Acute changes in passive stiffness of the individual hamstring muscles induced by resistance exercise: effects of contraction mode and range of motion

Foam rolling and stretching do not provide superior acute flexibility and stiffness improvements compared to any other warm-up intervention: A systematic review with meta-analysis

BACKGROUND

Acute improvement in range of motion (ROM) is a widely reported effect of stretching and foam rolling, which is commonly explained by changes in pain threshold and/or musculotendinous stiffness. Interestingly, these effects were also reported in response to various other active and passive interventions that induce responses such as enhanced muscle temperature. Therefore, we hypothesized that acute ROM enhancements could be induced by a wide variety of interventions other than stretching or foam rolling that promote an increase in muscle temperature.

METHODS

After a systematic search in PubMed, Web of Science, and SPORTDiscus databases, 38 studies comparing the effects of stretching and foam rolling with several other interventions on ROM and passive properties were included. These studies had 1134 participants in total, and the data analysis resulted in 140 effect sizes (ESs). ES calculations were performed using robust variance estimation model with R-package.

RESULTS

Study quality of the included studies was classified as fair (PEDro score = 4.58) with low to moderate certainty of evidence. Results showed no significant differences in ROM (ES = 0.01, p = 0.88), stiffness (ES = 0.09, p = 0.67), or passive peak torque (ES = -0.30, p = 0.14) between stretching or foam rolling and the other identified activities. Funnel plots revealed no publication bias.

CONCLUSION

Based on current literature, our results challenge the established view on stretching and foam rolling as a recommended component of warm-up programs. The lack of significant difference between interventions suggests there is no need to emphasize stretching or foam rolling to induce acute ROM, passive peak torque increases, or stiffness reductions.

Discussing Conflicting Explanatory Approaches in Flexibility Training Under Consideration of Physiology: A Narrative Review

The mechanisms underlying range of motion enhancements via flexibility training discussed in the literature show high heterogeneity in research methodology and study findings. In addition, scientific conclusions are mostly based on functional observations while studies considering the underlying physiology are less common. However, understanding the underlying mechanisms that contribute to an improved range of motion through stretching is crucial for conducting comparable studies with sound designs, optimising training routines and accurately interpreting resulting outcomes. While there seems to be no evidence to attribute acute range of motion increases as well as changes in muscle and tendon stiffness and pain perception specifically to stretching or foam rolling, the role of general warm-up effects is discussed in this paper. Additionally, the role of mechanical tension applied to greater muscle lengths for range of motion improvement will be discussed. Thus, it is suggested that physical training stressors can be seen as external stimuli that control gene expression via the targeted stimulation of transcription factors, leading to structural adaptations due to enhanced protein synthesis. Hence, the possible role of serial sarcomerogenesis in altering pain perception, reducing muscle stiffness and passive torque, or changes in the optimal joint angle for force development is considered as well as alternative interventions with a potential impact on anabolic pathways. As there are limited possibilities to directly measure serial sarcomere number, longitudinal muscle hypertrophy remains without direct evidence. The available literature does not demonstrate the necessity of only using specific flexibility training routines such as stretching to enhance acute or chronic range of motion.

Biceps femoris long head stiffens after 2 weeks of training cessation in highly trained sprinters

PURPOSE

Most athletes experience short-term training cessation because of illness, injury, post-season vacation, or other reasons. Passive muscle stiffness is a potential risk factor for a sprint-type hamstring strain injury, but limited information is available about the effect of short-term training cessation on passive muscle stiffness. The present study aimed to identify whether and how passive muscle stiffness of the biceps femoris long head (BFlh) would vary due to 2 weeks of training cessation in sprinters.

METHODS

Passive BFlh shear-wave speed (a proxy for stiffness) was measured using ultrasound shear-wave elastography in 28 male sprinters, before and after 2 weeks of intervention. During the 2 weeks, the participants in the training-cessation group (n = 14) were allowed to maintain their normal daily activities but not to perform any physical training, including stretching and resistance exercises. The participants in the training continuation group (n = 14) performed the training (including maximum speed sprint, plyometric, and weight training) prescribed by their coaches 5 days per week.

RESULTS

In the training-cessation group, passive BFlh shear-wave speed increased after the 2 weeks of training cessation (4.75 ± 0.77 to 5.00 ± 0.88 m/s, P < 0.001). In contrast, there was no significant difference before and after the 2 weeks of training continuation (4.90 ± 0.85 to 4.93 ± 0.85 m/s, P = 0.521).

CONCLUSIONS

The present findings indicate that muscles stiffen by training cessation in sprinting athletes.

Stiffness Changes in Shoulder Muscles between Pitchers and Position Players after Throwing Overhead Using Shear Wave Elastography and Throwing Motion Analysis

Objectives: The objective is to compare stiffness changes around the shoulder muscles between pitchers and position players after throwing overhead using shear wave elastography (SWE) in relation to throwing motion analysis and muscle strength. Methods: A total of 32 male college baseball players (12 pitchers and 20 position players) were observed throwing 20 times, and SWE was performed to evaluate 13 shoulder muscle items-tendons (supraspinatus, infraspinatus, subscapularis, and teres minor), muscles (supraspinatus, infraspinatus [transverse and oblique part], teres minor, lower trapezius, latissimus dorsi, and pectoralis minor), and capsules (posterior and posteroinferior). Motion analysis was used to assess elbow torque, forearm angle, forearm rotation speed, and maximum external rotation angle of the shoulder. Muscle strength was measured using a dynamometer for abduction, internal/external rotation of the shoulder at an abduction of 0°, internal/external rotation of the shoulder at an abduction of 90°, and internal/external rotation of shoulder at a flexion of 90°. Results: In the pitcher group, SWE values for the teres minor muscle and latissimus dorsi muscle increased significantly after throwing. In the position player group, SWE values for the teres minor muscle significantly increased, and SWE values of the pectoralis minor muscle decreased after throwing. In the pitcher group, positive correlations were found between the teres minor muscle and forearm rotation speed and between the latissimus dorsi muscle and forearm angle. No significant difference was found in muscle strength after throwing in any of the groups. Conclusions: Stiffness changes occurred after throwing and were related to the motion analysis, but the regions in which stiffness occurred varied between pitchers and position players.

Acute effects of resistance training at different range of motions on plantar flexion mechanical properties and force

The effects obtained from resistance training depend on the exercise range of motion (ROM) performed. We aimed to examine the acute effects of different exercise ROM resistance training on the plantar flexor muscles. Eighteen healthy untrained male adults participated in three conditions: calf raises in 1) partial condition [final (short muscle length) partial ROM], 2) full condition (full ROM), and 3) control condition. The ankle dorsiflexion (DF) ROM, passive torque at DF ROM, passive stiffness of muscle-tendon unit, and maximal voluntary isometric contraction (MVC-ISO) torque were measured before and immediately after the interventions. There were significant increases in DF ROM, passive torque at DF ROM, and a decrease in MVC-ISO, but no significant interaction in passive stiffness. Post hoc test, DF ROM demonstrated moderate magnitude increases in the full condition compared to the partial (p = 0.023, d = 0.74) and control (p = 0.003, d = 0.71) conditions. Passive torque at DF ROM also showed moderate magnitude increases in the full condition compared to the control condition (p = 0.016, d = 0.69). MVC-ISO had a moderate magnitude decrease in the full condition compared to the control condition (p = 0.018, d=-0.53). Resistance training in the full ROM acutely increases joint ROM to a greater extent than final partial ROM, most likely due to stretch tolerance.

Association between Gray-Scale Ultrasound Imaging and Serological Creatine Kinase for Quantifying Exercise-Induced Muscle Damage: An Observational Study

Limited evidence has verified if ultrasound imaging (US) can detect post-exercise muscle damage based on size, shape, and brightness metrics. This study aimed to analyze the correlation between creatine kinase (CK) concentration and (as a biomarker of muscle damage) changes in US gray-scale metrics after an exercise-induced muscle damage protocol. An observational study was conducted at a private university lab located in Madrid. Twenty-five untrained and asymptomatic volunteers were enrolled in this study. Baseline demographic data and body composition metrics were collected. In addition, the rectus femoris US data and CK concentration were assessed at baseline and after inducing muscle damage (24 and 48 h later). After calculating time differences for all the outcomes, the correlation between the changes observed with US and biomarkers was assessed. Significant CK concentration increases were found 24 h (p = 0.003) and 48 h (p < 0.001) after exercise. However, no significant changes in muscle size, shape, or brightness were found in any location (p > 0.05 for all). In addition, no significant associations were found between CK changes and US changes (p > 0.05 for all). Gray-scale US is not a sensitive tool for detecting muscle damage, as a protocol of exercise-induced muscle damage confirmed with CK produced no significant gray-scale US changes after 24 or 48 h. In addition, US and CK changes after 24 and 48 h were not associated with each other.

Effects of muscle fatigue on exercise-induced hamstring muscle damage: a three-armed randomized controlled trial

PURPOSE

Hamstring injuries in soccer reportedly increase towards the end of the matches' halves as well as with increased match frequency in combination with short rest periods, possibly due to acute or residual fatigue. Therefore, this study aimed to investigate the effects of acute and residual muscle fatigue on exercise-induced hamstring muscle damage.

METHODS

A three-armed randomized-controlled trial, including 24 resistance-trained males, was performed allocating subjects to either a training group with acute muscle fatigue + eccentric exercise (AF/ECC); residual muscle fatigue + eccentric exercise (RF/ECC) or a control group with only eccentric exercise (ECC). Muscle stiffness, thickness, contractility, peak torque, range of motion, pain perception, and creatine kinase were assessed as muscle damage markers pre, post, 1 h post, and on the consecutive three days.

RESULTS

Significant group × time interactions were revealed for muscle thickness (p = 0.02) and muscle contractility parameters radial displacement (Dm) and contraction velocity (Vc) (both p = 0.01), with larger changes in the ECC group (partial η2 = 0.4). Peak torque dropped by an average of 22% in all groups; stiffness only changed in the RF/ECC group (p = 0.04). Muscle work during the damage protocol was lower for AF/ECC than for ECC and RF/ECC (p = 0.005).

CONCLUSION

Hamstring muscle damage was comparable between the three groups. However, the AF/ECC group resulted in the same amount of muscle damage while accumulating significantly less muscle work during the protocol of the damage exercise.

TRIAL REGISTRATION

This study was preregistered in the international trial registration platform (WHO; registration number: DRKS00025243).

Acute changes in passive stiffness of the individual hamstring muscles induced by resistance exercise: effects of muscle length and exercise duration

PURPOSE

A previous study revealed that resistance exercise with eccentric contraction and a wide range of motion (ROM) can acutely decrease muscle stiffness of a specific muscle. To explore further approaches to decrease the stiffness, we examined the acute changes in passive stiffness of the individual hamstring muscles after eccentric-only resistance exercise with different combinations of muscle lengths and exercise durations.

METHODS

Thirteen healthy young male participants performed three sessions of eccentric-only exercises that comprised stiff-leg deadlift with different muscle lengths and exercise durations (duration per repetition × the total number of repetitions) on separate days as follows: (1) short muscle lengths with a short duration (SS); (2) long muscle lengths with a short duration (LS); and (3) long muscle lengths with a long duration (LL). Maximal joint ROM, passive torque, shear modulus of each hamstring muscle, and maximal isometric torque of knee flexion were measured before, and at 3, 30, and 60 min after each session.

RESULTS

The shear modulus of the semimembranosus was significantly lower at 3 min post-exercise (129.8 ± 22.7 kPa) than at pre-exercise (140.5 ± 19.1 kPa, p < 0.01) in LL, but not in SS or LS. No significant differences were observed in the shear moduli of the biceps femoris long head or semitendinosus between pre-exercise and 3 min post-exercise in any session.

CONCLUSION

The combination of long muscle lengths and a long duration during eccentric-only resistance exercise is important to immediately decrease the stiffness (shear modulus) of a specific muscle.

Resistance Training Induces Improvements in Range of Motion: A Systematic Review and Meta-Analysis

BACKGROUND

Although it is known that resistance training can be as effective as stretch training to increase joint range of motion, to date no comprehensive meta-analysis has investigated the effects of resistance training on range of motion with all its potential affecting variables.

OBJECTIVE

The objective of this systematic review with meta-analysis was to evaluate the effect of chronic resistance training on range of motion compared either to a control condition or stretch training or to a combination of resistance training and stretch training to stretch training, while assessing moderating variables.

DESIGN

For the main analysis, a random-effect meta-analysis was used and for the subgroup analysis a mixed-effect model was implemented. Whilst subgroup analyses included sex and participants' activity levels, meta-regression included age, frequency, and duration of resistance training.

DATA SOURCES

Following the systematic search in four databases (PubMed, Scopus, SPORTDiscus, and Web of Science) and reference lists, 55 studies were found to be eligible.

ELIGIBILITY CRITERIA

Controlled or randomized controlled trials that separately compared the training effects of resistance training exercises with either a control group, stretching group, or combined stretch and resistance training group on range of motion in healthy participants.

RESULTS

Resistance training increased range of motion (effect size [ES] = 0.73; p < 0.001) with the exception of no significant range of motion improvement with resistance training using only body mass. There were no significant differences between resistance training versus stretch training (ES = 0.08; p = 0.79) or between resistance training and stretch training versus stretch training alone (ES = - 0.001; p = 0.99). Although "trained or active people" increased range of motion (ES = 0.43; p < 0.001) "untrained and sedentary" individuals had significantly (p = 0.005) higher magnitude range of motion changes (ES = 1.042; p < 0.001). There were no detected differences between sex and contraction type. Meta-regression showed no effect of age, training duration, or frequency.

CONCLUSIONS

As resistance training with external loads can improve range of motion, stretching prior to or after resistance training may not be necessary to enhance flexibility.

Using Shear-Wave Elastography to Assess Exercise-Induced Muscle Damage: A Review

Shear-wave elastography is a method that is increasingly used to assess muscle stiffness in clinical practice and human health research. Recently, shear-wave elastography has been suggested and used to assess exercise-induced muscle damage. This review aimed to summarize the current knowledge of the utility of shear-wave elastography for assessment of muscle damage. In general, the literature supports the shear-wave elastography as a promising method for assessment of muscle damage. Increases in shear modulus are reported immediately and up to several days after eccentric exercise, while studies using shear-wave elastography during and after endurance events are showing mixed results. Moreover, it seems that shear modulus increases are related to the decline in voluntary strength loss. We recommend that shear modulus is measured at multiple muscles within a muscle group and preferably at longer muscle lengths. While further studies are needed to confirm this, the disruption of calcium homeostasis seems to be the primary candidate for the underlying mechanism explaining the increases in shear modulus observed after eccentric exercise. It remains to be investigated how well the changes in shear modulus correlate with directly assessed amount of muscle damage (biopsy).