Individual Region- and Muscle-specific Hamstring Activity at Different Running Speeds

Regional differences in amplitude and spatial homogeneity of muscle activity in the biceps femoris long head

PURPOSE

Hamstring injuries, particularly in the proximal Biceps femoris long head (BFlh), remain frequent in sports involving sprints and accelerations despite extensive research. Non-uniform muscle activity may contribute to these injuries by causing uneven load distribution. This study examines spatial homogeneity of muscle activity and amplitude in the proximal and distal BFlh at different knee flexion torque levels and muscle-tendon unit (MTU) lengths under controlled isometric conditions.

METHODS

Fifteen male recreational athletes performed unilateral isometric knee flexion contractions at three MTU lengths (0°, 45°, 90° hip flexion) and torque levels (30% MVC90, 60% MVC90, 90%MVC90) with high-density surface electromyography (HDsEMG) assessing proximal and distal activity.

RESULTS

The proximal BFlh exhibited lower spatial homogeneity and amplitude compared to the distal region across all conditions, with the largest homogeneity differences at lower torques and longer MTU lengths. Proximal homogeneity increased with torque and decreased with MTU length, while the distal region remained consistent. Amplitudes were lower proximally and decreased with MTU length in both regions.

CONCLUSION

The proximal-distal differences in spatial homogeneity and amplitude within the BFlh reflect non-uniform activation patterns along the BFlh and the proximal regions lower spatial homogeneity and amplitude of activation reflect non-uniform patterns, possibly contributing to injury risk.

Evolving the Control-Chaos Continuum: Part 2-Shifting "Attention" to Progress On-Pitch Rehabilitation

BACKGROUND: On-pitch rehabilitation is key to supporting return to sport in elite soccer (football). The control-chaos continuum (CCC) guides practitioners through the sport-specific components of return to sport. There is a need to update the framework with recent research in injury neurophysiology, soccer performance, and coaching science. CLINICAL QUESTION: How do practitioners integrate the insights from injury neurophysiology, soccer performance, and coaching science discussed in part 1 of this 2-part series into an updated version of the CCC, to enhance the planning and execution of on-pitch rehabilitation for elite soccer players? KEY RESULTS: The revised CCC framework emphasizes the design and delivery of progressive training in increasingly chaotic conditions. The updated framework supports practitioners to incorporate elements of visual-cognitive challenges, attentional challenges, decision making, and progression representation of the game model when players are preparing to return to sport. CLINICAL APPLICATION: The updated CCC outlines training progression from High Control, which involves returning to on-pitch linear running, to High Chaos, which simulates the team environment at game speed. The High Chaos phase can be tailored to support players during their reintegration into team training. The model is adaptable for both short- and long-term injuries, integrating physical-cognitive load monitoring and strength and power diagnostics to enhance decision making throughout return to sport. J Orthop Sports Phys Ther 2025;55(3):1-11. Epub 17 January 2025. doi:10.2519/jospt.2025.13159.

The Effect of the Nordic Hamstring Exercise on Hamstring Muscle Activity Distribution During High-Speed Running Estimated Using Multichannel Electromyography: A Pragmatic Randomized Controlled Trial

OBJECTIVE

To evaluate the effect of the Nordic hamstring exercise on normalized muscle activity and relative contribution of the biceps femoris long head, semitendinosus, and semimembranosus through multichannel electromyography in the late-swing phase of high-speed running.

DESIGN

A pragmatic, 2-arm, single-center randomized controlled trial. Participants were randomly assigned to a Nordic group or control group.

SETTING

Dutch male basketball.

PARTICIPANTS

Twenty injury-free players (mean age 18 ± 3 years).

INTERVENTION

A 12-week Nordic hamstring exercise intervention.

MAIN OUTCOME MEASURES

Level of normalized muscle activity (percentage maximal voluntary isometric contraction [%MVIC]) and relative contribution (%con) of hamstring muscles for 12 weeks.

RESULTS

The Nordic hamstring exercise intervention did not result in significant changes for 12 weeks. For normalized muscle activity, between-group differences (compared with the control group) for 12 weeks were 11.4 %MVIC (95% confidence interval [95% CI]: -11.0, 33.8) for the biceps femoris long head, -9.4 %MVIC (95% CI: -23.3, 5.2) for the semitendinosus, and -2.7 %MVIC (95% CI: -15.8, 10.3) for the semimembranosus, P = 0.151. For relative contribution, between-group differences for 12 weeks were -6.1 %con (95% CI: -2.4, 14.6) for the biceps femoris long head, -7.0 %con (95% CI: -13.6, -0.4) for the semitendinosus, and 0.9 %con (95% CI: -9.2, 11.0) for the semimembranosus P = 0.187. Positive values are in favor of the Nordic group.

CONCLUSIONS

A 12-week Nordic hamstring exercise intervention did not affect the level of muscle activity and relative contribution of hamstring muscles in the late-swing phase of high-speed running. Because of the low amount of data sets, results should be interpreted cautiously.

Return to Performance of a Soccer Player with an Adductor Longus Injury: A Case Report

Context: There is limited information on the quantification of external load and reconditioning programs during adductor longus injuries in soccer. Case Presentation: This case report describes a male professional soccer player (LaLiga) returning to performance following an adductor longus muscle injury during the 2022/2023 season. The player suffered the injury during a change of direction in a match. The injury was confirmed by ultrasound after 48 h, and the previously validated rehabilitation and reconditioning program was applied to the injured player. This case report has focused on the development of the on-field reconditioning program and the quantification of the load during this phase. The goal of this case report was to return the player to pre-injury loads using global positioning systems (GPS). Variables such as total distance, distances covered at different speeds and metabolic load variables were quantified during the injury process, with the aim of increasing them through training and reaching at least 75% of the game load. Therefore, objective performance criteria for making return-to-play decisions based on the use of GPS was determined. In addition, the return to play (RTP) was on the 20th day after the injury, and then four RTPs were recorded in the following 6 weeks after the injury occurred, without re-injury. Conclusions: The approach to the competition performance profile, through the quantification of the external load during the rehabilitation process of the injured player, allowed us a safe return to competition and continued competition with a 6-week follow-up.

Posterior thigh muscles activity during the active H-test: An electromyographic and kinematic analysis

The Askling's H-test is considered a useful return to play criterion after a hamstring muscle injury (HMI). However, it assesses only the active and passive flexibility of posterior thigh muscles. This may lead the practitioner to underestimate a compensation or abnormal movement pattern. The aim of this study was to analyze these kinematic aspects and their reliability, and evaluate the hamstring (HM) and gluteus maximus (GM) muscles' activities. Twelve healthy male volunteers were tested during two session of three trials for passive and active tests. Dynamic flexibility (97.2 ± 6.0°) was significantly greater than the passive one (70.5 ± 14.7°) (p < 0.001), and good intra-individual reproductibility for most kinematic characteristics was observed. Biceps Femoris long head, semitendinosus and GM mean activities (20.1 ± 11.2%; 14.3 ± 7.3% and 25.2 ± 22.1%, respectively) were found to be low to moderate, indicating that only a moderate level of activity occurred during the active H-test, in comparison to other movements such as sprinting itself. In addition, the activity of the posterior thigh muscles during the active H-test appeared to be variable among the volunteers. These findings suggest that the H-test should be interpreted on an individual basis rather than relying on general characteristics, and be considered as an intermediate tool before more strenuous activities such as returning to sprint. With this comprehensive approach, clinicians can gain a more accurate understanding of their patients' progress and make more informed decisions about their readiness to return to play.

Muscle Activity and Kinematics During Three Hamstring Strengthening Exercises Compared to Sprinting: A Cross-Sectional Study

Background

During sprinting, the biceps femoris long head predominantly gets injured, while hamstring strengthening exercises predominantly activate the semitendinosus more effectively. Understanding how joint dominance influences hamstring activity may offer clarity on appropriate exercise selection in strengthening programs.

Purpose

This study compared three hip-dominant hamstring exercises: the rocker, perpetuum mobile fast and slow (PMfast and PMslow) and the Nordic Hamstring exercise (NHE) on their potential to simulate sprint-like activity and kinematics.

Methods

Muscle activity of the posterior kinetic chain (biceps femoris, semitendinosus, gluteus maximus, and medial gastrocnemius) was measured with surface electromyography (sEMG) during the exercises and treadmill running at 75% of the individual maximal sprint velocity in male athletes. sEMG data were normalized to maximal sprinting. 3D-motion capture was employed to assess hip and knee angles.

Results

Eight male athletes were included (age: 24.0 years ± SD 2.9; body mass: 76.8 kg ± 7.7; height: 1.79 m ± 0.08). Greater activity of the hamstrings occurred during the explosive exercises ranging from 63.9% [95%CI: 56.3-71.5%] (rocker) to 49.0% [95%CI: 40.4-57.6%] (PMfast) vs. 34.0% [95%CI: 29.1-38.9%] (NHE) to 32.1% [95%CI: 26.9-37.3%] (PMslow). The rocker showed greatest hamstring and gluteus maximus activity. Biceps femoris consistently showed greater activity than the semitendinosus across all exercises in peak (mean difference: 0.16, [95%CI: 0.07-0.26]) and average (mean difference: 0.06, [95%CI: 0.01-0.11]) activity. PMfast, PMslow and NHE demonstrated less hip flexion angle at peak hamstring activity than the rocker and high-speed running and every exercise showed less hamstring elongation stress than during high-speed running.

Discussion

Hamstring activity is comparable to high-intensity treadmill running for NHE and PMslow, and greater for the rocker and PMfast. Gluteus maximus activity varied, with the rocker and PMfast showing greater activity than in sprinting. All examined exercises demonstrated their peak activity at short hamstring muscle length.

Level of evidence

3b.

Hip Contact Forces During Sprinting in Femoroacetabular Impingement Syndrome

PURPOSE

Sprinting often provokes hip pain in individuals with femoroacetabular impingement syndrome (FAIS). Asphericity of the femoral head-neck junction (cam morphology) characteristic of FAIS can increase the risk of anterior-superior acetabular cartilage damage. This study aimed to 1) compare hip contact forces (magnitude and direction) during sprinting between individuals with FAIS, asymptomatic cam morphology (CAM), and controls without cam morphology, and 2) identify the phases of sprinting with high levels of anteriorly directed hip contact forces.

METHODS

Forty-six recreationally active individuals with comparable levels of physical activity were divided into three groups (FAIS, 14; CAM, 15; control, 17) based on their history of hip/groin pain, results of clinical impingement tests, and presence of cam morphology (alpha angle >55°). Three-dimensional marker trajectories, ground reaction forces, and electromyograms from 12 lower-limb muscles were recorded during 10-m overground sprinting trials. A linearly scaled electromyogram-informed neuromusculoskeletal model was used to calculate hip contact force magnitude (resultant, anterior-posterior, inferior-superior, medio-lateral) and angle (sagittal and frontal planes). Between-group comparisons were made using two-sample t -tests via statistical parametric mapping ( P < 0.05).

RESULTS

No significant differences in magnitude or direction of hip contact forces were observed between FAIS and CAM or between FAIS and control groups during any phase of the sprint cycle. The highest anteriorly directed hip contact forces were observed during the initial swing phase of the sprint cycle.

CONCLUSIONS

Hip contact forces during sprinting do not differentiate recreationally active individuals with FAIS from asymptomatic individuals with and without cam morphology. Hip loading during early swing, where peak anterior loading occurs, may be a potential mechanism for cartilage damage during sprinting-related sports in individuals with FAIS and/or asymptomatic cam morphology.

Quantifying demands on the hamstrings during high-speed running: A systematic review and meta-analysis

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.

Do non-contact injuries occur during high-speed running in elite football? Preliminary results from a novel GPS and video-based method

OBJECTIVES

Understanding how injuries occur (inciting circumstances) is useful for developing etiological hypotheses and prevention strategies. The aims of this study were 1) to evaluate the feasibility of a method combining video and Global Positioning System data to estimate the speed and acceleration of activities leading to injuries and 2) to use this method to analyse the inciting circumstances leading to non-contact injuries.

DESIGN

Retrospective descriptive study.

METHODS

Injury inciting circumstances from 46 elite players over three seasons were analysed from video recordings and from external load measures collected through Catapult Vector S7 Global Positioning System.

RESULTS

In total 34 non-contact injuries were analysed. Sixteen out of the seventeen hamstring injuries occurred when players were running for (median and interquartile range) 16.75 m (8.42-26.65 m) and achieved a peak speed of 29.28 km·h-1 (26.61-31.13 km·h-1) which corresponded to 87.55 % of players' maximal speed (78.5 %-89.75 %). Of the three adductor injuries, one occurred whilst the player was decelerating without the ball, one occurred whilst the player was accelerating and controlling the ball at knee level, and one occurred whilst the player was performing an instep kick. Two quadriceps injuries occurred whilst the players were kicking either whilst walking or running.

CONCLUSIONS

From the preliminary results reported in this study most hamstring injuries occurred when players ran >25 km·h-1 and above 80 % of their maximal speed. This study suggests that this novel approach can allow a detailed and standardised analysis of injury inciting circumstances.

An Acute Transition from Rearfoot to Forefoot Strike does not Induce Major Changes in Plantarflexor Muscles Activation for Habitual Rearfoot Strike Runners

Footstrike pattern has received increased attention within the running community because there is a common belief that forefoot strike running (FFS) is more advantageous (i.e., improve performance and reduce running injuries) than rearfoot strike running (RFS) in distance running. Literature reports suggest greater knee joint flexion magnitude and initial knee angle during stance in FFS compared with RFS running We examined the EMG activation of the triceps surae muscles during an acute transition from RFS to FFS strike. We tested the hypothesis that due to larger knee flexion in FFS the gastrocnemius muscles possibly decrease their EMG activity because muscle fascicles operate under unfavorable conditions. Fourteen competitive healthy middle- and long-distance runners who were habitual RFS runners ran on a treadmill at three speeds: 12, 14, and 16 km·h-1. Each running speed was performed with both FFS and RFS patterns. Lower limb kinematics in the sagittal plane and normalized electromyography (EMG) activity of medial gastrocnemius proximal, middle and distal regions, lateral gastrocnemius and soleus muscles were compared between footstrike patterns and running speeds across the stride cycle. Contrary to our expectations, the knee joint range of motion was similar in FFS and RFS running. However, the sagittal plane ankle joint motion was greater (p < 0.01) while running with FFS, resulting in a significantly greater muscle-tendon unit lengthening (p < 0.01) in FFS compared with RFS running. In addition, medial and lateral gastrocnemius showed higher EMG activity in FFS compared with RFS running in the late swing and early stance but only for a small percentage of the stride cycle. However, strike patterns and running speed failed to induce region-specific activation differences within the medial gastrocnemius muscle. Overall, well-trained RFS runners are able to change to FFS running by altering only the ankle joint kinematics without remarkably changing the EMG activity pattern.

Activity distribution among the hamstring muscles during high-speed running: A descriptive multichannel surface EMG study

PURPOSE

This study assessed activity distribution among the hamstring muscles during high-speed running. The objective was to compare within and between muscle activity, relative contribution and hip and knee joint angles at peak muscle activity during high-speed running.

METHODS

Through multichannel electromyography, we measured muscle activity in male basketball players during high-speed running on a treadmill at 15 locations: five for biceps femoris long head, four for semitendinosus, and six for semimembranosus. Muscle activity was calculated for each location within each hamstring muscle individually for each percent of a stride cycle.

RESULTS

Twenty-nine non-injured basketball players were included (mean age: 17 ± 1 years; mass, 85 ± 9 kg; height, 193 ± 9 cm). Heterogeneous activity was found for all individual hamstring muscles across multiple events of the stride cycle. In the late-swing phase, muscle activity and relative contribution of the semimembranosus was significantly higher than of the semitendinosus. There was no significant difference in hip and knee joint angles at instant of peak muscle activity, assessed locally within individual hamstring muscles, as well as in general over the whole hamstring muscle.

CONCLUSION

Hamstring muscles were most active in the late-swing phase during high-speed running. In this phase, the semimembranosus was most active and the semitendinosus was least active. Within the biceps femoris long head, the most proximal region was significantly more active in the late-swing phase, compared to other muscle regions. For each muscle and location, peak muscle activity occurred at similar hip and knee joint angles.

Effects of Fatigue Induced by Repeated Sprints on Sprint Biomechanics in Football Players: Should We Look at the Group or the Individual?

The aim of this study was to analyse the influence of fatigue on sprint biomechanics. Fifty-one football players performed twelve maximal 30 m sprints with 20 s recovery between each sprint. Sprint kinetics were computed from running speed data and a high-frequency camera (240 Hz) was used to study kinematic data. A cluster analysis (K-mean clustering) was conducted to classify individual kinematic adaptations. A large decrease in maximal power output and less efficiency in horizontally orienting the ground reaction force were observed in fatigued participants. In addition, individual changes in kinematic components were observed, and, according to the cluster analysis, five clusters were identified. Changes in trunk, knee, and hip angles led to an overall theoretical increase in hamstring strain for some players (Cluster 5, 20/51) but to an overall decrease for some others (Cluster 1, 11/51). This study showed that the repeated sprint ability (RSA) protocol had an impact on both kinetics and kinematics. Moreover, fatigue affected the kinematics in a different way for each player, and these individual changes were associated with either higher or lower hamstring length and thus strain.

The Association between Pre-season Running Loads and Injury during the Subsequent Season in Elite Gaelic Football

The aim of this study was to determine if the quantity of running load performed in pre-season affects the incidence of injury in elite Gaelic footballers. It was hypothesized that a greater quantity of running loads completed will reduce the incidence rate of injury. A cohort of elite male Gaelic football players (n = 25) was prospectively monitored throughout one full season. This longitudinal study involved the collection of GPS data and injury data. Participants were retrospectively divided into two groups and assigned to a high (HTL, completed >50% of pre-season sessions, n = 13) or low (LTL, completed <50% of pre-season sessions, n = 12) training load group based on the percentage of pre-season sessions completed. Data for total distance, PlayerLoad™, meters covered at running speeds (4.0−4.84 m/s), meters covered at high running speeds (4.85−6.39 m/s), meters covered at sprint speeds (>6.4 m/s) and high-intensity running meters (high-speed running meters and sprint meters combined) were collected during all sessions. A one-way analysis of variance (ANOVA) was completed to understand the variation of external training load data across the different phases of the season. A series of repeated measures of ANOVA were subsequently completed to understand the variation of external training load data across seasonal phases within the training groups. Although the LTL group had a higher incidence rate of non-contact injuries (large effect size) per 1000 h of exposure in each phase of the season, statistical analysis revealed that there was no significant difference (F = 4.32, p = 0.173, partial η2 = 0.684, large) between the HTL (14.9 ± 4.17/1000 h) and the LTL (24.5 ± 7.36/1000 h) groups. Additionally, the HTL group was able to sustain greater running loads in the competitive phases of the season compared to the LTL group, total distance (F = 8.10, p < 0.001, partial η2 = 0.299, large), high-speed running distance (F = 8.74, p < 0.001, partial η2 = 0.304, large) and high-intensity running distance (F = 7.63, p < 0.001, partial η2 = 0.276, large). Furthermore, players who complete a greater proportion of running loads in pre-season may alter their body composition levels to more optimal levels, which in turn may reduce the risk of injury while also helping increase or maintain performance-related fitness markers such as aerobic fitness.

Sub-elite sprinters and rugby players possess different morphological characteristics of the individual hamstrings and quadriceps muscles

Numerous studies have clarified that sprinters possess unique morphological characteristics of the thigh muscles compared with non-athletes. However, little evidence is available regarding the morphological differences between sprinters and rugby players. This study aimed to examine the morphological differences in the individual hamstrings and quadriceps femoris muscles between sub-elite sprinters and rugby players. Ultrasound images were acquired from the proximal, middle, and distal regions of the thigh. From the images, the anatomical cross-sectional areas were calculated for 14 sub-elite sprinters, 14 rugby players, and 14 non-athletes. The calculated anatomical cross-sectional areas were normalized to two-thirds power of the body mass, and the normalized values of all regions were averaged as those of the individual muscles. In the hamstrings, the sizes of the biceps femoris short head and semitendinosus were greater in the sprinters than in the rugby players and/or non-athletes (all p < 0.05). In contrast, in the quadriceps femoris, the sizes of the rectus femoris, vastus lateralis, and vastus intermedius were the greatest in the rugby players (all p < 0.05). In the middle region of the biceps femoris short head and the proximal-middle regions of the semitendinosus, the muscle sizes were greater in the sprinters than in the rugby players (all p < 0.05), and vice versa in the middle-distal regions of the rectus femoris (all p < 0.05). These results suggest that 1) sub-elite sprinters possess larger sizes of the biceps femoris short head and semitendinosus, whereas rugby players have larger sizes of the rectus femoris, vastus lateralis, and vastus intermedius, and 2) each of the athletes has different size distributions, especially along the lengths of BFsh, ST, and RF. The findings of the present study would be helpful for rugby players in designing training regimens aimed at enhancing sprint performance.

Novel Insights Into Biarticular Muscle Actions Gained From High-Density Electromyogram

Biarticular muscles have traditionally been considered to exhibit homogeneous neuromuscular activation. The regional activation of biarticular muscles, as revealed from high-density surface electromyograms, seems however to discredit this notion. We thus hypothesize the regional activation of biarticular muscles may contribute to different actions about the joints they span. We then discuss the mechanistic basis and methodological implications underpinning our hypothesis.

Fatigue induces altered spatial myoelectric activation patterns in the medial gastrocnemius during locomotion

This research investigates the effects of muscle fatigue on spatial myoelectric patterns in the lower limb during locomotion. Both spatial and frequency aspects of neuromuscular recruitment in the medial gastrocnemius change in response to fatigue, resulting in altered myoelectric patterns during walking and running. These data may help us better understand the adaptations that occur in lower limb muscles to avoid overuse injuries caused by fatigue.

Contribution of the peroneus longus neuromuscular compartments to eversion and plantarflexion of the ankle

Compartmentalization of animal and human skeletal muscle by multiple motor nerve branches known as the neuromuscular compartment (NMC) has been observed primarily in muscles that participate in a plane of motion. In this context, the peroneus longus muscle contributes to eversion and plantarflexion of the ankle and the presence of NMCs has been reported. However, no research has reported the selective activation of the compartments of the peroneus longus during the performance of different ankle movements. The purpose of this research was to determine the contribution of peroneus longus NMCs, through multi-channel surface electromyography (sEMG), to eversion and plantarflexion movements. Multi-channel sEMG was recorded from the peroneus longus muscle by using an electrode grid during eversion and plantarflexion of the ankle at 10%, 30%, 50%, and 70% of maximal voluntary isometric contraction (MVIC). The root mean square and displacement of the center of mass position in the X (COMx) and Y (COMy) components were calculated. The primary finding was that eversion showed significantly higher sEMG amplitude than plantarflexion in the posterior compartment in low, moderate, and high percentages of MVIC. However, no significant difference in sEMG amplitude was observed in the anterior compartment between eversion and plantarflexion. In addition, a posterior displacement of the COMx in eversion compared to plantarflexion in all MVIC percentages, with greater topographic distancing of the COMx at higher levels of activation. In conclusion, the peroneus longus muscle presented NMCs; the anterior compartment contributed to both eversion and plantarflexion movements, whereas the posterior compartment mainly contributed to the eversion movement of the ankle in low, moderate, and high percentages of MVIC.

Gluteus and posterior thigh muscle sizes in sprinters: Their distributions along muscle length

Muscle hypertrophy can occur non-uniformly in athletes who repetitively perform particular movements, presumably leading to a unique muscle size distribution along the length. The present study aimed to examine if sprinters have unique size distributions within the gluteus and posterior thigh muscles. Nineteen male sprinters and 20 untrained males participated in the present study. T1-weighted magnetic resonance images of the hips and right thigh were obtained in order to determine whole and regional (proximal, middle, and distal) volumes of the gluteus maximus and individual posterior thigh muscles. The results showed that the volumes of all the examined muscles relative to body mass were significantly larger in sprinters than in untrained males (all P < 0.001, d = 1.40-3.29). Moreover, the magnitude of the difference in relative volume between sprinters and untrained males was different between the regions within the gluteus maximus (P = 0.048, partial η² = 0.187), semitendinosus (P = 0.004, partial η² = 0.331), and adductor magnus (P = 0.007, partial η² = 0.322), but not within the other posterior thigh muscles (P = 0.091-0.555, partial η² = 0.025-0.176). The magnitude of the difference in relative volume between the sprinters and untrained males was greatest in the distal regions within the gluteus maximus and semitendinosus, while the proximal region within the adductor magnus. These findings indicate that sprinters have unique size distributions within the gluteus maximus, semitendinosus, and adductor magnus, which may be attributed to their competitive and training activities. HighlightsSprinters showed larger gluteus maximus and individual posterior thigh muscles than untrained males.The magnitude of difference varied within the gluteus maximus, semitendinosus, and adductor magnus.The greatest difference was found in distal regions within the gluteus maximus and semitendinosus, while proximal region within the adductor magnus.

Validity of a Rehab and Reconditioning Program Following an Adductor Longus Injury in Professional Soccer

CONTEXT

The high rates of adductor injuries and reinjuries in soccer have suggested that the current rehabilitation programs may be insufficient; therefore, there is a need to create prevention and reconditioning programs to prepare athletes for the specific demands of the sport.

OBJECTIVE

The aim of this study is to validate a rehab and reconditioning program (RRP) for adductor injuries through a panel of experts and determine the effectiveness of this program through its application in professional soccer.

DESIGN

A 20-item RRP was developed, which was validated by a panel of experts anonymously and then applied to 12 injured male professional soccer players.

SETTING

Soccer pitch and indoor gym.

PARTICIPANTS

Eight rehabilitation fitness coaches (age = 33.25 [2.49] y) and 8 academic researchers (age = 38.50 [3.74] y) with PhDs in sports science and/or physiotherapy. The RRP was applied to 12 male professional players (age = 23.75 [4.97] y; height = 180.56 [8.41] cm; mass = 76.89 [3.43] kg) of the Spanish First and Second Division (La Liga).

INTERVENTIONS

The experts validated an indoor and on-field reconditioning program, which was based on strengthening the injured muscle and retraining conditional capacities with the aim of reducing the risk of reinjury.

MAIN OUTCOME MEASURES

Aiken V for each item of the program and number of days taken by the players to return to full team training.

RESULTS

The experts evaluated all items of the program very highly as seen from Aiken V values between 0.77 and 0.94 (range: 0.61-0.98) for all drills, and the return to training was in 13.08 (±1.42) days.

CONCLUSION

This RRP following an injury to the adductor longus was validated by injury experts, and initial results suggested that it could permit a faster return to team training.

Muscle size of individual hip extensors in sprint runners: Its relation to spatiotemporal variables and sprint velocity during maximal velocity sprinting

Hip extensor muscle size is related to sprint running performance. However, the mechanisms underlying this relationship remain unclear. To gain insights into this issue, the present study examined the relationships between the individual hip extensor sizes, spatiotemporal variables (step frequency and length, and their determinants), and sprint velocity during maximal velocity sprinting. Magnetic resonance images of the hip and right thigh were obtained from 26 male sprinters to determine the volumes of the gluteus maximus, individual hamstrings and adductors, and gracilis. Muscle volumes were normalized to their respective body mass and recorded as relative muscle volumes. The sprinters performed a 100-m sprint with their maximal effort. Their sprint motions were recorded using cameras to calculate the mean sprint velocity and the spatiotemporal variables at 50–60 m interval. The sprint velocity was significantly correlated with the relative volume of the semitendinosus (r = 0.497, P = 0.010), but not with the volumes of the other examined muscles. The relative volume of semitendinosus significantly correlated with the stance distance (r = 0.414, P = 0.036) and the stance distance adjusted by the stance time (r = 0.490, P = 0.011). Moreover, there were significant correlations between the stance distance and step length (r = 0.592, P = 0.001), and between the step length and sprint velocity (r = 0.509, P = 0.008). These results suggest that the semitendinosus contributes to attaining long stance distance and thereby high sprint velocity during maximal velocity sprinting.

Superimposing hip extension on knee flexion evokes higher activation in biceps femoris than knee flexion alone

Hamstring muscle function during knee flexion has been linked to hamstring injury and performance. However, it is unclear whether knee flexion alone (KF) requires similar hamstring electromyography (EMG) activity pattern to simultaneous hip extension and knee flexion (HE-KF), a combination that occurs in the late swing phase of sprinting. This study examined whether HE-KF maximal voluntary isometric contraction (MVIC) evokes higher (EMG) activity in biceps femoris long head (BFlh) and semitendinosus (ST) than KF alone. Effects of shank rotation angles were also tested. Twenty-one males performed the above-mentioned MVICs while EMG activity was measured along ST and BFlh. Conditions were compared using a one-way mixed functional ANOVA model under a fully Bayesian framework. Higher EMG activity was found in HE-KF in all shank rotation positions than in KF in the middle region of BFlh (highest in the 9th channel, by 0.022 mV [95%CrI 0.014 to 0.030] in neutral shank position). For ST, this was only observed in the neutral shank position and in the most proximal channel (by 0.013 mV [95%CrI 0.001 to 0.025]). We observed muscle- and region-specific responses to HE-KF. Future studies should examine whether hamstring activation in this task is related to injury risk and sprint performance.

Lower limb muscle injury location shift from posterior lower leg to hamstring muscles with increasing discipline-related running velocity in international athletics championships

OBJECTIVE

To analyse the rates of lower limb muscle injuries in athletics disciplines requiring different running velocities during international athletics championships.

DESIGN

Prospective total population study.

METHODS

During 13 international athletics championships (2009-2019) national medical teams and local organizing committee physicians daily reported all newly incurred injuries using the same study design, injury definition and data collection procedures. In-competition lower limb muscle injuries of athletes participating in disciplines involving running (i.e. sprints, hurdles, jumps, combined events, middle distances, long distances, and marathon) were analysed.

RESULTS

Among the 12,233 registered athletes, 344 in-competition lower limb muscle injuries were reported (36% of all in-competition injuries). The proportion, incidence rates and injury burden of lower limb muscles injuries differed between disciplines for female and male athletes. The most frequently injured muscle group was hamstring in sprints, hurdles, jumps, combined events and male middle distances runners (43-75%), and posterior lower leg in female middle distances, male long distances, and female marathon runners (44-60%). Hamstring muscles injuries led to the highest burden in all disciplines, except for female middle distance and marathon and male long distance runners. Hamstring muscles injury burden was generally higher in disciplines requiring higher running velocities, and posterior lower leg muscle injuries higher in disciplines requiring lower running velocities.

CONCLUSIONS

The present study shows discipline-specific injury location in competition context. Our findings suggest that the running velocity could be one of the factors that play a role in the occurrence/location of muscle injuries.

Sprint Specificity of Isolated Hamstring-Strengthening Exercises in Terms of Muscle Activity and Force Production

To train hamstring muscle specifically to sprint, strengthening programs should target exercises associated with horizontal force production and high levels of hamstring activity. Therefore, the objectives of this study were to analyze the correlation between force production capacities during sprinting and hamstring strengthening exercises, and to compare hamstring muscle activity during sprinting and these exercises. Fourteen track and field regional level athletes performed two maximal 50-m sprints and six strengthening exercises: Nordic hamstring exercises without and with hip flexion, Upright-hip-extension in isometric and concentric modalities, Standing kick, and Slide-leg-bridge. The sprinting horizontal force production capacity at low (F0) and high (V0) speeds was computed from running velocity data. Hamstring muscle performances were assessed directly or indirectly during isolated exercises. Hamstring muscle electromyographic activity was recorded during all tasks. Our results demonstrate substantially large to very large correlations between V0 and performances in the Upright-hip-extension in isometric (r_s = 0.56; p = 0.040), Nordic hamstring exercise without hip flexion (r_s = 0.66; p = 0.012) and with 90° hip flexion (r_s = 0.73; p = 0.003), and between F0 and Upright-hip-extension in isometric (r_s = 0.60; p = 0.028) and the Nordic hamstring exercise without hip flexion (r_s = 0.59; p = 0.030). However, none of the test exercises activated hamstring muscles more than an average of 60% of the maximal activation during top-speed sprinting. In conclusion, training programs aiming to be sprint-specific in terms of horizontal force production could include exercises such as the Upright-hip-extension and the Nordic hamstring exercise, in addition to maximal sprinting activity, which is the only exercise leading to high levels of hamstring muscle activity.

Eccentric Strength Assessment of Hamstring Muscles with New Technologies: a Systematic Review of Current Methods and Clinical Implications

BACKGROUND

Given the severe economic and performance implications of hamstring injuries, there are different attempts to identify their risk factors for subsequently developing injury prevention strategies to reduce the risk of these injuries. One of the strategies reported in the scientific literature is the application of interventions with eccentric exercises. To verify the effectiveness of these interventions, different eccentric strength measurements have been used with low-cost devices as alternatives to the widespread used isokinetic dynamometers and the technically limited handheld dynamometers. Therefore, the purpose of the present systematic review was to summarize the findings of the scientific literature related to the evaluation of eccentric strength of hamstring muscles with these new technologies.

METHODS

Systematic searches through the PubMed, Scopus, and Web of Science databases, from inception up to April 2020, were conducted for peer reviewed articles written in English, reporting eccentric strength of hamstrings assessed by devices, different to isokinetic and handheld dynamometers, in athletes.

RESULTS

Seventeen studies were finally included in the review with 4 different devices used and 18 parameters identified. The pooled sample consisted of 2893 participants (97% male and 3% female: 22 ± 4 years). The parameters most used were peak force (highest and average), peak torque (average and highest), and between-limb imbalance (left-to-right limb ratio). There is inconsistency regarding the association between eccentric hamstrings strength and both injury risk and athletic performance. There is no standardized definition or standardization of the calculation of the used parameters.

CONCLUSIONS

The current evidence is insufficient to recommend a practical guide for sports professionals to use these new technologies in their daily routine, due to the need for standardized definitions and calculations. Furthermore, more studies with female athletes are warranted. Despite these limitations, the eccentric strength of hamstring muscles assessed by different devices may be recommended for monitoring the neuromuscular status of athletes.

Human myoelectric spatial patterns differ among lower limb muscles and locomotion speeds

The spatial distribution of myoelectric activity within lower limb muscles is often nonuniform and can change during different stationary tasks. Recent studies using high-density electromyography (EMG) have suggested that spatial muscle activity may also differ among muscles during locomotion, but contrasting electrode array sizes and experimental designs have limited cross-study comparisons. Here, we sought to determine if spatial EMG patterns differ among lower limb muscles and locomotion speeds. We recorded high-density EMG from the vastus medialis, tibialis anterior, biceps femoris, medial gastrocnemius, and lateral gastrocnemius muscles of 11 healthy subjects while they walked (1.2 and 1.6 m/s) and ran (2.0, 3.0, 4.0, and 5.0 m/s) on a treadmill. To overcome the detrimental effects of cable, electrode, and soft tissue movements on high-density EMG signal quality during locomotion, we applied multivariate signal cleaning methods. From these data, we computed the spatial entropy and center of gravity from the total myoelectric activity within each recording array during the stance or swing phases of the gait cycle. We found heterogeneous spatial EMG patterns evidenced by contrasting spatial entropy among lower limb muscles. As locomotion speed increased, mean entropy values decreased in four of the five recorded muscles, indicating that EMG signal amplitudes were more spatially heterogeneous, or localized, at faster speeds. The EMG center of gravity location also shifted in multiple muscles as locomotion speed increased. Contrasting myoelectric spatial distributions among muscles likely reflect differences in muscle architecture, but increasingly localized activity and spatial shifts in the center of gravity location at faster locomotion speeds could be influenced by preferential recruitment of faster motor units under greater loads.

Ultrasound-Guided Percutaneous Needle Electrolysis and Rehab and Reconditioning Program for Rectus Femoris Muscle Injuries: A Cohort Study with Professional Soccer Players and a 20-Week Follow-Up

Rectus femoris muscle strains are one of the most common injuries occurring in sports such as soccer. The purpose of this study was to describe the safety and feasibility of a combination of percutaneous needle electrolysis (PNE) and a specific rehab and reconditioning program (RRP) following an injury to the rectus femoris in professional soccer players. Thirteen professional soccer players received PNE treatment 48 h after a grade II rectus femoris muscle injury, followed by a the RRP 24 h later. Assessment of recovery from injury was done by registering the days taken to return to train (RTT), return to play (RTP), and structural and functional progress of the injured muscle was registered through ultrasound imaging and match-GPS parameters. Also, adverse events and reinjuries were recorded in the follow up period of twenty weeks. The RTT registered was 15.62 ± 1.80 days and RTP was 20.15 ± 2.79 days. After fourteen days, the ultrasound image showed optimal repair. Match-GPS parameters were similar before and after injury. There were no relapses nor were any serious adverse effects reported during the 20-week follow-up after the RTP. A combination of PNE and a specific RRP facilitated a faster RTP in previously injured professional soccer players enabling them to sustain performance and avoid reinjuries.

Managing the return to sport of the elite footballer following semimembranosus reconstruction

Hamstring strains are the most common injury in elite football and typically occur during high-speed running. Despite its important contribution to power production in the late swing phase, injury to the semimembranosus (SM) is less common than to the biceps femoris, but may involve the free tendon and depending on the degree of retraction, warrant surgical repair. Few case reports detail clinical reasoning, supported by objective data during rehabilitation in elite footballers, and none have described the return to sport (RTS) process following this type of hamstring injury. In this article, we outline the management and RTS of an English Premier League (EPL) footballer who suffered a high-grade SM proximal tendon tear during training. Due to the degree of retraction of the free tendon, the player underwent surgical reconstruction at the recommendation of an orthopaedic surgeon. Early physiotherapy care, nutritional support, on- and off-pitch injury-specific reconditioning and global athletic development are outlined, alongside strength and power diagnostic and global positioning systems data, assessment of pain, player feedback and MRI informed clinical reasoning and shared decision-making during the RTS process. 18 weeks post-surgery the player returned to team training, transferring to a new club 3 weeks later. 2.5 years post RTS, the player remains free of re-injury playing regularly in the EPL.

Understanding the association between external training load measures and injury risk in Elite Gaelic football

BACKGROUND

The current investigation examined the association between external training load variables and injury risk within elite Gaelic football.

METHODS

Workload and injury variables were collected from thirty-seven elite Gaelic footballers (mean±SD age of 24.2±2.9 years) from one elite squad across a two-season observational period. External training load variables included total distance (m), High speed running (m; ≥17.1 km·h^-1), Sprint distance (m; 22 km·h^-1), Accelerations (n), Average metabolic power (W·kg^-1), high-power distance (m; ≥25 W·kg^-1). Cumulative 1- weekly, 2-weekly, 3-weekly and 4-weekly training loads; acute: chronic workload ratio (ACWR) was analysed across specific distributions of low, moderate and high loading with respect to a reference group of the measure quantified. General estimating equations were utilized to understand the association of these variables with injury risk.

RESULTS

Strong associations (AUC>0.50) were observed amongst models developed for one weekly loading for relative distance, average metabolic power and high-power indices with similar trends observed for two, three and four weekly which showed a strong positive association within injury risk for all external loading metrics (AUC>0.50), with average metabolic power, and high-power distance showing the strongest association across the three-four week loading scales (AUC>0.60). When the ACWR was considered for external load measures these showed a positive linear association with injury risk (AUC>0.50). When intensity measures were considered relative distance showed an associated risk for injury across one and two-weekly models but not three and four weekly models. When odds risk association was considered a consistent trend towards moderate loading across external loading measures was apparent within the observed cohort.

CONCLUSIONS

The current investigation reports for the first time the injury association for external loading measures within elite Gaelic football. Data show that a range of measures are associated with increased or decreased injury risk depending on the loading scheme applied by coaches within elite Gaelic football.

Eccentric hamstring strength in elite track and field athletes on the British Athletics world class performance program

OBJECTIVES

This novel study aims to provide unique data on eccentric hamstring strength in elite track and field athletes.

DESIGN

Clinical measurement, cross-sectional study.

SETTING

Across two British Athletics performance centres.

PARTICIPANTS

44 elite British track and field athletes.

MAIN OUTCOME MEASURES

Eccentric hamstring force and torque were evaluated using the Nordbord device. Injury history and demographic data was collected to assess whether differences between gender, event group, limb symmetry and previous injury history were present.

RESULTS

Average peak force for males and females was 418.38N and 318.54N. Relative to body weight there were no gender differences (Male 5.21N.kg^-1, Female 4.99N.kg^-1) (p = 0.62). The right limb was significantly stronger in long sprint (400m athletes) (p = 0.00018) (d = 0.56). No differences in relative force or torque were observed between previously injured and non-injured limbs.

CONCLUSIONS

This study provides unique data in elite track and field athletes. Relative force per kilogram should be used when comparing male and female athletes. Unlike other studies, we found no difference in eccentric strength between previously injured and non-injured limbs. The novel finding of increased eccentric strength demonstrated in the right limb in 400m sprinters may be due to the asymmetric demands of bend running and may be considered normal.

Sprint versus isolated eccentric training: Comparative effects on hamstring architecture and performance in soccer players

AIMS

The purpose of this study was to compare the effects of hamstring eccentric (NHE) strength training versus sprint training programmed as complements to regular soccer practice, on sprint performance and its mechanical underpinnings, as well as biceps femoris long head (BFlh) architecture.

METHODS

In this prospective interventional control study, sprint performance, sprint mechanics and BFlh architecture variables were compared before versus after six weeks of training during the first six preseason weeks, and between three different random match-pair groups of soccer players: "Soccer group" (n = 10), "Nordic group" (n = 12) and "Sprint group" (n = 10).

RESULTS

For sprint performance and mechanics, small to large pre-post improvements were reported in "Sprint group" (except maximal running velocity), whereas only trivial to small negative changes were reported in "Soccer group" and "Nordic group". For BFlh architecture variables, "Sprint" group showed moderate increase in fascicle length compared to smaller augment for the "Nordic" group with trivial changes for "Soccer group". Only "Nordic" group presented small increases at pennation angle.

CONCLUSIONS

The results suggest that sprint training was superior to NHE in order to increase BFlh fascicle length although only the sprint training was able to both provide a preventive stimulus (increase fascicle length) and at the same time improve both sprint performance and mechanics. Further studies with advanced imaging techniques are needed to confirm the validity of the findings.

Comparison of Signal Processing Methods for Reducing Motion Artifacts in High-Density Electromyography During Human Locomotion

Objective: High-density electromyography (EMG) is useful for studying changes in myoelectric activity within a muscle during human movement, but it is prone to motion artifacts during locomotion. We compared canonical correlation analysis and principal component analysis methods for signal decomposition and component filtering with a traditional EMG high-pass filtering approach to quantify their relative performance at removing motion artifacts from high-density EMG of the gastrocnemius and tibialis anterior muscles during human walking and running. Results: Canonical correlation analysis filtering provided a greater reduction in signal content at frequency bands associated with motion artifacts than either traditional high-pass filtering or principal component analysis filtering. Canonical correlation analysis filtering also minimized signal reduction at frequency bands expected to consist of true myoelectric signal. Conclusions: Canonical correlation analysis filtering appears to outperform a standard high-pass filter and principal component analysis filter in cleaning high-density EMG collected during fast walking or running.