1
|
Bramah C, Mendiguchia J, Dos'Santos T, Morin JB. Exploring the Role of Sprint Biomechanics in Hamstring Strain Injuries: A Current Opinion on Existing Concepts and Evidence. Sports Med 2024; 54:783-793. [PMID: 37725240 PMCID: PMC11052868 DOI: 10.1007/s40279-023-01925-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/21/2023]
Abstract
Hamstring strain injuries are one of the most common injuries in sprint-based sports with the mechanism of injury considered the result of an interaction between applied mechanical strain and the capacity of the muscle to tolerate strain. To date, injury prevention and rehabilitation strategies have frequently focused on enhancing the capacity of the hamstrings to tolerate strain, with little consideration of factors directly influencing mechanical strain. Sprint running biomechanics are one factor proposed to influence the mechanical strain applied to the hamstrings that may be modified (towards reduced strain) within rehabilitation and injury prevention programs. This article aims to explore the theoretical mechanistic link between sprint running mechanics and hamstring strain injury, along with the available supporting evidence. In doing so, it hopes to provide practitioners with an understanding of mechanical parameters that may influence hamstring strain injury whilst also identifying areas for further research exploration.
Collapse
Affiliation(s)
- Christopher Bramah
- School of Health and Society, University of Salford, Allerton Building, Frederick Road Campus, Salford, M6 6PU, UK.
- Manchester Institute of Health and Performance, Manchester, UK.
| | - Jurdan Mendiguchia
- Department of Physical Therapy, ZENTRUM Rehab and Performance Centre, Barañain, Spain
| | - Thomas Dos'Santos
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
- Manchester Institute of Sport, Metropolitan University, Manchester, UK
| | - Jean-Benoȋt Morin
- University Jean Monnet Saint-Etienne, Lyon 1, University Savoie Mont-Blanc, Inter-University Laboratory of Human Movement Biology, EA 7424, Saint-Etienne, France
| |
Collapse
|
2
|
Crawford SK, Wille CM, Joachim MR, Lee KS, Heiderscheit BC. Ultrasound shear wave seeds reduced following hamstring strain injury but not after returning to sport. Insights Imaging 2024; 15:7. [PMID: 38191955 PMCID: PMC10774410 DOI: 10.1186/s13244-023-01571-x] [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: 09/04/2023] [Accepted: 11/17/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVES The purpose of the study was to investigate differences in ultrasound shear wave speed (SWS) between uninjured and injured limbs following hamstring strain injury (HSI) at time of injury (TOI), return to sport (RTS), and 12 weeks after RTS (12wks). METHODS This observational, prospective, cross-sectional design included male and female collegiate athletes who sustained an HSI. SWS imaging was performed at TOI, RTS, and 12wks with magnetic resonance imaging. SWS maps were acquired by a musculoskeletal-trained sonographer at the injury location of the injured limb and location-matched on the contralateral limb. The average SWS from three 5 mm diameter Q-boxes on each limb were used for analysis. A linear mixed effects model was performed to determine differences in SWS between limbs across the study time points. RESULTS SWS was lower in the injured limb compared to the contralateral limb at TOI (uninjured - injured limb difference: 0.23 [0.05, 0.41] m/s, p = 0.006). No between-limb differences in SWS were observed at RTS (0.15 [-0.05, 0.36] m/s, p = 0.23) or 12wks (-0.11 [-0.41, 0.18] m/s, p = 0.84). CONCLUSIONS The SWS in the injured limb of collegiate athletes after HSI was lower compared to the uninjured limb at TOI but not at RTS or 12 weeks after RTS. CRITICAL RELEVANCE STATEMENT Hamstring strain injury with structural disruption can be detected by lower injured limb shear wave speed compared to the uninjured limb. Lack of between-limb differences at return to sport may demonstrate changes consistent with healing. Shear wave speed may complement traditional ultrasound or MRI for monitoring muscle injury. KEY POINTS • Ultrasound shear wave speed can non-invasively measure tissue elasticity in muscle injury locations. • Injured limb time of injury shear wave speeds were lower versus uninjured limb but not thereafter. • Null return to sport shear wave speed differences may correspond to structural changes associated with healing. • Shear wave speed may provide quantitative measures for monitoring muscle elasticity during recovery.
Collapse
Affiliation(s)
- Scott K Crawford
- Department of Kinesiology, University of Wisconsin-Madison, 1300 University Ave, Madison, WI, 53706, USA.
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, 1685 Highland Ave, Madison, WI, 53705, USA.
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA.
| | - Christa M Wille
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, 1685 Highland Ave, Madison, WI, 53705, USA
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
- Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Mikel R Joachim
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, 1685 Highland Ave, Madison, WI, 53705, USA
- Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Kenneth S Lee
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Bryan C Heiderscheit
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, 1685 Highland Ave, Madison, WI, 53705, USA
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
- Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI, USA
| |
Collapse
|
3
|
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).
Collapse
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
| |
Collapse
|
4
|
Veeck F, Ruas CV, Pinto MD, Grazioli R, Cardoso GP, Albuquerque T, Schipper L, Valente HG, Santos VH, Dornelles M, Rabaldo P, Rocha CS, Baroni BM, Cadore EL, Pinto RS. Low Pre-Season Hamstring-to-Quadriceps Strength Ratio Identified in Players Who Further Sustained In-Season Hamstring Strain Injuries: A Retrospective Study from a Brazilian Serie A Team. Sports (Basel) 2023; 11:sports11040089. [PMID: 37104163 PMCID: PMC10140913 DOI: 10.3390/sports11040089] [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: 03/10/2023] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 04/28/2023] Open
Abstract
A common pre-season injury prevention assessment conducted by professional football clubs is the hamstring-to-quadriceps (H:Q) strength ratio calculated by peak torque (PT). However, it is debatable whether players that present low pre-season H:Q ratios are more susceptible to further sustaining in-season hamstring strain injuries (HSI). Based upon retrospective data from a Brazilian Serie A football squad, a particular season came to our attention as ten out of seventeen (~59%) professional male football players sustained HSI. Therefore, we examined the pre-season H:Q ratios of these players. H:Q conventional (CR) and functional (FR) ratios, and the respective knee extensor/flexor PT from the limbs of players further sustaining in-season HSI (injured players, IP) were compared to the proportional number of dominant/non-dominant limbs from uninjured players (UP) in the squad. FR and CR were ~18-22% lower (p < 0.01), whereas quadriceps concentric PT was ~25% greater for IP than UP (p = 0.002). Low scores of FR and CR were correlated (p < 0.01) with high levels of quadriceps concentric PT (r = -0.66 to -0.77). In conclusion, players who sustained in-season HSI had lower pre-season FR and CR compared to UP, which appears to be associated with higher levels of quadriceps concentric torque than hamstring concentric or eccentric torque.
Collapse
Affiliation(s)
- Filipe Veeck
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre 90690-200, Brazil
| | - Cassio V Ruas
- Brazilian Institute of Neuroscience and Neurotechnology, Institute of Physics Gleb Wataghin, University of Campinas, São Paulo 13083-854, Brazil
- School of Medical and Health Sciences, Edith Cowan University, Joondalup 6027, Australia
| | - Matheus Daros Pinto
- School of Medical and Health Sciences, Edith Cowan University, Joondalup 6027, Australia
| | - Rafael Grazioli
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre 90690-200, Brazil
| | - Gustavo Pacheco Cardoso
- Medical and Technical Department, Grêmio Foot-Ball Porto Alegrense, Porto Alegre 90250-590, Brazil
| | - Thiago Albuquerque
- Medical and Technical Department, Grêmio Foot-Ball Porto Alegrense, Porto Alegre 90250-590, Brazil
| | - Lucas Schipper
- Medical and Technical Department, Grêmio Foot-Ball Porto Alegrense, Porto Alegre 90250-590, Brazil
- Physical Therapy Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
| | - Henrique Gonçalves Valente
- Medical and Technical Department, Grêmio Foot-Ball Porto Alegrense, Porto Alegre 90250-590, Brazil
- Physical Therapy Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
| | - Victor H Santos
- Medical and Technical Department, Grêmio Foot-Ball Porto Alegrense, Porto Alegre 90250-590, Brazil
| | - Márcio Dornelles
- Medical and Technical Department, Grêmio Foot-Ball Porto Alegrense, Porto Alegre 90250-590, Brazil
| | - Paulo Rabaldo
- Medical and Technical Department, Grêmio Foot-Ball Porto Alegrense, Porto Alegre 90250-590, Brazil
| | - Clarice S Rocha
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre 90690-200, Brazil
| | - Bruno Manfredini Baroni
- Physical Therapy Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
| | - Eduardo Lusa Cadore
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre 90690-200, Brazil
| | - Ronei Silveira Pinto
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre 90690-200, Brazil
| |
Collapse
|
5
|
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; 10:125. [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.
Collapse
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
| |
Collapse
|