and performance. PLoS One 2023; 18:e0281966. [PMID: 36862645 PMCID: PMC9980768 DOI: 10.1371/journal.pone.0281966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/04/2023] [Indexed: 03/03/2023] Open
Abstract
The Nordic hamstring exercise (NHE) has commonly been investigated in isolation, however, within practice multiple modalities are commonly incorporated. However, the NHE has a low level of compliance within sport, with sprinting being potentially being preferred. The present study aimed to observe the effect of a lower-limb program with either additional NHE or sprinting on the modifiable risk factors hamstring strain injury (HSI) and athletic performance. 38 collegiate athletes were randomly assigned into three groups: control standardised lower-limb training program (n = 10 (2 female, 8 male), age = 23.50 ± 2.95 years, height = 1.75 ± 0.09 m, mass 77.66 ± 11.82 kg), additional NHE (n = 15 (7 female, 8 male), age = 21.40 ± 2.64 years, height = 1.74 ± 0.04 m, mass 76.95 ± 14.20 kg) and additional sprinting (n = 13 (4 female, 9 male), age = 22.15 ± 2.54 years, height = 1.74 ± 0.05 m, mass 70.55 ± 7.84 kg). All participants performed a standardised lower-limb training program twice per week for seven weeks, including Olympic lifting derivatives, squatting movements, and the Romanian deadlift, with experimental groups performing with either additional sprinting or NHE. Bicep femoris architecture, eccentric hamstring strength, jump performance, lower-limb maximal strength and sprint ability were measured pre and post. All training groups demonstrated significant (p < 0.001), small-moderate increases in Bicep femoris architecture (g = 0.60-1.22), with significant (p < 0.001), small-large increases in absolute and relative eccentric peak force (g = 0.60-1.84). Significant and small increases were observed in take-off velocity and mean propulsion force (p < 0.02, g = 0.47-0.64), with non-significant and small increases for both the sprint and control training groups for mean propulsion force (p > 0.05, g = 0.42-0.50). Nordic and sprint training groups had significant and small increases in peak absolute and relative net force (p < 0.001, g = 0.44-0.60). The control group had a non-significant trivial increase in absolute peak net force (p > 0.05, g = 0.22), with a significant and small increase in relative peak relative net force (p = 0.034, g = 0.48). Significant and small decreases for the NHE and sprinting training groups was observed for 0-10 m, 0-20 m, and 10-20 m sprint time (p < 0.010, g = 0.47-0.71). Performing multiple modalities, with either additional NHE or sprinting, as part of a complete resistance training program was superiorly effective for measures of modifiable risk factors HSI, with similar increases observed in measures of athletic performance derived from the standardised lower-limb training program.
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Affiliation(s)
- Nicholas J. Ripley
- Human Performance Laboratory, University of Salford, Salford, United Kingdom
- * E-mail:
| | - Matthew Cuthbert
- Human Performance Laboratory, University of Salford, Salford, United Kingdom
- The Football Association Group, St George’s Park, Burton-upon-Trent, Staffordshire, United Kingdom
| | - Paul Comfort
- Human Performance Laboratory, University of Salford, Salford, United Kingdom
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - John J. McMahon
- Human Performance Laboratory, University of Salford, Salford, United Kingdom
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28
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du Moulin W, Bourne M, Diamond LE, Konrath J, Vertullo C, Lloyd D, Saxby DJ. Shape differences in the semitendinosus following tendon harvesting for anterior cruciate ligament reconstruction. J Orthop Res 2023; 41:44-53. [PMID: 35434842 PMCID: PMC10084140 DOI: 10.1002/jor.25337] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/12/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023]
Abstract
Following hamstring autograft anterior cruciate ligament reconstruction (ACLR), muscle length, cross-sectional area, and volume are reduced. However, these discrete measures of morphology do not account for complex three-dimensional muscle shape. The primary aim of this study was to determine between-limb semitendinosus (ST) shape and regional morphology differences in young adults following tendon harvest for ACLR and to compare these differences with those in healthy controls. In this cross-sectional study, magnetic resonance imaging was performed on 18 individuals with unilateral ACLR and 18 healthy controls. Bilaterally, ST muscles were segmented, and shape differences assessed between limbs and compared between groups using Jaccard index (0-1) and Hausdorff distance (mm). Length (cm), peak cross-sectional area (cm2 ), and volume (cm3 ) were measured for the entire muscle and proximal, middle, and distal regions, and compared between limbs and groups. Compared to healthy controls, the ACLR group had significantly (p < 0.001, Cohen's d = -2.33) lower bilateral ST shape similarity and shape deviation was significantly (p < 0.001, d = 2.12) greater. Shape deviation was greatest within the distal region of the ACLR (Hausdorff: 23.1 ± 8.68 mm). Compared to both the uninjured contralateral limb and healthy controls, deficits in peak cross-sectional area and volume in ACLR group were largest in proximal (p < 0.001, d = -2.52 to -1.28) and middle (p < 0.001, d = -1.81 to -1.04) regions of the ST. Overall, shape analysis provides unique insight into regional adaptations in ST morphology post-ACLR. Findings highlight morphological features in distal ST not identified by traditional discrete morphology measures. Clinical significance: Following ACLR, risk of a secondary knee or primary hamstring injury has been reported to be between 2-to-5 times greater compared to those without ACLR. Change in semitendinosus (ST) shape following ACLR may affect force transmission and distribution within the hamstrings and might contribute to persistent deficits in knee flexor and internal rotator strength.
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Affiliation(s)
- William du Moulin
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Matthew Bourne
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Laura E Diamond
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Jason Konrath
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Principia Technology, Crawley, Western Australia, Australia
| | - Christopher Vertullo
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Knee Research Australia, Gold Coast, Queensland, Australia
| | - David Lloyd
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - David J Saxby
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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29
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Tumiñá-Ospina DM, Rivas-Campo Y, García-Garro PA, Gómez-Rodas A, Afanador DF. Efectividad de los ejercicios nórdicos sobre la incidencia de lesiones de isquiotibiales en futbolistas profesionales y amateur masculinos entre los 15 y 41 años. Revisión sistemática. REVISTA IBEROAMERICANA DE CIENCIAS DE LA ACTIVIDAD FÍSICA Y EL DEPORTE 2022. [DOI: 10.24310/riccafd.2022.v11i3.15338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Introducción: Las lesiones musculares son comunes en futbolistas, siendo la lesión de isquiotibiales la más frecuente. Objetivo: Analizar la evidencia existente sobre los efectos de los ejercicios nórdicos en la incidencia de lesiones de isquiotibiales en jugadores de fútbol profesional y amateur masculinos entre los 15 y 41 años. Materiales y métodos: Se llevó a cabo una revisión sistemática siguiendo las recomendaciones de la declaración PRISMA, realizando la búsqueda de artículos en PubMed, BVS, Cochrane, Web OF Science y SCOPUS, además de consultar Google Scholar. La búsqueda se realizó basada en la estrategia PICO con los siguientes términos: hamstring muscles, exercise, rehabilitation, therapy, athletic injuries, soccer. Resultados: un total de 257 artículos resultaron de la búsqueda, siendo 5 los artículos incluidos en este estudio. Todos los estudios evidenciaron efectos positivos de los ejercicios nórdicos para los deportistas. Conclusiones: los ejercicios nórdicos redujeron la incidencia de lesión de isquiotibiales en 4 de los estudios analizados, el porcentaje de cumplimiento de las sesiones de intervención condicionaron la calidad de los efectos mientras que el momento de aplicación de la intervención (pre- o post-entreno) no influyó
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30
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Moran J, Vali N, Drury B, Hammami R, Tallent J, Chaabene H, Ramirez-Campillo R. The effect of volume equated 1- versus 2-day formats of Nordic hamstring exercise training on fitness in youth soccer players: A randomised controlled trial. PLoS One 2022; 17:e0277437. [PMID: 36580466 PMCID: PMC9799302 DOI: 10.1371/journal.pone.0277437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/27/2022] [Indexed: 12/30/2022] Open
Abstract
PURPOSE This randomised controlled trial examined the effect of an 8-week volume-equated programme of Nordic hamstring exercise (NHE) training, executed at frequencies of 1- or 2-days per week, on fitness (10 m and 40 m sprint, '505' change of direction [COD] and standing long jump [SLJ]) in male youth soccer players (mean age: 16.4 ± 0.81 years). METHOD Players were divided into an experimental group (n = 16) which was further subdivided into 1-day (n = 8) and 2-day (n = 8) per week training groups and a control group (n = 8). RESULTS There were significant group-by-time interactions for 10-m sprint (p<0.001, η2 = 0.120, d = 2.05 [0.57 to 3.53]), 40-m sprint (p = 0.001, η2 = 0.041, d = 1.09 [-0.23 to 2.4]) and COD (p = 0.002, η2 = 0.063, d = 1.25 [-0.09 to 2.59). The experimental group demonstrated a 'very large' effect size (d = 3.02 [1.5 to 4.54]) in 10-m sprint, and 'large' effect sizes in 40-m sprint (d = 1.94 [0.98 to 2.90]) and COD (d = 1.84 [0.85 to 2.83). The control group showed no significant changes. There were no significant differences between the 1-day and 2-day training groups. In three of the four tests (40 m, COD, SLJ) the 2-day group demonstrated larger effect sizes. Ratings of perceived exertion (RPE) were significantly lower in the 2-day group (p<0.001, 3.46 [1.83 to 5.04). CONCLUSION The NHE increases fitness in youth soccer players and there may be advantages to spreading training over two days instead of one.
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Affiliation(s)
- Jason Moran
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Colchester, United Kingdom
- * E-mail:
| | - Norodin Vali
- Department of Exercise Physiology, Shahid Rajaee Teacher Training University, Tehran, Iran
| | - Ben Drury
- Department of Sport, Hartpury University, Gloucestershire, United Kingdom
| | - Raouf Hammami
- Higher Institute of Sport and Physical Education of Ksar-Said, Universite de La Manouba, Tunis, Tunisia
- Research Laboratory: Education, Motor Skills, Sports and Health, Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Jamie Tallent
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Colchester, United Kingdom
| | - Helmi Chaabene
- Department of Sports and Health Sciences, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany
- Higher Institute of Sports and Physical Education, Kef, University of Jendouba, Jendouba, Tunisia
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Laboratory, Faculty of Rehabilitation Sciences, School of Physical Therapy, Universidad Andres Bello, Santiago, Chile
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Lim J, Wong S, McErlain-Naylor SA, Scanlan A, Goggins L, Ahmun R, Comfort P, Weldon A. Strength and Conditioning for Cricket Fielding: A Narrative Review. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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32
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Carmichael DS, Hickey JT, Tofari PJ, Bourne MN, Ward MR, Timmins RG. Effect of an Isometric or Eccentric Hip Extension Exercise Intervention on Hamstring Strength, Architecture, and Morphology. Med Sci Sports Exerc 2022; 54:2196-2207. [PMID: 35941515 DOI: 10.1249/mss.0000000000003012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to investigate hamstring architectural, strength, and morphological adaptations after an eccentric or isometric hip extension exercise intervention. METHODS Twenty-four recreationally active males performed either an eccentric ( n = 12) or an isometric hip extension ( n = 12) exercise intervention, twice per week for 6 wk, followed by a 4-wk detraining period. Biceps femoris long head (BFlh) architecture was assessed pre-intervention, mid-intervention, post-intervention, and post-detraining via two-dimensional ultrasound. Strength was assessed pre-intervention, post-intervention, and post-detraining during an isokinetic knee flexion, an isometric hip extension, a Nordic hamstring exercise, and a single-leg hamstring bridge repetition to fatigue test. Hamstring muscle morphology was assessed via magnetic resonance imaging before strength testing sessions. RESULTS The eccentric hip extension exercise intervention significantly lengthened BFlh fascicles (+19.7%, P < 0.001, d = 1.57), increased eccentric knee flexion torque (ECC 60°·s -1 , +12%, P < 0.005, d = 0.66; ECC 180°·s -1 , +8.3%, P < 0.05, d = 0.41), and increased BFlh (+13.3%, P < 0.001, d = 1.96) and semimembranosus (SM) muscle volume (+12.5%, P < 0.001, d = 2.25). After 4 wk of detraining, BFlh fascicles were significantly shortened in the eccentric group (-14.8%, P < 0.005, d = -1.25), whereas eccentric knee flexion torque and BFlh and SM volumes were unchanged. The isometric hip extension exercise intervention significantly increased isometric knee flexion torque (+10.4%, P < 0.05, d = 0.54), isometric hip extension force (+12.4%, P < 0.05, d = 0.41), and semitendinosus volume (+15%, P = 0.054, d = 1.57). All other outcome measures saw no significant changes. After 4 wk of detraining, no significant changes to any variables were observed in the isometric group. CONCLUSIONS The eccentric but not isometric hip extension exercise intervention significantly increased BFlh fascicle length. Both exercise interventions demonstrated contraction mode-specific increases in strength. However, the eccentric hip extension exercise intervention resulted in preferential hypertrophy of BFlh and SM, and the isometric hip extension exercise intervention led to selective hypertrophy of semitendinosus.
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Affiliation(s)
- Declan S Carmichael
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, AUSTRALIA
| | | | - Paul J Tofari
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, AUSTRALIA
| | - Matthew N Bourne
- School of Health Sciences and Social Work, Griffith University, Gold Coast, AUSTRALIA
| | - Mark R Ward
- Imaging @ Olympic Park, Melbourne, AUSTRALIA
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Miyazaki T, Fujii N. Effects of changes in optimal muscle fibre length in the biceps femoris long head on muscle force during the late swing phase of maximal speed sprinting: a simulation study. Sports Biomech 2022:1-16. [PMID: 36346916 DOI: 10.1080/14763141.2022.2140070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022]
Abstract
Hamstring strain injuries would frequently occur during the late swing phase of sprinting, while increasing biceps femoris long head's (BFlh) fascicle length induced by eccentric contraction exercises can reduce the risk of strain injuries. Thus, using a musculoskeletal modelling simulation, we examined how manipulating BFlh optimal muscle fibre length would change muscle force during the late swing phase of sprinting for providing knowledge preventing hamstring strain injuries. A motion capture system was used to collect kinematic data from 40 male athletes during maximal speed sprinting. Muscle force and force-generating capabilities determined by force-length-velocity properties were estimated with three BFlh optimal muscle fibre lengths (90%, 110% and 120%), which were perturbed from the nominal (100%). During the late swing phase of sprinting, the muscle force and force-generating capabilities, induced by the force-length property rather than the force-velocity property, were increased by increases in BFlh optimal muscle fibre length. Moreover, magnitudes of the simulated increases in muscle force and force-generating capabilities were correlated with the peak BFlh muscle-tendon unit length. These results demonstrate that lengthening BFlh optimal muscle fibre might increase muscle force during the late swing phase, and the magnitude of increment would be associated with increasing muscle-tendon unit length.
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Affiliation(s)
| | - Norihisa Fujii
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
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Alt T, Severin J, Schmidt M. Quo Vadis Nordic Hamstring Exercise-Related Research?-A Scoping Review Revealing the Need for Improved Methodology and Reporting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11225. [PMID: 36141503 PMCID: PMC9517005 DOI: 10.3390/ijerph191811225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Abstract
The objective of this scoping review is to assess Nordic Hamstring Exercise quality (ANHEQ) of assessments and interventions according to the ANHEQ rating scales and to present practical recommendations for the expedient design and reporting of future studies. A total of 71 Nordic Hamstring Exercise (NHE) assessments and 83 NHE interventions were selected from the data sources PubMed, Scopus, and SPORTDiscus. Research studies which were presented in peer-reviewed academic journals and implemented the NHE during laboratory-based assessments or multi-week interventions met the eligibility criteria. NHE assessments analyzed force (51%), muscle activation (41%), knee angle kinematics (38%), and bilateral symmetry (37%). NHE interventions lasted 4-8 weeks (56%) and implied an exercise volume of two sessions per week (66%) with two sets per session (41%) and ≥8 repetitions per set (39%). The total ANHEQ scores of the included NHE assessments and interventions were 5.0 ± 2.0 and 2.0 ± 2.0 (median ± interquartile range), respectively. The largest deficits became apparent for consequences of impaired technique (87% 0-point-scores for assessments) and kneeling height (94% 0-point-scores for interventions). The 0-point-scores were generally higher for interventions compared to assessments for rigid fixation (87% vs. 34%), knee position (83% vs. 48%), kneeling height (94% vs. 63%), and separate familiarization (75% vs. 61%). The single ANHEQ criteria, which received the highest score most frequently, were rigid fixation (66% of assessments) and compliance (33% of interventions). The quality of NHE assessments and interventions was generally 'below average' or rather 'poor'. Both NHE assessments and interventions suffered from imprecise reporting or lacking information regarding NHE execution modalities and subsequent analyses. Based on the findings, this scoping review aggregates practical guidelines how to improve the design and reporting of future NHE-related research.
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Affiliation(s)
- Tobias Alt
- Department of Biomechanics, Performance Analysis and Strength & Conditioning, Olympic Training and Testing Centre Westphalia, 44139 Dortmund, Germany
| | - Jannik Severin
- Institute of Movement and Neuroscience, German Sport University, 50933 Cologne, Germany
| | - Marcus Schmidt
- Institute for Sport and Sport Science, TU Dortmund University, 44227 Dortmund, Germany
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Shah S, Collins K, Macgregor LJ. The Influence of Weekly Sprint Volume and Maximal Velocity Exposures on Eccentric Hamstring Strength in Professional Football Players. Sports (Basel) 2022; 10:sports10080125. [PMID: 36006091 PMCID: PMC9414047 DOI: 10.3390/sports10080125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Hamstring strains are the most common moderate-major severity injuries in football. The majority of hamstring injuries occur during sprinting, with low eccentric hamstring strength being associated with an elevated risk. Objective: To examine the relationship between sprinting and eccentric hamstring strength by monitoring total weekly sprint distance and weekly efforts > 90% and >95% of maximum velocity. Methods: Fifty-eight professional male footballers were observed over one-and-a-half seasons. Players’ running was monitored during training and matches using GPS, and eccentric hamstring strength was measured weekly. Results: Weekly sprint distance (ρ = −0.13, p < 0.01) and weekly efforts >90% of maximum velocity (ρ = −0.08, p = 0.01) both displayed significant inverse relationships with the percentage change in eccentric hamstring strength; weekly efforts >95% of maximum velocity showed no relationship with hamstring strength (ρ = −0.02, p = 0.45). Only weekly efforts >90% of maximum velocity significantly influenced the mean percentage change in eccentric hamstring force, F(3,58) = 3.71, p = 0.01, with significant differences occurring when comparing 7−8 sprint efforts with 0−2 efforts (0.11%, p = 0.03) and 5−6 efforts (0.12%, p = 0.03). Conclusions: Eccentric hamstring strength levels significantly decrease when 7−8 weekly sprint efforts are completed at >90% of maximum velocity. Monitoring weekly sprint loading at velocities > 90% of maximum velocity may be valuable to help to reduce the risk of hamstring injuries in professional football.
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Affiliation(s)
- Sunnan Shah
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK
| | - Kieran Collins
- Gaelic Sports Research Centre, Institute of Technology Tallaght, D24 FKT9 Dublin, Ireland
| | - Lewis J. Macgregor
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK
- Correspondence: ; Tel.: +44-(0)178646-6475
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36
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Kishigami K, Kanehisa H, Qi S, Arimitsu T, Miyachi M, Iemitsu M, Sanada K. Relationship between thigh muscle cross-sectional areas and single leg stand-up test in Japanese older women. PLoS One 2022; 17:e0269103. [PMID: 35700158 PMCID: PMC9197025 DOI: 10.1371/journal.pone.0269103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 05/13/2022] [Indexed: 11/19/2022] Open
Abstract
In older adults, the quantitative decline of the quadriceps femoris is associated with the augmentation of difficulty in the execution of a stand-up task. However, it is unclear whether the cross-sectional areas (CSAs) of individual thigh muscles differ between older adults who can stand up from a 40-cm-height chair on a single leg and those who cannot. To investigate this, the present study determined the CSAs of individual mid-thigh muscles in 67 Japanese women aged 60–77 years by using a magnetic resonance imaging method. Participants were asked to stand up from a 40-cm-height chair on a single leg, and those who could and could not stand up without leaning back and maintain a standing posture for 3 seconds on a single leg were allocated into the successful group (SG, n = 40) and unsuccessful group (USG, n = 27), respectively. Only the CSA of the adductors (sum of the adductor longus and adductor magnus) was significantly smaller in USG compared to SG. When CSA was expressed relative to the two-third power of body mass, the values for the four heads of the quadriceps femoris and biceps femoris long head, as well as the adductors, were significantly lower in USG than in SG. The current results indicate that in terms of the value relative to body mass, the reduced CSAs of the adductors and biceps femoris long head, as well as the four heads of the quadriceps femoris, are associated with the failure of attempts to stand up from a 40-cm-height chair on a single leg in older women. This may be due to the anatomical function of the two muscle groups, which contributes to hip extension movement involved in transitioning from a sitting position to a standing position during the stand-up task.
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Affiliation(s)
- Keiko Kishigami
- College of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Hiroaki Kanehisa
- College of Sport and Health Science, Ritsumeikan University, Shiga, Japan
- National Institute of Fitness and Sports in KANOYA, Kagoshima, Japan
| | - Shumeng Qi
- College of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Takuma Arimitsu
- College of Sport and Health Science, Ritsumeikan University, Shiga, Japan
- Faculty of Health Care, Department of Human Health Hachinohe Gakuin University, Aomori, Japan
| | - Motohiko Miyachi
- Faculty of Sport Sciences, School of Sport and Sciences, Waseda University, Tokyo, Japan
- Department of Health Promotion and Exercise, National Institute of Health and Nutrition, Tokyo, Japan
| | - Motoyuki Iemitsu
- College of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Kiyoshi Sanada
- College of Sport and Health Science, Ritsumeikan University, Shiga, Japan
- * E-mail:
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37
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New field ergometer to reproducibly measure maximum strength and rate of force development of hamstrings. Sci Sports 2022. [DOI: 10.1016/j.scispo.2022.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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38
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Van Hooren B, Vanwanseele B, van Rossom S, Teratsias P, Willems P, Drost M, Meijer K. Muscle forces and fascicle behavior during three hamstring exercises. Scand J Med Sci Sports 2022; 32:997-1012. [PMID: 35307884 PMCID: PMC9314024 DOI: 10.1111/sms.14158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/12/2022] [Accepted: 03/14/2022] [Indexed: 01/05/2023]
Abstract
Knowledge about muscular forces and fascicle behavior during hamstring exercises can optimize exercise prescription, but information on these outcomes across different exercises is lacking. We aimed to characterize and compare lower‐limb muscle forces and biceps femoris long head muscle fascicle behavior between three hamstring exercises: the Nordic hamstring curl (NHC), single‐leg Roman chair (RCH), and single‐leg deadlift (DL). Ten male participants performed the exercises while full‐body kinematics, ground reaction forces, surface muscle activation, and biceps femoris long head fascicle behavior were measured. Mean fascicle length was highest in the DL, followed by the RCH and NHC. Fascicle lengthening was higher in the NHC compared with the RCH and DL, with no difference between the RCH and DL. Biceps femoris short and long head, semitendinosus, and semimembranosus peak forces were generally higher in the NHC compared with the RCH and DL, while mean forces during the eccentric phase were generally not different between the NHC and RCH. Peak forces in the NHC coincided with low biceps femoris long head and semimembranosus muscle activation. The NHC generally has the highest peak hamstring muscle forces and results in more fascicle lengthening when compared to the DL and RCH. The NHC may therefore be most effective to promote increases in fascicle length. While the NHC may be effective to promote biceps femoris short head and semitendinosus strength adaptations, the RCH and DL may be more effective to promote strength increases in the biceps femoris long head and semimembranosus.
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Affiliation(s)
- Bas Van Hooren
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Benedicte Vanwanseele
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Sam van Rossom
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Panayiotis Teratsias
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Paul Willems
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Maarten Drost
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Kenneth Meijer
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
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39
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Alonso-Fernández D, Fernández-Rodríguez R, Taboada-Iglesias Y, Gutiérrez-Sánchez Á. Effects of Copenhagen Adduction Exercise on Muscle Architecture and Adductor Flexibility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116563. [PMID: 35682148 PMCID: PMC9180184 DOI: 10.3390/ijerph19116563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 02/04/2023]
Abstract
Groin injuries are one of the most prevalent in sports, especially due to the hip adductor muscles’ weakness, which is considered as a risk factor. The Copenhagen adduction exercise (CAE) has been demonstrated to increase the strength of adductor muscles, but its effects on the architectural characteristics and flexibility of the adductors has been little studied. The aim of the present study was to analyse the impact on the muscular architecture and flexibility of the adductor musculature after 8 weeks of CAE-based training and after 4 weeks of subsequent detraining. A sample of 45 active subjects (26.1 ± 2.8 years old) were randomly divided into a control group with no intervention and an experimental group with an intervention based on 8 weeks of CAE training and 4 weeks of subsequent detraining. The muscle thickness of adductors was measured before and after training and detraining using ultrasound imaging and hip abduction range with goniometry. A significant increase in muscle thickness (left leg: +17.83%, d = 1.77, p < 0.001//right leg: +18.38%, d = 1.82, p < 0.001) and adductor flexibility was found in the experimental group (left leg: +7.3%, d = 0.96, p < 0.05//right leg: +7.15%, d = 0.94, p < 0.05), and after detraining, both variables returned to their initial values. These results could indicate that CAE would be a suitable strategy to modify the architecture of the adductors and thus form part of training protocols designed for the prevention and rehabilitation of muscle injuries.
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Affiliation(s)
- Diego Alonso-Fernández
- Department of Special Didactics, Faculty of Education and Sport Sciences, University of Vigo, 36005 Pontevedra, Spain; (R.F.-R.); (Y.T.-I.); (Á.G.-S.)
- Education, Physical Activity and Health Research Group (Gies-10-DE3), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36208 Vigo, Spain
- Correspondence:
| | - Rosana Fernández-Rodríguez
- Department of Special Didactics, Faculty of Education and Sport Sciences, University of Vigo, 36005 Pontevedra, Spain; (R.F.-R.); (Y.T.-I.); (Á.G.-S.)
| | - Yaiza Taboada-Iglesias
- Department of Special Didactics, Faculty of Education and Sport Sciences, University of Vigo, 36005 Pontevedra, Spain; (R.F.-R.); (Y.T.-I.); (Á.G.-S.)
- Education, Physical Activity and Health Research Group (Gies-10-DE3), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36208 Vigo, Spain
| | - Águeda Gutiérrez-Sánchez
- Department of Special Didactics, Faculty of Education and Sport Sciences, University of Vigo, 36005 Pontevedra, Spain; (R.F.-R.); (Y.T.-I.); (Á.G.-S.)
- Education, Physical Activity and Health Research Group (Gies-10-DE3), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36208 Vigo, Spain
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40
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Goreau V, Pigne R, Bernier N, Nordez A, Hug F, Lacourpaille L. Hamstring muscle activation strategies during eccentric contractions are related to the distribution of muscle damage. Scand J Med Sci Sports 2022; 32:1335-1345. [PMID: 35611628 PMCID: PMC9541962 DOI: 10.1111/sms.14191] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/07/2022] [Accepted: 05/20/2022] [Indexed: 01/25/2023]
Abstract
Large inter‐individual variability of activation strategies is observed during hamstring strengthening exercises but their consequences remain unexplored. The objective of this study was to determine whether individual activation strategies are related to the distribution of damage across the hamstring muscle heads semimembranosus (SM), semitendinosus (ST), and biceps femoris (BF) after eccentric contractions. 24 participants performed 5 sets of 15 maximal eccentric contractions of knee flexors on a dynamometer, while activation of each muscle head was assessed using surface electromyography. Knee flexion maximal isometric strength was assessed before exercise and 48 h afterward. Shear modulus was measured using shear wave elastography before exercise and 30 min afterward to quantify the distribution of damage across the hamstring muscle heads. At 48 h, maximal knee flexion torque had decreased by 15.9% ± 16.9% (p < 0.001). Although no differences between activation ratios of each muscle were found during the eccentric exercise (all p > 0.364), we reported a heterogeneous distribution of damage, with a larger change in shear modulus of ST/Hams than SM/Hams (+70.8%, p < 0.001) or BF/Hams (+50.3%, p < 0.001). A large correlation was found between the distribution of activation and the distribution of damage for ST/Hams (r = 0.69; p < 001). This study provides evidence that the distribution of activation during maximal eccentric contractions has mechanical consequences for synergist muscles. Further studies are needed to understand whether individual activation strategies influence the distribution of structural adaptations after a training program.
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Affiliation(s)
- Valentin Goreau
- Movement-Interactions-Performance, MIP, UR 4334, Nantes Université, Nantes, France
| | - Robin Pigne
- Movement-Interactions-Performance, MIP, UR 4334, Nantes Université, Nantes, France
| | - Nathan Bernier
- CIAMS, Université d'Orléans, Orléans, France.,CIAMS, Université Paris-Saclay, Orsay, France
| | - Antoine Nordez
- Movement-Interactions-Performance, MIP, UR 4334, Nantes Université, Nantes, France.,Institut Universitaire de France (IUF), Paris, France
| | - François Hug
- Movement-Interactions-Performance, MIP, UR 4334, Nantes Université, Nantes, France.,Institut Universitaire de France (IUF), Paris, France.,LAMHESS, Université Côte d'Azur, Nice, France
| | - Lilian Lacourpaille
- Movement-Interactions-Performance, MIP, UR 4334, Nantes Université, Nantes, France
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41
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Vetter S, Schleichardt A, Köhler HP, Witt M. The Effects of Eccentric Strength Training on Flexibility and Strength in Healthy Samples and Laboratory Settings: A Systematic Review. Front Physiol 2022; 13:873370. [PMID: 35574461 PMCID: PMC9100951 DOI: 10.3389/fphys.2022.873370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022] Open
Abstract
Background: The risk of future injury appears to be influenced by agonist fascicle length (FL), joint range of motion (ROM) and eccentric strength. Biomechanical observations of the torque-angle-relationship further reveal a strong dependence on these factors. In practice, a longer FL improves sprinting performance and lowers injury risk. Classical stretching is a popular and evidenced-based training for enhancing ROM but does not have any effects on FL and injury risk. However, recent studies show that eccentric-only training (ECC) improves both flexibility and strength, and effectively lowers risk of injury. Objectives: To review the evidence on benefits of ECC for flexibility and strength. Methods: COCHRANE, PUBMED, SCOPUS, SPOLIT, and SPONET were searched for laboratory trials that compare ECC to at least one comparison group. Studies were eligible if they examined both strength and flexibility metrics in a healthy sample (<65 years) and met criteria for controlled or randomized clinical trials (CCT, RCT). 18 studies have been included and successfully rated using the PEDro scale. Results: 16 of 18 studies show strong evidence of strength and flexibility enhancements for the lower limb. While improvements between ECC and concentric training (CONC) were similar for eccentric (+19 ± 10% vs. +19 ± 11%) and isometric strength (+16 ± 10% vs. +13 ± 6%), CONC showed larger improvements for concentric strength (+9 ± 6% vs. +16 ± 7%). While for ROM ECC showed improvements (+9 ± 7%), no results could be found for CONC. The overall effectiveness of ECC seems to be higher than of CONC. Conclusion: There is clear evidence that ECC is an effective method for changes in muscle architecture, leading to both flexibility and strength improvements for the lower limb. Due to limited data no shoulder study could be included. Further research is needed for the upper body joints with a focus on functional and structural adaptions. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021283248, identifier CRD42021283248
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Affiliation(s)
- Sebastian Vetter
- Department of Biomechanics in Sports, Faculty of Sports Science, Leipzig University, Leipzig, Germany
| | - Axel Schleichardt
- Department of Biomechanics, Institute for Applied Training Science, Leipzig, Germany
| | - Hans-Peter Köhler
- Department of Biomechanics in Sports, Faculty of Sports Science, Leipzig University, Leipzig, Germany
| | - Maren Witt
- Department of Biomechanics in Sports, Faculty of Sports Science, Leipzig University, Leipzig, Germany
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Nestin and osteocrin mRNA increases in human semitendinosus myotendinous junction 7 days after a single bout of eccentric exercise. Histochem Cell Biol 2022; 158:49-64. [DOI: 10.1007/s00418-022-02101-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2022] [Indexed: 11/26/2022]
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43
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Eustace SJ, Morris R, Tallis J, Page RM, Greig M. The influence of angle-specific torque of the knee flexors and extensors on the angle-specific dynamic control ratio in professional female soccer players. J Sports Sci 2022; 40:1235-1242. [PMID: 35389325 DOI: 10.1080/02640414.2022.2061251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of this study was to assess whether dynamic torque ratios (DCR) from isokinetic strength assessments of eccentric knee flexors (eccKF) and concentric knee extensors (conKE) display differences when stratified into specific angle-specific DCR (DCRAST) groups. Fifty-two professional female soccer players (age 21.30 ± 4.44 years; height 166.56 ± 5.17 cm; mass 61.55 ± 5.73 kg) from the English Women's Super League completed strength assessments of both lower limbs on an isokinetic dynamometer at 60°∙s-1. Angle-specific torque (AST) were used to calculate DCRAST to create sub-groups using clustering algorithms. The results identified for the dominant side that the Medium DCRAST group elicited significantly higher conKE AST when compared to Low and High DCRAST groups at increased knee extension (P ≤ 0.05). For the non-dominant side, the High DCRAST group had significantly higher and lower eccKF and conKE AST compared to the Low DCRAST group at increased knee extension (P ≤ 0.05). This study highlights that the inclusion of AST data may subsequently help practitioners to prescribe exercise that promotes strength increases at targeted joint angles. In turn, these approaches can be used to help reduce injury risk, identify rehabilitation responses and help inform return to play.
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Affiliation(s)
- Steven James Eustace
- School of Life Sciences, Science & Health Building, Coventry University, Coventry, UK
| | - Rhys Morris
- School of Life Sciences, Science & Health Building, Coventry University, Coventry, UK
| | - Jason Tallis
- School of Life Sciences, Science & Health Building, Coventry University, Coventry, UK
| | - Richard Michael Page
- Sports Injuries Research Group, Department of Sport and Physical Activity, Edge Hill University, Ormskirk, UK
| | - Matt Greig
- Sports Injuries Research Group, Department of Sport and Physical Activity, Edge Hill University, Ormskirk, UK
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Rudisill SS, Varady NH, Kucharik MP, Eberlin CT, Martin SD. Evidence-Based Hamstring Injury Prevention and Risk Factor Management: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Sports Med 2022:3635465221083998. [PMID: 35384731 DOI: 10.1177/03635465221083998] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Hamstring injuries are common among athletes. Considering the potentially prolonged recovery and high rate of recurrence, effective methods of prevention and risk factor management are of great interest to athletes, trainers, coaches, and therapists, with substantial competitive and financial implications. PURPOSE To systematically review the literature concerning evidence-based hamstring training and quantitatively assess the effectiveness of training programs in (1) reducing injury incidence and (2) managing injury risk factors. STUDY DESIGN Systematic review and meta-analysis; Level of evidence, 1. METHODS A computerized search of MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, and SPORTDiscus with manual screening of selected reference lists was performed in October 2020. Randomized controlled trials investigating methods of hamstring injury prevention and risk factor management in recreational, semiprofessional, and professional adult athletes were included. RESULTS Of 2602 articles identified, 108 were included. Eccentric training reduced the incidence of hamstring injury by 56.8% to 70.0%. Concentric hamstring strength increased with eccentric (mean difference [MD], 14.29 N·m; 95% CI, 8.53-20.05 N·m), concentric, blood flow-restricted, whole-body vibration, heavy back squat, FIFA 11+ (Fédération Internationale de Football Association), and plyometric training methods, whereas eccentric strength benefited from eccentric (MD, 26.94 N·m; 95% CI, 15.59-38.30 N·m), concentric, and plyometric training. Static stretching produced greater flexibility gains (MD, 10.89°; 95% CI, 8.92°-12.86°) than proprioceptive neuromuscular facilitation (MD, 9.73°; 95% CI, 6.53°-12.93°) and dynamic stretching (MD, 6.25°; 95% CI, 2.84°-9.66°), although the effects of static techniques were more transient. Fascicle length increased with eccentric (MD, 0.90 cm; 95% CI, 0.53-1.27 cm) and sprint training and decreased with concentric training. Although the conventional hamstring/quadriceps (H/Q) ratio was unchanged (MD, 0.03; 95% CI, -0.01 to 0.06), the functional H/Q ratio significantly improved with eccentric training (MD, 0.10; 95% CI, 0.03-0.16). In addition, eccentric training reduced limb strength asymmetry, while H/Q ratio and flexibility imbalances were normalized via resistance training and static stretching. CONCLUSION Several strategies exist to prevent hamstring injury and address known risk factors. Eccentric strengthening reduces injury incidence and improves hamstring strength, fascicle length, H/Q ratio, and limb asymmetry, while stretching-based interventions can be implemented to improve flexibility. These results provide valuable insights to athletes, trainers, coaches, and therapists seeking to optimize hamstring training and prevent injury.
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Affiliation(s)
- Samuel S Rudisill
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA.,Rush Medical College of Rush University, Chicago, Illinois, USA
| | - Nathan H Varady
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA.,Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Michael P Kucharik
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA
| | - Christopher T Eberlin
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA
| | - Scott D Martin
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA
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Measuring Muscle Activity in Sprinters Using T2-Weighted Magnetic Resonance Imaging. Int J Sports Physiol Perform 2022; 17:774-779. [PMID: 35235903 DOI: 10.1123/ijspp.2021-0327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE This study aimed to investigate the level of muscle activity during sprint running using T2-weighted magnetic resonance imaging. METHODS Fourteen male sprinters (age 21.2 [4.0] y; height 171.8 [4.2] cm, weight 65.5 [5.3] kg, 100-m personal record 11.01 [0.41] s; mean [SD]) performed 3 sets of three 60-m round-trip sprints. Before and after the round-trip sprints, 3 T magnetic resonance imaging scans were performed to obtain the T2 values of the 14 athletes' lower-extremity muscles. RESULTS After the 60-m round-trip sprints, the T2 value of the gluteus maximus, long head of biceps femoris, semitendinosus, semimembranosus, adductor brevis, adductor longus, adductor magnus, and gracilis increased significantly. The rate of change in the T2 values before and after the 60-m round-trip sprints was notably higher in the semitendinosus and gluteus maximus than in the other muscles. CONCLUSIONS These findings demonstrate the specific physiological metabolism of the lower-extremity muscles during fast sprinting. There are particularly high levels of muscle activity in the gluteus maximus and semitendinosus during sprint performance.
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Nishida S, Ito W, Ohishi T, Yoshida R, Sato S, Nakamura M. The Effect of Ankle Position on Peak Eccentric Force during The Nordic Hamstring Exercise. J Sports Sci Med 2022; 21:43-48. [PMID: 35250332 PMCID: PMC8851116 DOI: 10.52082/jssm.2022.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/27/2021] [Indexed: 06/14/2023]
Abstract
Peak eccentric force during the Nordic hamstring exercise (NHE) is recognized as a predictive factor for hamstring strain injury (HSI). During the NHE, the knee flexor muscles are eccentrically contracting to resist the knee joint extension. Therefore, it is thought that the action of the gastrocnemius muscle, and thus the ankle position, influences peak eccentric force during the NHE. However, the effect of ankle position on peak eccentric force during the NHE remains unclear. Therefore, we investigated the effect of ankle position on peak eccentric force during the NHE in a cohort of 50 healthy young male rugby players (mean age, 18.7 ± 1.2 years; mean body mass, 81.7 ± 15.2 kg; height, 1.72 ± 0.06 m) with no history of HSI. Each participant performed NHE strength testing with the ankle dorsiflexed or plantarflexed position and was instructed to fall forward as far as possible within 3 s. Peak eccentric force, reported relative to body mass (N/kg), of both legs was recorded, and the mean values of both legs were compared in both ankle positions. The mean peak eccentric force was significantly greater with the ankle plantarflexed position than the dorsiflexed position (3.8 ± 1.1 vs. 3.5 ± 1.1 N/kg, respectively, p = 0.049). These results indicate that ankle position should be carefully considered when measuring peak eccentric force during the NHE and performing NHE training.
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Affiliation(s)
- Satoru Nishida
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka, Japan
| | - Wataru Ito
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | | | - Riku Yoshida
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Shigeru Sato
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Masatoshi Nakamura
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
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Persistent knee flexor strength deficits identified through the NordBord eccentric test compared with “gold standard” isokinetic concentric testing during the first year after anterior cruciate ligament reconstruction with a hamstring tendon autograft. Phys Ther Sport 2022; 55:119-124. [DOI: 10.1016/j.ptsp.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/04/2022] [Accepted: 03/13/2022] [Indexed: 11/22/2022]
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Test-Retest of a Novel Wii Board-Based Device to Assess Eccentric Knee Flexor Strength During the Nordic Hamstring Exercise. J Sport Rehabil 2022; 31:651-656. [PMID: 35213823 DOI: 10.1123/jsr.2021-0255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/16/2021] [Accepted: 01/04/2022] [Indexed: 11/18/2022]
Abstract
This study aimed to assess the test-retest reliability of a Wii board-based device to assess the eccentric knee strength. Healthy participants (n = 20, 22.7 [3.4] y, 1.71 [0.09] m, 69 [13] kg) performed 2 assessments-days 1 and 2-of the Nordic hamstring exercise (3 trials per day, 3 min of rest between trials, and 48 h between trials) on a padded board with an attached Wii Balance Board (WBB). A ratchet inelastic strap made the contact between the participant's distal aspect of both legs and the inverted upper surface of the WBB. The means among 3 trials were used to extract the absolute strength and the left and the right limb strengths. No between-session differences were found (P range = .691-.981). The intraclass correlation coefficient range showed excellent results (.905-.926), as the Cronbach α test (above .94). The correlation was high (r > .91; .820 < r2 < .862). The Bland-Altman analysis returned high levels of agreement. The standard error of measurement ranged from 5.56 to 11.07 N and the minimal detectable change from 15.42 to 30.68 N. The percentage of standard error of measurement values were 2.95%, 3.74%, 2.88%, respectively, for absolute strength, right limb strength, and left limb strength. The adapted system showed an excellent cost-benefit relationship with optimal test-retest reliability. The findings suggest that the adapted system, using the WBB, is a reliable method for measuring the eccentric knee strength.
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Nishida S, Nakamura M, Kiyono R, Sato S, Yasaka K, Yoshida R, Nosaka K. Relationship between Nordic hamstring strength and maximal voluntary eccentric, concentric and isometric knee flexion torque. PLoS One 2022; 17:e0264465. [PMID: 35213652 PMCID: PMC8880649 DOI: 10.1371/journal.pone.0264465] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/10/2022] [Indexed: 12/03/2022] Open
Abstract
Nordic hamstring exercise is performed to prevent knee flexor muscle strain injuries and used to assess their injury risks. However, what exactly Nordic hamstring strength indicates is not clear. We investigated the relationship between Nordic hamstring strength and maximal voluntary contraction (MVC) torque of the knee flexors measured by an isokinetic dynamometer. Sixteen healthy young men who had not experienced hamstring strain injuries participated in the study. In Nordic hamstring, each participant was instructed to lean forward as far as possible in 3 s (approximately 30°/s), and force at the ankle joint of the dominant leg was measured during the movement. The force was multiplied by lower leg length and converted into torque. MVC torque of the knee flexors was measured isometrically at 30°, 45°, 60°, and 90° knee flexion joint angles, and concentrically and eccentrically at 30°/s and 60°/s in 10°–90° knee flexion for the dominant leg in a prone position. Correlations among the dependent variables were assessed using Pearson’s correlation coefficients. Peak Nordic hamstring torque ranged 96.8–163.5 Nm, and peak MVC eccentric torque ranged 50.7–109.4 Nm at 30°/s and 59.2–121.2 Nm at 60°/s. No significant correlations were evident between the peak Nordic hamstring torque and peak eccentric knee flexion torque (r = 0.24–0.3, p = 0.26–0.4). This was also the case for the Nordic hamstring torque and MVC torque of isometric (r = −0.03–0.1, p = 0.71–0.92) and concentric contractions (r = 0.28–0.49, p = 0.053–0.29). These results show that Nordic hamstring strength is not associated with the knee flexor torque measured by an isokinetic dynamometer. It may be that other factors than static and dynamic hamstring strengths affect Nordic hamstring strength.
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Affiliation(s)
- Satoru Nishida
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka, Japan
- * E-mail:
| | - Masatoshi Nakamura
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Ryosuke Kiyono
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Shigeru Sato
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Koki Yasaka
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Riku Yoshida
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Kazunori Nosaka
- Center for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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The Dose-Response of the Nordic Hamstring Exercise on Biceps Femoris Architecture and Eccentric Knee Flexor Strength: A Randomized Interventional Trial. Int J Sports Physiol Perform 2022; 17:646-654. [PMID: 35176727 DOI: 10.1123/ijspp.2021-0276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/24/2021] [Accepted: 09/16/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE To examine the dose-response of the Nordic hamstring exercise (NHE) on biceps femoris long head (BFlh) architecture and eccentric knee flexor strength. DESIGN Randomized interventional trial. METHODS Forty recreationally active males completed a 6-week NHE training program consisting of either intermittent low volumes (group 1; n = 10), low volumes (group 2; n = 10), initial high volumes followed by low volumes (group 3; n = 10), or progressively increasing volumes (group 4; n = 10). A 4-week detraining period followed each program. Muscle architecture was assessed weekly during training and after 2 and 4 weeks of detraining. Eccentric knee flexor strength was assessed preintervention and postintervention and after 2 and 4 weeks of detraining. RESULTS Following 6 weeks of training, BFlh fascicle length (FL) increased in group 3 (mean difference = 0.83 cm, d = 0.45, P = .027, +7%) and group 4 (mean difference = 1.48 cm, d = 0.94, P = .004, +14%). FL returned to baseline following detraining in groups 3 and 4. Strength increased in group 2 (mean difference = 53.6 N, d = 0.55, P = .002, +14%), group 3 (mean difference = 63.4 N, d = 0.72, P = .027, +17%), and group 4 (mean difference = 74.7, d = 0.83, P = .006, +19%) following training. Strength returned to baseline following detraining in groups 2 and 3 but not in group 4. CONCLUSIONS Initial high volumes of the NHE followed by lower volumes, as well as progressively increasing volumes, can elicit increases in BFlh FL and eccentric knee flexor strength. Low volumes of the NHE were insufficient to increase FL, although as few as 48 repetitions in 6 weeks did increase strength.
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