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Lin N, Cavaleri R, Rio E, Stanton TR, Imam J, Moukhaiber N, Thomson D, Williamson C, Andary T, Summers SJ. The relationship between sustained hamstring pain and reorganisation of somatosensory representations: a randomised, controlled study. Pain 2024:00006396-990000000-00639. [PMID: 38968398 DOI: 10.1097/j.pain.0000000000003312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 05/21/2024] [Indexed: 07/07/2024]
Abstract
ABSTRACT Recurrent hamstring injuries are highly prevalent amongst sporting populations. It has been hypothesised that pain from an initial hamstring injury may induce reorganisation of somatosensory representations that could contribute to reinjury. However, because of the cross-sectional nature of existing research, it remains unknown whether somatosensory changes are a cause or effect of pain or if they are driven by other potentially confounding factors. Here, we explored the effect of experimentally induced sustained hamstring pain on tasks that interrogate somatosensory and spatial representations. Fifty healthy participants were randomly allocated to an experimental group that performed an eccentric exercise protocol on the right hamstring to induce delayed onset muscle soreness or a control group performing a repetition-matched concentric exercise protocol. The tactile cortical representation was assessed using two-point discrimination and tactile localisation, whereas the proprioceptive representation was assessed using a left-right judgement task. Peripersonal spatial representations were assessed using an auditory localisation task. Assessments were performed at baseline and day 2. No between-group differences in tactile acuity were observed. However, improvements in left-right judgments and worsening of auditory localisation occurred in the experimental group compared with the control group. This study provides preliminary evidence showing that somatosensory changes occur in response to sustained hamstring pain. Experimentally induced, sustained hamstring pain elicited enhancements in proprioceptive processing and deficits in peripersonal spatial processing, suggesting a shift in the allocation of attentional resources from the external (peripersonal) to internal (body) environment. These findings may hold important implications for reinjury risk and rehabilitation following hamstring pain.
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Affiliation(s)
- Natalie Lin
- Western Sydney University, Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, New South Wales, Australia
| | - Rocco Cavaleri
- Western Sydney University, Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, New South Wales, Australia
- Queensland University of Technology, School of Biomedical Sciences, Queensland, Australia
| | - Ebonie Rio
- La Trobe University Melbourne, School of Allied Health, Victoria, Australia
| | - Tasha R Stanton
- University of South Australia, IIMPACT in Health, South Australia, Australia
- Persistent Pain Research Group, Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), South Australia, Australia
| | - Jawwad Imam
- Western Sydney University, Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, New South Wales, Australia
| | - Nadia Moukhaiber
- Western Sydney University, Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, New South Wales, Australia
| | - Daniel Thomson
- Western Sydney University, Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, New South Wales, Australia
| | - Cody Williamson
- Macarthur Football Club, A-League, New South Wales, Australia
| | - Toni Andary
- South Western Sydney Local Health District, New South Wales, Australia
| | - Simon J Summers
- Western Sydney University, Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, New South Wales, Australia
- Queensland University of Technology, School of Biomedical Sciences, Queensland, Australia
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Nescolarde L, Yanguas J, Hernández-Hermoso JA. Localized hamstring bioimpedance in marathon runners is related to muscle high-energy enzyme serum levels and predicts race time. Front Physiol 2024; 15:1337119. [PMID: 38505706 PMCID: PMC10948513 DOI: 10.3389/fphys.2024.1337119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 02/12/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction: The aim was to analyze the response of serum levels of inflammatory, high-energy muscle biomarkers and hamstring localized bioimpedance (L-BIA) measurements to marathon running and to ascertain whether they correlate with each other or with race time. Methods: Blood samples and hamstrings tetra-polar L-BIA measurements from 14 Caucasian male recreational athletes at the Barcelona Marathon 2019 were collected at base line, immediately after and 48 h post-race. Serum C reactive protein (sCRP), creatinine kinase (sCK) and lactate dehydrogenase (sLDH) were determined using an AU-5800 chemistry analyzer. L-BIA was obtained at 50 kHz with a Quantum V Segmental phase-sensitive bioimpedance analyzer. Results: Median sCRP increased (4-fold) after 48 h post-race. Median sCK and sLDH levels increased immediately post-race (3-fold, 2-fold) and 48h post-race (5-fold, 1-fold). Left, right and combined hamstring reactance (Xc) and phase angle (PhA) increased immediately post-race. Xc combined hamstring pre- and immediately post-race correlated with race-time and with sCK and sLDH median levels pre-race. Xc combined hamstring pre- and immediately post-race > 15.6 Ω and 15.8 Ω, respectively, predicted the race time of 3:00:00 h. Conclusion: L-BIA reactance (Xc) is an objective direct, real time, easy, noninvasive bioelectrical parameter that may predict muscle and marathon athlete performance.
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Affiliation(s)
- Lexa Nescolarde
- Department of Electronic Engineering, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Javier Yanguas
- FIFA Medical Center of Excellence, Ciutat Esportiva Futbol Club Barcelona, Medical Department, Futbol Club Barcelona, Barcelona, Spain
| | - José A. Hernández-Hermoso
- Department of Orthopedic Surgery and Traumatology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Department of Surgery, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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Yagiz G, Fredianto M, Ulfa M, Ariani I, Agustin AD, Shida N, Moore EWG, Kubis HP. A retrospective comparison of the biceps femoris long head muscle structure in athletes with and without hamstring strain injury history. PLoS One 2024; 19:e0298146. [PMID: 38408057 PMCID: PMC10896514 DOI: 10.1371/journal.pone.0298146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/17/2024] [Indexed: 02/28/2024] Open
Abstract
INTRODUCTION Hamstring strain injuries (HSI) and re-injuries are endemic in high-speed running sports. The biceps femoris long head (BFlh) is the most frequently injured muscle among the hamstrings. Structural parameters of the hamstring muscle are stated to be susceptible to strain injuries at this location. This retrospective study targeted comparing the BFlh's structural parameters between previously injured and uninjured athletes. METHODS Nineteen male athletes with previous BFlh strain injury history and nineteen athletes without former lower extremity injury history were included in this study. Fascicle length, mid-muscle belly and distal musculotendinous (MTJ) passive stiffnesses of the biceps femoris long head (BFlh) were examined via b-mode panoramic ultrasound scanning and ultrasound-based shear-wave elastography. Parameter comparisons of both legs within and between athletes with and without injury history were performed. RESULTS Comparison of the BFlh fascicle length between the injured leg of the injured group and the legs of the controls revealed a trend to shorter fascicle lengths in the injured leg (p = 0.067, d = -0.62). However, the mid-muscle belly passive stiffness of the BFlh was significantly higher in the injured legs (p = 0.009, d = 0.7) compared with the controls. Additionally, the distal MTJ stiffness was much higher in the previously injured legs compared with controls (p < 0.001, d = 1.6). CONCLUSIONS Outcomes support the importance of BFlh properties related to stiffness, and fascicle length for injury susceptibility in athletes. Future prospective studies should determine whether the higher stiffness in the injured athletes is a cause or consequence of the HSI. Physical therapy and rehabilitation programmes after HSI should focus on BFlh muscle properties i.e., elasticity and fascicle length for reducing re-injury and increasing sports performance.
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Affiliation(s)
- Gokhan Yagiz
- Department of Kinesiology, College of Health and Human Performance, East Carolina University, Greenville, NC, United States of America
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Amasya University, Amasya, Republic of Türkiye
| | - Meiky Fredianto
- Faculty of Medicine and Health Sciences, Orthopaedics and Traumatology Division, Surgery Department, School of Medicine, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
- Department of Orthopaedic Surgery, Siloam Hospitals Yogyakarta, Yogyakarta, Indonesia
| | - Maria Ulfa
- Faculty of Medicine and Health Sciences, School of Medicine, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
- Master of Hospital Administration, Postgraduate Program, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Indira Ariani
- Department of Radiology, Siloam Hospitals Yogyakarta, Yogyakarta, Indonesia
| | | | - Nami Shida
- Faculty of Health Sciences, Department of Physical Therapy, Tokyo Metropolitan University, Tokyo, Japan
| | - E Whitney G Moore
- Department of Kinesiology, College of Health and Human Performance, East Carolina University, Greenville, NC, United States of America
| | - Hans-Peter Kubis
- Institute for Applied Human Physiology, School of Human and Behavioural Sciences, Bangor University, Bangor, Wales, United Kingdom
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Calderón-Díaz M, Silvestre Aguirre R, Vásconez JP, Yáñez R, Roby M, Querales M, Salas R. Explainable Machine Learning Techniques to Predict Muscle Injuries in Professional Soccer Players through Biomechanical Analysis. SENSORS (BASEL, SWITZERLAND) 2023; 24:119. [PMID: 38202981 PMCID: PMC10780883 DOI: 10.3390/s24010119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/25/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024]
Abstract
There is a significant risk of injury in sports and intense competition due to the demanding physical and psychological requirements. Hamstring strain injuries (HSIs) are the most prevalent type of injury among professional soccer players and are the leading cause of missed days in the sport. These injuries stem from a combination of factors, making it challenging to pinpoint the most crucial risk factors and their interactions, let alone find effective prevention strategies. Recently, there has been growing recognition of the potential of tools provided by artificial intelligence (AI). However, current studies primarily concentrate on enhancing the performance of complex machine learning models, often overlooking their explanatory capabilities. Consequently, medical teams have difficulty interpreting these models and are hesitant to trust them fully. In light of this, there is an increasing need for advanced injury detection and prediction models that can aid doctors in diagnosing or detecting injuries earlier and with greater accuracy. Accordingly, this study aims to identify the biomarkers of muscle injuries in professional soccer players through biomechanical analysis, employing several ML algorithms such as decision tree (DT) methods, discriminant methods, logistic regression, naive Bayes, support vector machine (SVM), K-nearest neighbor (KNN), ensemble methods, boosted and bagged trees, artificial neural networks (ANNs), and XGBoost. In particular, XGBoost is also used to obtain the most important features. The findings highlight that the variables that most effectively differentiate the groups and could serve as reliable predictors for injury prevention are the maximum muscle strength of the hamstrings and the stiffness of the same muscle. With regard to the 35 techniques employed, a precision of up to 78% was achieved with XGBoost, indicating that by considering scientific evidence, suggestions based on various data sources, and expert opinions, it is possible to attain good precision, thus enhancing the reliability of the results for doctors and trainers. Furthermore, the obtained results strongly align with the existing literature, although further specific studies about this sport are necessary to draw a definitive conclusion.
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Affiliation(s)
- Mailyn Calderón-Díaz
- Faculty of Engineering, Universidad Andres Bello, Santiago 7550196, Chile;
- Ph.D. Program in Health Sciences and Engineering, Universidad de Valparaiso, Valparaiso 2362735, Chile
- Millennium Institute for Intelligent Healthcare Engineering (iHealth), Valparaiso 2362735, Chile
| | - Rony Silvestre Aguirre
- Laboratorio de Biomecánica, Centro de Innovación Clínica MEDS, Santiago 7691236, Chile; (R.S.A.); (R.Y.); (M.R.)
| | - Juan P. Vásconez
- Faculty of Engineering, Universidad Andres Bello, Santiago 7550196, Chile;
| | - Roberto Yáñez
- Laboratorio de Biomecánica, Centro de Innovación Clínica MEDS, Santiago 7691236, Chile; (R.S.A.); (R.Y.); (M.R.)
| | - Matías Roby
- Laboratorio de Biomecánica, Centro de Innovación Clínica MEDS, Santiago 7691236, Chile; (R.S.A.); (R.Y.); (M.R.)
| | - Marvin Querales
- School of Medical Technology, Universidad de Valparaiso, Valparaiso 2362735, Chile;
| | - Rodrigo Salas
- Ph.D. Program in Health Sciences and Engineering, Universidad de Valparaiso, Valparaiso 2362735, Chile
- Millennium Institute for Intelligent Healthcare Engineering (iHealth), Valparaiso 2362735, Chile
- School of Biomedical Engineering, Universidad de Valparaiso, Valparaiso 2362735, Chile
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Palermi S, Vittadini F, Vecchiato M, Corsini A, Demeco A, Massa B, Pedret C, Dorigo A, Gallo M, Pasta G, Nanni G, Vascellari A, Marchini A, Lempainen L, Sirico F. Managing Lower Limb Muscle Reinjuries in Athletes: From Risk Factors to Return-to-Play Strategies. J Funct Morphol Kinesiol 2023; 8:155. [PMID: 37987491 PMCID: PMC10660751 DOI: 10.3390/jfmk8040155] [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: 09/16/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023] Open
Abstract
Muscle injuries and subsequent reinjuries significantly impact athletes, especially in football. These injuries lead to time loss, performance impairment, and long-term health concerns. This review aims to provide a comprehensive overview of the current understanding of muscle reinjuries, delving into their epidemiology, risk factors, clinical management, and prevention strategies. Despite advancements in rehabilitation programs and return-to-play criteria, reinjury rates remain alarmingly high. Age and previous muscle injuries are nonmodifiable risk factors contributing to a high reinjury rate. Clinical management, which involves accurate diagnosis, individualized rehabilitation plans, and the establishment of return-to-training and return-to-play criteria, plays a pivotal role during the sports season. Eccentric exercises, optimal loading, and training load monitoring are key elements in preventing reinjuries. The potential of artificial intelligence (AI) in predicting and preventing reinjuries offers a promising avenue, emphasizing the need for a multidisciplinary approach to managing these injuries. While current strategies offer some mitigation, there is a pressing need for innovative solutions, possibly leveraging AI, to reduce the incidence of muscle reinjuries in football players. Future research should focus on this direction, aiming to enhance athletes' well-being and performance.
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Affiliation(s)
- Stefano Palermi
- Public Health Department, University of Naples Federico II, 80131 Naples, Italy
| | | | - Marco Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, 35128 Padova, Italy
| | | | - Andrea Demeco
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Bruno Massa
- Public Health Department, University of Naples Federico II, 80131 Naples, Italy
| | - Carles Pedret
- Sports Medicine and Imaging Department, Clinica Diagonal, 08950 Barcelona, Spain;
| | - Alberto Dorigo
- Radiology Unit, Casa di Cura Giovanni XXIII, 31050 Monastier, Italy
| | - Mauro Gallo
- Radiology Unit, Casa di Cura Giovanni XXIII, 31050 Monastier, Italy
| | | | | | | | | | - Lasse Lempainen
- FinnOrthopaedics, Hospital Pihlajalinna, 20520 Turku, Finland;
| | - Felice Sirico
- Public Health Department, University of Naples Federico II, 80131 Naples, Italy
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Ehiogu UD, Schöffl V, Jones G. Rehabilitation of Annular Pulley Injuries of the Fingers in Climbers: A Clinical Commentary. Curr Sports Med Rep 2023; 22:345-352. [PMID: 37800745 DOI: 10.1249/jsr.0000000000001107] [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: 10/07/2023]
Abstract
ABSTRACT The annular pulley ligaments of the fingers are one of the most injured anatomical structures in those who participate in climbing. Despite this, there is a paucity of guidance clearly describing the rehabilitation and physical preparation parameters to return to sport following such injuries. The foundation of effective rehabilitation is the judicious application of progressive loading to increase the morphological and material properties of the damaged tissues. We maintain the optimal management of the climbing athlete after a traumatic annular flexor pulley system rupture should be grounded in the principles of strength and conditioning.
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Affiliation(s)
| | | | - Gareth Jones
- School of Health and Applied Sciences, Leeds Becket University, Leeds, West Yorkshire, United Kingdom
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Kerin F, O'Flanagan S, Coyle J, Farrell G, Curley D, McCarthy Persson U, De Vito G, Delahunt E. Intramuscular Tendon Injuries of the Hamstring Muscles: A More Severe Variant? A Narrative Review. SPORTS MEDICINE - OPEN 2023; 9:75. [PMID: 37578668 PMCID: PMC10425319 DOI: 10.1186/s40798-023-00621-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 07/20/2023] [Indexed: 08/15/2023]
Abstract
Hamstring strain injuries (HSI) are one of the most common sport-related injuries. They have a high injury burden and a high recurrence rate. The development of novel muscle injury grading systems has provided new insights into the possible impact of injury location on the time to return to play (TTRTP) and re-injury following HSI. In particular, injuries to the intramuscular tendon (IMT) may be present in up to 41% of all HSI and have been described as a 'serious thigh muscle strain'. Re-injury rates as high as 60% have been described in elite track and field athletes, as well as prolonged TTRTP. A systematic search was carried out using appropriate keywords to identify articles reporting on HSI involving the IMT in athletes. The primary aim was to determine whether IMT injuries warrant being classified as a distinct clinical entity with different expected outcomes to other hamstring muscle injuries. This narrative review summarises the existing evidence on: (1) the anatomy of the IMT and its response to injury; (2) the role of MRI and novel grading scales in IMT injury management (3) clinical assessment of IMT injuries, (4) TTRTP and re-injury rates across sports following IMT, (5) conservative rehabilitation and the role of specific 'IMT-oriented' strategies, and (6) indications for and approaches to surgery. The review found that important clinical outcomes such as re-injury rates and TTRTP vary across populations, cohorts and sports which suggest that outcomes are specific to the sporting context. Bespoke rehabilitation, tailored to IMT injury, has been shown to significantly reduce re-injuries in elite track and field athletes, without compromising TTRTP. Continued prospective studies across other sports and cohorts, are warranted to further establish relevant clinical findings, indications for surgical intervention and outcomes across other sporting cohorts.
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Affiliation(s)
- Fearghal Kerin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
| | - Stuart O'Flanagan
- Leinster Rugby, Dublin, Ireland
- Radiology Department, Sports Surgery Clinic, Dublin, Ireland
| | - Joe Coyle
- Radiology Department, Sports Surgery Clinic, Dublin, Ireland
| | | | | | - Ulrik McCarthy Persson
- 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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Jankaew A, Chen JC, Chamnongkich S, Lin CF. Therapeutic Exercises and Modalities in Athletes With Acute Hamstring Injuries: A Systematic Review and Meta-analysis. Sports Health 2023; 15:497-511. [PMID: 35996322 PMCID: PMC10293564 DOI: 10.1177/19417381221118085] [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: 11/16/2022] Open
Abstract
CONTEXT Hamstring strain is a common injury to the lower limbs. Early intervention in the acute phase aids with restoring hamstring function and prevents secondary related injury. OBJECTIVE To systematically review and summarize the effectiveness of exercise-based interventions combined with physical modalities currently used in athletes with acute hamstring injuries. DATA SOURCES Five databases (EMBASE, Medline, Cochrane Library, SPORTDiscus, and Web of Science) were searched from inception to July 2021. STUDY SELECTION A total of 4569 studies were screened. Nine randomized controlled trials (RCTs) on the effect of therapeutic exercise programs with and without physical agents in athletes with acute hamstring injuries were identified for meta-analysis. STUDY DESIGN Systematic review and meta-analysis. LEVEL OF EVIDENCE Level 1. DATA EXTRACTION The studies were screened, and the evidence was rated using the PEDro scale. Nine RCTs with PEDro scores ranging between 3 and 9 were included and extracted pain intensity, time to return to play (TTRTP), and reinjury rate in the study. RESULTS Loading exercises during extensive lengthening were shown to facilitate TTRTP at P < 0.0001 but did not prevent recurrence (P = 0.17), whereas strengthening with trunk stabilization and agility exercise did not reduce the duration of injury recurrence (P = 0.16), but significantly reduced the reinjury rate (P < 0.007) at a 12-month follow-up. The results of the stretching programs and solely physical modalities could not be pooled in the statistical analysis. CONCLUSION The meta-analysis indicated that a loading program helps athletes to return to sports on a timely basis. Although strengthening with trunk stabilization and agility exercise cannot significantly reduce recovery time, the program can prevent reinjury. The clinical effects of stretching programs and pure physical modality interventions could not be concluded in this study due to limited evidence. PROSPERO REGISTRATION CRD42020183035.
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Affiliation(s)
- Amornthep Jankaew
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jih-Ching Chen
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Samatchai Chamnongkich
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Cheng-Feng Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Physical Therapy Center, National Cheng Kung University Hospital, Tainan, Taiwan
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Orth D, Slebioda N, Cavada A, van Bergen N, Deschle N, Hoozemans M. Persistent Unilateral Force Production Deficits Following Hand Injury in Experienced Climbers: A Reliability and Retrospective Injury Study. Wilderness Environ Med 2023; 34:22-30. [PMID: 36517389 DOI: 10.1016/j.wem.2022.10.001] [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: 03/21/2022] [Revised: 10/02/2022] [Accepted: 10/03/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION In climbing, research is needed to guide clinical and training advice regarding strength differences between hands. The objectives of this study were to establish test-retest reliability of a field-based apparatus measuring sport-specific unilateral isometric hand strength and to investigate whether these measures detect between-hand differences in climbers with and without a history of unilateral hand injury. METHODS A reliability and case-control injury study was carried out. Seventeen intermediate-advanced climbers without and 15 intermediate-advanced climbers with previous unilateral hand injury participated. Unilateral isometric fingertip flexor strength was assessed during maximal voluntary contraction (MVC) and peak rate of force development (RFD) tests in full-crimp overhead position. The magnitude of within-group between-hand differences was calculated using a generalized estimating equation to evaluate if prior injury was associated with lower MVC and RFD outcomes and whether hand dominance influenced the magnitude of these effects. The control group was assessed 1 wk later to determine intraclass correlation coefficients (ICCs) for all measures. RESULTS The MVC (ICC 0.91-0.93) and the RFD (ICC 0.92-0.83) tests demonstrated moderate-to-high reliability. When accounting for handedness, those with prior injury showed 7% (P=0.004) reduced MVC and 13% (P=0.008) reduced RFD in the injured hand. The nondominant hand was also significantly weaker in MVC (11%, P<0.001) and RFD (12%, P=0.02) outcomes. For uninjured climbers, MVC and RFD were not significantly higher in the dominant hand (differing by 4% and 5%, respectively). CONCLUSIONS Previous climbing injury was associated with persistent weakness in the injured limb and exacerbated handedness effects. Therefore, recommendations for rehabilitation should be considered.
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Affiliation(s)
- Dominic Orth
- Department of Health Sciences and Biostatistics (Sport and Exercise Medicine Group), Swinburne University of Technology, Melbourne, Australia; Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Ninka Slebioda
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Antonio Cavada
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Nikki van Bergen
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Nicolas Deschle
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marco Hoozemans
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Muscle Architecture, Morphology, and Mechanical and Functional Properties of Biceps Femoris Long Head in Professional Soccer Players with a Prior Healed Injured Hamstring. J Clin Med 2022; 11:jcm11237222. [PMID: 36498796 PMCID: PMC9738030 DOI: 10.3390/jcm11237222] [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: 11/08/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The aim of the present study was to compare the fascicle length, pennation angle, muscle thickness and stiffness of the biceps femoris long head, and eccentric hamstring strength between injured dominant limbs, injured non-dominant limbs, uninjured dominant limbs and uninjured non-dominant legs in previously injured players, and between dominant and non-dominant legs in uninjured elite soccer players. MATERIALS AND METHODS Twenty elite soccer players participated in this study. Ultrasound imaging and MyotonPRO were used to determine the morphological and mechanical properties of the biceps femoris long head. Isokinetic and Nordic hamstring exercises were used to assess eccentric hamstring strength. RESULTS Previously injured players showed substantially lower fascicle length and muscle thickness, and significantly higher biceps femoris long head stiffness than uninjured players, without differences between limbs. CONCLUSION The morphological and mechanical properties of elite soccer players with hamstring injury history were different from those in uninjured players. The lack of differences between limbs showed that these values are characteristics of individual players that must be considered in the design of programs to prevent BFlh injury.
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11
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Ritzmann R, Strütt S, Torreno I, Riesterer J, Centner C, Suarez-Arrones L. Neuromuscular characteristics of agonists and antagonists during maximal eccentric knee flexion in soccer players with a history of hamstring muscle injuries. PLoS One 2022; 17:e0277949. [PMID: 36455059 PMCID: PMC9714924 DOI: 10.1371/journal.pone.0277949] [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: 04/22/2022] [Accepted: 11/07/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Muscle strain injuries (MSIs) in the hamstrings are among the most prevalent injuries in elite soccer. We aimed to examine the relation between biomechanical maladaptation in eccentric strength and neuromuscular factors separated by their time and frequency domains. METHODS 20 elite soccer players with a previous history of unilateral MSI in the M. biceps femoris (BF) long head and 20 without MSI participated. Knee flexion torques, rate of torque development (RTD) and electromyographic signals (EMG) of the BF, the M. semitendinosus (SMT) and knee extensors were obtained during unilateral maximal eccentric knee flexions performed at slow (30°/s) and fast (120°/s) angular speeds. Root mean squares and mean power frequency (MF) was calculated. RESULTS In the group with a history of MSI, reduced maximal eccentric flexion torque (slow eccentrics -8±11, p<0.05; fast eccentrics -18±13 N*m, p<0.05) and RTD (-33±28 N*m/s, p<0.05; -95±47 N*m/s, p<0.05) concomitantly occurred with diminished agonistic myoelectrical activities (-4±5% of MVC, p<0.05; -10±7% of MVC, p<0.05) and MFs (-24±13 Hz, p<0.05; -24±18 Hz, p<0.05) in the BF. Simultaneously, antagonistic myoelectric activity was elevated (+4±3% of MVC, p<0.05; +3±3% of MVC, p<0.05) in MSI affected legs as compared to unaffected legs for both eccentric contractions. Deficits in myoelectrical activity (r2 = 0.715, p<0.05; r2 = 0.601, p<0.05) and MF (r2 = 0.484, p<0.05; r2 = 0.622, p<0.05) correlated with deficits in maximal torque in the affected leg in the MSI group. Analysis of SMT demonstrated no significant differences. CONCLUSION Positive relationships between neuromuscular deficits and the reduced eccentric strength profile underpin neuronal inhibition after MSI. This persistent involvement of dysfunctional synergist and antagonist neural hamstring function in strength weakness is of clinical relevance in sports medicine for prevention and rehabilitation.
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Affiliation(s)
- Ramona Ritzmann
- Department of Sports and Sport Science, University of Freiburg, Freiburg, Germany
- * E-mail:
| | - Sarah Strütt
- Praxisklinik Rennbahn AG, Muttenz, Switzerland
- FC Basel, Basel, Switzerland
| | | | | | | | - Luis Suarez-Arrones
- FC Lugano, Lugano, Switzerland
- Department of Sports and Computer Science, Section of Physical Education and Sports, Universidad Pablo de Olavide, Seville, Spain
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12
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Differences in the recruitment properties of the corticospinal pathway between the biceps femoris and rectus femoris muscles. Brain Res 2022; 1790:147963. [PMID: 35679903 DOI: 10.1016/j.brainres.2022.147963] [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: 03/09/2022] [Revised: 05/24/2022] [Accepted: 06/02/2022] [Indexed: 11/21/2022]
Abstract
The neuromuscular activity in the hamstring and quadriceps muscles is vital for rapid force control during athletic movements. This study aimed to investigate the recruitment properties of the corticospinal pathway of the biceps femoris long head (BFlh) and rectus femoris (RF) muscles. Thirty-two male subjects were participated in this study. Corticospinal excitability was investigated for BFlh and RF during the isometric knee flexion and extension tasks, respectively, using transcranial magnetic stimulation. A sigmoidal relationship was observed between the stimulus intensity and amplitude of motor-evoked potentials and characterized by a plateau value, maximum slope, and threshold. Compared with RF, BFlh had a significantly lower plateau value (P < 0.001, d = 1.17), maximum slope (P < 0.001, r = 0.79), and threshold (P = 0.003, d = 0.62). The results showed that the recruitment properties of the corticospinal pathway significantly differ between BFlh and RF. These results reveal that when a sudden large force is required during athletic movements, the RF can produce force through a rapid increase in the recruitment of motor units. The BFlh, on the other hand, requires larger or more synchronized motor commands for enabling the proper motor unit behavior to exert large forces. These differences in the neurophysiological factors between the hamstrings and quadriceps can have a substantial effect on the balance of force generation during athletic activities.
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Abstract
OBJECTIVE To identify risk factors for quadriceps muscle strain injury in sport. DESIGN Risk factor systematic review. LITERATURE SEARCH A systematic search was conducted in the MEDLINECINAHL, Embase, AMED, AUSPORT, SPORTDiscus, PEDro, and Cochrane Library databases (from inception to September 2021). STUDY SELECTION CRITERIA Studies reporting prospective data to evaluate risk factors related to index and/or recurrent quadriceps muscle strain injury. DATA SYNTHESIS A risk-of-bias assessment (using a modified Quality in Prognosis Studies tool) was performed, and we used best-evidence synthesis to qualitatively synthesize the data to quantify relationships between risk factors and quadriceps muscle injury. RESULTS Sixteen studies were included, capturing 2408 quadriceps injuries in 11 719 athletes. Meta-analyses were not performed due to clinical heterogeneity. The dominant kicking leg (over 3154 individuals, 1055 injuries), a previous history of quadriceps muscle injury (6208 individuals, 975 injuries), and a recent history of hamstring strain (4087 individuals, 581 injuries) were intrinsic factors associated with quadriceps injury. Extrinsic factors relating to the preseason period and competitive match play increased quadriceps injury risk; participating at higher levels of competition decreased quadriceps injury risk. Age, weight, and flexibility (intrinsic factors) had no association with quadriceps injury. CONCLUSION Previous quadriceps injury, recent hamstring injury, the dominant kicking leg, and competitive match play were the strongest risk factors for future quadriceps muscle injury in sport. J Orthop Sports Phys Ther 2022;52(6):389-400. doi:10.2519/jospt.2022.10870.
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14
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Tensiomyography Allows to Discriminate between Injured and Non-Injured Biceps Femoris Muscle. BIOLOGY 2022; 11:biology11050746. [PMID: 35625474 PMCID: PMC9138955 DOI: 10.3390/biology11050746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/01/2022] [Accepted: 05/10/2022] [Indexed: 11/16/2022]
Abstract
The hamstring muscle group is the most frequently injured muscle group in non-contact muscle injuries in sports involving high-speed running. A total of 84% of hamstring injuries affect the biceps femoris (BF) muscle. Clinical assessments and magnetic resonance imaging (MRI) are routinely used for diagnosis and plan management. MRI-negative scans for clinically diagnosed hamstring injuries range from 14% to 45%. We tested the hypothesis that the functional differences between injured and non-injured BF assessed by tensiomyography can be used for diagnostic and classification purposes. We compared an injured group of 53 international-level soccer players and sprinters with 53 non-injured international-level soccer players and sprinters of both sexes. Comparing the injured vs. non-injured athletes and the left vs. right side in all of the athletes, we used the percentage of absolute differences in the BF contraction time (Tc) to classify non-injured and injured BF muscles. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) and the precision−recall curve (PRC) were used to measure the classification accuracy and to identify cut-off limits using the Tc differences. There was a very high ROC AUC value of 0.981 (SE = 0.009, p < 0.000), with 98.11% of the injured muscles being correctly classified (cut-off point 12.50% on Tc differences), and an AUPRC value of 0.981, with association classification criteria at >9.87. Tensiomyography has a high predictive ability to discriminate between injured and non-injured BF non-invasively and functionally.
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15
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Opar DA, Ruddy JD, Williams MD, Maniar N, Hickey JT, Bourne MN, Pizzari T, Timmins RG. Screening Hamstring Injury Risk Factors Multiple Times in a Season Does Not Improve the Identification of Future Injury Risk. Med Sci Sports Exerc 2022; 54:321-329. [PMID: 34559727 DOI: 10.1249/mss.0000000000002782] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To determine if eccentric knee flexor strength and biceps femoris long head (BFlh) fascicle length were associated with prospective hamstring strain injury (HSI) in professional Australian Football players, and if more frequent assessments of these variables altered the association with injury risk. METHODS Across two competitive seasons, 311 Australian Football players (455 player seasons) had their eccentric knee flexor strength during the Nordic hamstring exercise and BFlh architecture assessed at the start and end of preseason and in the middle of the competitive season. Player age and injury history were also collected in preseason. Prospective HSIs were recorded by team medical staff. RESULTS Seventy-four player seasons (16%) sustained an index HSI. Shorter BFlh fascicles (<10.42 cm) increased HSI risk when assessed at multiple time points only (relative risk [RR], 1.9; 95% confidence interval [CI], 1.2-3.0). Neither absolute (N) nor relative (N·kg-1) eccentric knee flexor strength was associated with HSI risk, regardless of measurement frequency (RR range, 1.0-1.1); however, between-limb imbalance (>9%), when measured at multiple time points, was (RR, 1.8; 95% CI, 1.1-3.1). Prior HSI had the strongest univariable association with prospective HSI (RR, 2.9; 95% CI, 1.9-4.3). Multivariable logistic regression models identified a combination of prior HSI, BFlh architectural variables and between-limb imbalance in eccentric knee flexor strength as optimal input variables; however, their predictive performance did not improve with increased measurement frequency (area under the curve, 0.681-0.726). CONCLUSIONS More frequent measures of eccentric knee flexor strength and BFlh architecture across a season did not improve the ability to identify which players would sustain an HSI.
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Affiliation(s)
| | | | - Morgan D Williams
- School of Health, Sport and Professional Practice, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UNITED KINGDOM
| | | | - Jack T Hickey
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Victoria, AUSTRALIA
| | | | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, AUSTRALIA
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16
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Is Muscle Architecture Different in Athletes with a Previous Hamstring Strain? A Systematic Review and Meta-Analysis. J Funct Morphol Kinesiol 2022; 7:jfmk7010016. [PMID: 35225902 PMCID: PMC8884017 DOI: 10.3390/jfmk7010016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 11/16/2022] Open
Abstract
Hamstring strains are a frequent injury in sports and are characterized by a high recurrence rate. The aim of this review was to examine the muscle and tendon architecture in individuals with hamstring injury. A systematic literature search in four databases yielded eleven studies on architecture following injury. Differences in the fascicle length (FL), pennation angle (PA) and muscle size measures (volume, thickness and physiological cross-sectional area) at rest were not significantly different between the previously injured limb and the contralateral limb (p > 0.05). There was moderate evidence that biceps femoris long head (BFlh) FL shortening was greater during contraction in the injured compared to the contralateral limb. The BFlh FL was smaller in athletes with a previous injury compared to uninjured individuals (p = 0.0015) but no differences in the FL and PA of other muscles as well as in the aponeurosis/tendon size were observed (p > 0.05). An examination of the FL of both leg muscles in individuals with a previous hamstring strain may be necessary before and after return to sport. Exercises that promote fascicle lengthening of both injured and uninjured leg muscles may be beneficial for athletes who recover from a hamstring injury.
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17
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Alizadeh S, Sarvestan J, Svoboda Z, Alaei F, Linduška P, Ataabadi PA. Hamstring and ACL injuries impacts on hamstring-to-quadriceps ratio of the elite soccer players: A retrospective study. Phys Ther Sport 2021; 53:97-104. [PMID: 34894617 DOI: 10.1016/j.ptsp.2021.12.001] [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: 07/17/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to compare the angle-specific (AS) and non-angle-specific (NAS) hamstring to quadriceps conventional and functional ratios between healthy, hamstring- and ACL-injured elite soccer players. One hundred and eleven players (27.42 ± 8.01 years, 182.11 ± 6.79 cm, 75.93 ± 7.25 kg) completed a series of concentric knee flexor and extensor strength in addition to eccentric knee flexor strength was measured at an angular velocity of 60°.s-1. Normalized and raw peak torque values, and the torque-angle profiles were extracted for analysis. Conventional and functional NAS (peak values) and AS (waveform ratios) hamstring to quadriceps ratios were calculated and compared between the groups. Healthy players produced greater functional and conventional ratios compared to players with either ACL or hamstring injury. Players with hamstring injury produced a lower AS functional ratios between 46° and 54° of knee flexion. Players suffering from ACL injury depicted a lower value for the AS functional ratio between 33° and 56° of knee flexion. Although NAS can identify soccer players with previous hamstring or ACL injury, the range where there is a strength deficiency is eluded. With the use of AS the range where the deficiency is present can be identified, and clinicians can benefit from this analysis to design robust rehabilitation protocols.
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Affiliation(s)
- Shahab Alizadeh
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Javad Sarvestan
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czech Republic.
| | - Zdeněk Svoboda
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czech Republic
| | - Fatemeh Alaei
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czech Republic
| | - Petr Linduška
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czech Republic
| | - Peyman Aghaie Ataabadi
- Department of Biomechanics and Sports Injuries, Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran
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18
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Nara G, Samukawa M, Oba K, Koshino Y, Ishida T, Kasahara S, Tohyama H. The deficits of isometric knee flexor strength in lengthened hamstring position after hamstring strain injury. Phys Ther Sport 2021; 53:91-96. [PMID: 34890906 DOI: 10.1016/j.ptsp.2021.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To investigate the effects of knee flexion angle on peak torque, rate of torque development (RTD) during isometric contraction and hamstring flexibility after hamstring strain injury (HSI). DESIGN Cross-sectional. SETTING Controlled laboratory research. PARTICIPANTS Fourteen male athletes with a history of HSI and 14 athletes without HSI (controls). MAIN OUTCOME MEASURES Hamstring flexibility was evaluated using active knee extension test. Isometric knee flexion peak torque and RTD were determined at 30°, 60°, and 90° of knee flexion measured by an isokinetic dynamometer. RESULTS Individuals with a history of HSI had statistically significant, moderate deficits in isometric peak torque at 30° of knee flexion (P = 0.037; effect size = 0.55) in the HSI limb than in the uninjured limb, but not at 60° and 90° of knee flexion. In the control group, no significant differences in isometric peak torque at any angle were found between limbs. No differences in peak RTD and flexibility were found between limbs in both groups. CONCLUSIONS Isometric peak torque at 30° of knee flexion was lower in the injured limb than in the uninjured limb. Isometric strength deficits after HSI tended to be affected by lengthened hamstring angles.
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Affiliation(s)
- Ginji Nara
- Rehabilitation Center, NTT Medical Center Sapporo, Sapporo, Japan; Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Kensuke Oba
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan; Department of Rehabilitation, Hitsujigaoka Hospital, Sapporo, Japan
| | - Yuta Koshino
- Rehabilitation Center, NTT Medical Center Sapporo, Sapporo, Japan; Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Tomoya Ishida
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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19
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Mikami K, Samukawa M, Oba K, Nakamura K, Suzumori Y, Ishida Y, Matsumoto H, Aoki Y, Ishida T, Yamanaka M, Tohyama H. Torque-angle curve of the knee flexors in athletes with a prior history of hamstring strain. Phys Ther Sport 2021; 54:29-35. [PMID: 34929533 DOI: 10.1016/j.ptsp.2021.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To investigate the knee flexor torque-angle curve after hamstring strain injury using different muscle action types and angular velocities. DESIGN Cross-sectional. SETTING Controlled laboratory. PARTICIPANTS Thirteen collegiate athletes injured hamstring strain (21.0 ± 0.8 years; 173.9 ± 6.5 cm; 70.1 ± 10.5 kg). MAIN OUTCOME MEASURES Concentric and eccentric knee flexor torque was measured at 60 & 300°/sec. Peak torque and average torque every 10° were determined from torque-angle curve and injured side was compared with non-injured side. RESULTS No significant differences were found in the concentric muscle actions. However, the eccentric peak torque was significantly lower on the injured side at 60°/sec (p = 0.048) and at 300°/sec (p = 0.002). The average eccentric torque was significantly lower on the injured side at 60°/sec from 10° to 20° of knee flexion (p = 0.012-0.018) and at 300°/sec from 10° to 60° of knee flexion (p = 0.005-0.049). CONCLUSION The knee flexor torque-angle curve changes with eccentric muscle action after hamstring injury. Eccentric torque declines were close to full knee extension at 60°/sec and a wide range of knee flexion at 300°/sec. The assessment and rehabilitation of eccentric hamstring strength may be important to consider the effect of the angular velocity after hamstring strain injury.
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Affiliation(s)
- Kentaro Mikami
- Department of Rehabilitation, Hokushin Orthopaedic Hospital, Sapporo, Japan
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Kensuke Oba
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan; Department of Rehabilitation, Hitsujigaoka Hospital, Sapporo, Japan
| | - Kentaro Nakamura
- Department of Rehabilitation, Sapporo Spine Clinic, Sapporo, Japan
| | - Yuki Suzumori
- Department of Rehabilitation, Hitsujigaoka Hospital, Sapporo, Japan
| | - Yuko Ishida
- Sports Medical Center, Japan Institute of Sports Sciences, Tokyo, Japan
| | - Hisashi Matsumoto
- Department of Rehabilitation, Hokushin Orthopaedic Hospital, Sapporo, Japan
| | - Yoshimitsu Aoki
- Department of Orthopedic Surgery, Hokushin Orthopaedic Hospital, Sapporo, Japan
| | - Tomoya Ishida
- Department of Rehabilitation, Hokushin Orthopaedic Hospital, Sapporo, Japan; Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Masanori Yamanaka
- Faculty of Health Sciences, Hokkaido Chitose College of Rehabilitation, Chitose, Japan
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20
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Buhmann R, Trajano GS, Kerr GK, Shield AJ. Lower knee flexion and hip extension rate of torque development in athletes with previous hamstring strain injury. J Sports Sci 2021; 40:534-541. [PMID: 34787048 DOI: 10.1080/02640414.2021.2003981] [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: 10/19/2022]
Abstract
Persistent deficits in strength and voluntary activation have been observed in athletes with a history of hamstring strain injury. The mechanisms contributing to these deficits are poorly understood and consequently may not be appropriately addressed during rehabilitation. This study aimed to investigate the impact of intended knee flexor contraction mode (concentric, eccentric or isometric) on the rate of torque development and surface electromyography (sEMG) rise in athletes with and without a history of unilateral hamstring strain injury. The impact of the previous injury on hip extensor rate of torque development was also investigated. Previously injured limbs exhibited a slower rate of torque development (mean difference = -31%, p = 0.02, Cohen's d = 0.62) and biceps femoris rate of sEMG rise (mean difference = -181% · s-1, p = 0.003, Cohen's d = 1.10) during intended eccentric knee flexor contractions compared with control limbs. Previously injured (mean difference = -29%, p = 0.01, Cohen's d = 0.85) and contralateral uninjured limbs (mean difference = -31%, p = 0.007, Cohen's d = 0.73) exhibited a slower rate of torque development during isometric hip extensor contractions compared with control limbs. These findings may highlight lower levels of descending input to hamstring motoneurons in previously injured athletes.
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Affiliation(s)
- Robert Buhmann
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, Australia
| | - Gabriel S Trajano
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Graham K Kerr
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Anthony J Shield
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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21
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Martínez-Rodríguez R, Galán-Del-Río F, Cantalapiedra JA, Flórez-García MT, Martínez-Martín J, Álvaro-Meca A, Koppenhaver SL, Fernández-de-Las-Peñas C. Reliability and discriminative validity of real-time ultrasound elastography in the assessment of tissue stiffness after calf muscle injury. J Bodyw Mov Ther 2021; 28:463-469. [PMID: 34776179 DOI: 10.1016/j.jbmt.2021.06.019] [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: 10/09/2020] [Revised: 04/18/2021] [Accepted: 06/09/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the reliability and discriminative validity of real-time ultrasound elastography (RTE) measures of soft-tissue elasticity after calf muscle tear. DESIGN Cross-sectional, intra/inter-examiner reliability and comparative validity study. SETTING Department of Physical Therapy. PARTICIPANTS Twenty-one recreational athletes were included and examined 6 weeks after sustaining a grade I-II calf musculature tear. MAIN OUTCOME MEASURES Soft-tissue elasticity was measured by two experienced assessors using RTE assessments in both the longitudinal and transverse planes of the athletes' injured and uninjured calf muscles. Elasticity was estimated by using the strain ratio (SR), which was calculated by dividing the strain (displacement) value taken at the medial gastrocnemius-soleus myotendinous junction (reference) by the strain value taken at the centre of the injury (index) as visualized on B-mode sonogram. Intra- and inter-observer reliability was estimated calculating intra-class correlation coefficients (ICCs) and standard error of measurement (SEM). Differences in elasticity between injured and healthy legs were assessed using t-tests or Wilcoxon tests for repeated measures. RESULTS All RTE assessments in both planes showed ICC values ranging from 0.77 to 0.95 and SEM values ranging from 0.72 to 0.99. Additionally, RTE enabled both assessors to determine differences in elastic properties between injured and control legs (p < 0.001). CONCLUSION RTE measures of calf muscles demonstrated good reliability and were able to differentiate injured from non-injured muscle tissue. RTE may provide a fast and objective measure in sports medicine to improve the detection of risk factors for muscle injury related to alterations of the mechanical behaviour of soft tissues during healing process.
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Affiliation(s)
| | - Fernando Galán-Del-Río
- Spanish Football Federation, Physiotherapy Team, Madrid, Spain; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Juan Aboítiz Cantalapiedra
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain; Orthopaedic Surgery, Traumatology and Rehabilitation Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Mariano T Flórez-García
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain; Orthopaedic Surgery, Traumatology and Rehabilitation Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Javier Martínez-Martín
- Orthopaedic Surgery, Traumatology and Rehabilitation Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Alejandro Álvaro-Meca
- Department of Preventive Medicine & Public Health, Universidad Rey Juan Carlos, Madrid, Spain
| | | | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain
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22
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Role of Ultrasound in Managing Hamstring Muscle Injuries. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00330-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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23
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Increased short interval intracortical inhibition in participants with previous hamstring strain injury. Eur J Appl Physiol 2021; 122:357-369. [PMID: 34729636 DOI: 10.1007/s00421-021-04839-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/27/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Cortical mechanisms may contribute to weakness in participants with previous hamstring strain injury. This study aims to examine intra-cortical inhibition (SICI) and corticospinal excitability in previously injured participants. METHODS In this cross-sectional study, TMS was used to examine SICI, silent period, silent period: MEP ratios and area under the stimulus response curve in the biceps femoris and medial hamstrings. Comparisons were made between participants with (n = 10) and without (n = 10) previous hamstring strain injury. Motor threshold and isometric knee flexor strength were also compared between participants and the relationship between strength and SICI in control and previously injured participants was examined. RESULTS Isometric knee flexor strength was lower in previously injured limbs compared with control limbs (mean difference = - 41 Nm (- 26%) [95% CI = - 80 to - 2 Nm], p = 0.04, Cohen's d = - 1.27) and contralateral uninjured limbs (mean difference = - 23 Nm (- 17%), [95% CI = - 40 to - 6 Nm], p = 0.01, Cohen's d = - 0.57). Previously injured limbs exhibited smaller responses to paired pulse stimulation (i.e. greater levels of SICI) in the biceps femoris compared with control limbs (mean difference = - 19%, [95% CI = - 34 to - 5%], p = 0.007, Cohen's d = - 1.33). Isometric knee flexor strength was associated with the level of SICI recorded in the biceps femoris in previously injured participants (coefficient = 23 Nm [95% CI = 7-40 Nm], adjusted R2 = 0.31, p = 0.01). There were no differences in markers of corticospinal excitability between previously injured and control limbs (all p > 0.24, all Cohen's d < 0.40). CONCLUSION Athletes with previous injury in the biceps femoris exhibit increased SICI in this muscle compared with control participants. Increased SICI is related to lower levels of hamstring strength, and rehabilitation programs targeting the removal of intra-cortical inhibition should be considered.
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Shu D, Zhang C, Dai S, Wang S, Liu J, Ding J. Acute Effects of Foam Rolling on Hamstrings After Half-Marathon: A Muscle Functional Magnetic Resonance Imaging Study. Front Physiol 2021; 12:723092. [PMID: 34690798 PMCID: PMC8526727 DOI: 10.3389/fphys.2021.723092] [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: 06/10/2021] [Accepted: 09/15/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose: Foam rolling (FR) is widely used for post-exercise muscle recovery; yet, the effects of FR on skeletal muscle inflammation and microvascular perfusion following prolonged exercise are poorly understood. We aim to address the gap in knowledge by using magnetic resonance imaging (MRI) T2 mapping and intravoxel incoherent motion (IVIM) sequences to study the acute effects of FR on hamstrings following half-marathon running in recreational runners. Methods: Sixteen healthy recreational marathon runners were recruited. After half-marathon running, FR was performed on the hamstrings on the dominant side, while the other limb served as a control. MRI T2 and IVIM scans were performed bilaterally at baseline (pre-run), 2–3 h after running (post-run), immediately after FR (post-FR0), 30 min after FR (post-FR30) and 60 min after FR (post-FR60). T2, a marker for inflammatory edema, as well as IVIM microvascular perfusion fraction index f for biceps femoris long head (BFL), semitendinosus (ST) and semimembranosus (SM) were determined. Total Quality Recovery (TQR) scale score was also collected. Results: Both T2 and f were higher at post-run compared to pre-run in all hamstrings on both sides (all p < 0.05; all d > 1.0). For the FR side, T2 decreased, and f increased significantly at post-FR0 and post-FR30 compared to post-run in all muscles (p < 0.05; all d > 0.4) except for f at BFL and SM at post-FR30 (both p > 0.05), though f at BFL was still marginally elevated at post-FR30 (p = 0.074, d = 0.91). Both parameters for all muscles returned to post-run level at post-FR60 (all p > 0.05; all d < 0.4) except for T2 at SM (p = 0.037). In contrast, most MRI parameters were not changed at post-FR0, post-FR30 and post-FR60 compared to post-run for the control side (p < 0.05; d < 0.2). TQR scores were elevated at post-FR0 and post-FR30 compared to post-run (both p < 0.05; both d > 1.0), and returned to the post-run level at post-FR60 (p > 0.99; d = 0.09). Changes in TQR scores compared to post-run at any time points after FR were correlated to T2 for ST at post-FR30 (r = 0.50, p = 0.047) but not T2 for other muscles and any changes in f values. Conclusions: Hamstrings inflammatory edema and microvascular perfusion were elevated following half-marathon running, which were detectable with MRI T2 mapping and IVIM sequences. FR resulted in acute alleviation in inflammation and greater microvascular perfusion; however, the effects seemed to last only for a short period of time (30–60 min). FR can provide short-term benefits to skeletal muscle after prolonged running.
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Affiliation(s)
- Dingbo Shu
- Department of Radiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,School of Clinical Medicine, Hangzhou Normal University, Hangzhou, China.,Institute of Sport Medicine, Hangzhou Normal University, Hangzhou, China
| | - Chuan Zhang
- School of Physical Education and Sports, Central China Normal University, Wuhan, China
| | - Siyu Dai
- School of Clinical Medicine, Hangzhou Normal University, Hangzhou, China.,Institute of Sport Medicine, Hangzhou Normal University, Hangzhou, China
| | - Shubo Wang
- Department of Mechanical Engineering, University of Delaware, Newark, DE, United States
| | - Jie Liu
- Department of Radiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Institute of Sport Medicine, Hangzhou Normal University, Hangzhou, China
| | - Jianping Ding
- Department of Radiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Institute of Sport Medicine, Hangzhou Normal University, Hangzhou, China
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Indirect Structural Muscle Injuries of Lower Limb: Rehabilitation and Therapeutic Exercise. J Funct Morphol Kinesiol 2021; 6:jfmk6030075. [PMID: 34564194 PMCID: PMC8482242 DOI: 10.3390/jfmk6030075] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022] Open
Abstract
Muscle injuries are the most common trauma in team and individual sports. The muscles most frequently affected are those of the lower limb, and in particular hamstrings, adductors, rectus femoris and calf muscles. Although several scientific studies have tried to propose different rehabilitation protocols, still too often the real rehabilitation process is not based on scientific knowledge, especially in non-elite athletes. Moreover, the growing use of physical and instrumental therapies has made it increasingly difficult to understand what can be truly effective. Therefore, the aim of the present paper is to review proposed therapeutic algorithms for muscle injuries, proposing a concise and practical summary. Following a three-phase rehabilitation protocol, this review aims to describe the conservative treatment of indirect structural muscle injuries, which are the more routinely found and more challenging type. For each phase, until return to training and return to sport are completed, the functional goal, the most appropriate practitioner, and the best possible treatment according to current evidence are expressed. Finally, the last section is focused on the specific exercise rehabilitation for the four main muscle groups with a structured explanatory timetable.
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26
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Alonso-Fernandez D, Martinez-Fernandez J, Docampo-Blanco P, Fernandez-Rodriguez R. Impact of Askling L-PROTOCOL on Biceps Femoris Architecture, Hamstring Flexibility and Sprint Performance. Int J Sports Med 2021; 43:373-380. [PMID: 34464983 DOI: 10.1055/a-1627-0957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Eccentric training has been shown to be important for hamstring strain injuries rehabilitation and prevention. The Askling L-PROTOCOL (L-P), comprising three exercises aimed at eccentric training and hamstring lengthening, was shown to improve this injuries recovery and relapse times in comparison with other traditional exercise-based protocols. However, the causes of these results remain unclear. This study looks at the impact of an 8-week L-P followed by 4 weeks of detraining on the architecture of the biceps femoris long head, hamstring flexibility and sprint performance. Twenty-eight healthy individuals were divided into two groups: an experimental group, which carried out the L-P, and a control group with no training. Muscle architecture was measured using 2D ultrasound, hamstring flexibility using goniometry and sprint performance using sports radar equipment before (M1) and after (M2) the training period and after detraining (M3). No significant changes were observed between M1 and M2 in the experimental group with regard to fascicle length (t=- 0.79, P>0.05), theoretical maximum speed (t=- 1.43, P>0.05), horizontal force (t=0.09, P>0.05), force application during sprint running (t=- 0.09, P>0.05) and horizontal power (t=- 0.97, P>0.05), but, however, changes were observed in hamstring flexibility (t=- 4.42, d=0.98, P<0.001) returning to pre-training values after detraining period (t=- 1.11, P>0.05). L-P has been shown to be an eccentric protocol of moderate intensity and easy implementation that could be interesting to include throughout a sports season.
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Affiliation(s)
- Diego Alonso-Fernandez
- Faculty of Science Education and Sport, University of Vigo, Spain, Department of Special didactics, Education, Physical Activity and Health Research Group (Gies10-DE3), Galicia Sur Health Research Institute (IIS), SERGAS-UVIGO (Spain)
| | - Juan Martinez-Fernandez
- SEEFI (Spanish Society of Ultrasound in Physiotherapy) and Biomedical Institute Hygea, Vigo, Spain
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27
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Muscle- and Region-Specific Associations Between Muscle Size and Muscular Strength During Hip Extension and Knee Flexion in the Hamstrings. J Sport Rehabil 2021; 30:1172-1177. [PMID: 34426558 DOI: 10.1123/jsr.2021-0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/24/2021] [Accepted: 06/14/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Strength deficits of the hamstrings following sports injuries decrease athletic performance and increase the risk of injury recurrence. Previous studies have shown a high correlation between the muscular strength during hip-extension and knee-flexion and total muscle size of the hamstrings. However, it remains unclear which region of the individual hamstring muscles is closely associated with muscular strength. OBJECTIVE To investigate the relationship between the size of each region of the individual hamstring muscles and muscular strength during hip extension and knee flexion. DESIGN Within-subject repeated measures. SETTING University laboratory. PARTICIPANTS Twenty healthy young male volunteers who regularly engaged in sports activities. OUTCOME MEASURES Anatomical cross-sectional areas were acquired from the proximal, middle, and distal regions of the biceps femoris long head, biceps femoris short head, semitendinosus, and semimembranosus. Hip-extension and knee-flexion strength were measured during maximal voluntary isometric and concentric contractions (angular velocities of 60°/s and 180°/s). RESULTS The anatomical cross-sectional area of the distal regions in biceps femoris long head (r = .525-.642) and semitendinosus (r = .567) were significantly correlated with hip-extension strength under all conditions and only at an angular velocity of 180°/s, respectively. Meanwhile, anatomical cross-sectional areas of the distal regions in biceps femoris short head (r = .587-.684) and semimembranosus (r = .569-.576) were closely associated with knee-flexion strength under all conditions. CONCLUSION These results suggest that muscle size in the distal regions of biceps femoris long head and semitendinosus greatly contributes to the production of hip-extension strength, whereas that of biceps femoris short head and semimembranosus significantly contributes to the generation of knee-flexion strength. These findings could be useful for designing training and rehabilitation programs to efficiently improve strength deficits following sports injuries such as strain injury and anterior cruciate ligament tears.
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Presland JD, Timmins RG, Maniar N, Tofari PJ, Kidgell DJ, Shield AJ, Dickson J, Opar DA. Muscle Activity and Activation in Previously Strain-Injured Lower Limbs: A Systematic Review. Sports Med 2021; 51:2311-2327. [PMID: 34309803 DOI: 10.1007/s40279-021-01487-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Lower limb muscle strain injury is highly prevalent in running-based sports and is considered a risk factor for recurrent injury. It is possible that differences in muscle activity and activation in previously strain-injured limbs may contribute to the elevated risk of reinjury. OBJECTIVES To systematically review available literature investigating whether muscle activity and/or activation is different in previously strain-injured muscles compared to contralateral uninjured muscles or uninjured controls. METHODS A systematic review of literature in SPORTDiscus, MEDLINE Complete, CINAHL and Web of Science was conducted. Full-text English articles which compared indicators of neuromuscular function between injured and uninjured contralateral limbs or control groups in those with a history of muscle strain injury were included. RESULTS Twelve studies were included in the review after eligibility criteria were applied. A best evidence synthesis revealed moderate to limited evidence suggesting differences in surface electromyography (sEMG) amplitude, integrated sEMG amplitude, inter-muscle sEMG ratios and voluntary activation in injured limbs, most often during eccentric contractions. Studies utilising sprinting assessments demonstrated conflicting evidence when comparing late swing phase biceps femoris sEMG amplitude between limbs with a history of hamstring strain injury and uninjured contralateral limbs. CONCLUSIONS Differences in muscle activity and activation were observed between injured and uninjured limbs across a variety of strength assessments. The evidence supporting these differences was most often moderate or limited and was generally observed during eccentric contractions. Mostly conflicting or limited evidence was found to suggest that participants with previous hamstring strain injury demonstrate no differences in muscle activity during running tasks when compared with their uninjured counterparts or contralateral limbs. TRIAL REGISTRY PROSPERO (ID, CRD42019135681).
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Affiliation(s)
- Joel D Presland
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Melbourne, VIC, 3065, Australia.
| | - Ryan G Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Melbourne, VIC, 3065, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, VIC, Australia
| | - Nirav Maniar
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Melbourne, VIC, 3065, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, VIC, Australia
| | - Paul J Tofari
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Melbourne, VIC, 3065, Australia
| | - Dawson J Kidgell
- School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
| | - Anthony J Shield
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jessica Dickson
- Library and Academic Research Services, Australian Catholic University, Melbourne, VIC, Australia
| | - David A Opar
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Melbourne, VIC, 3065, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, VIC, Australia
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29
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Mühlenfeld N, Steendahl IB, Berthold DP, Meyer T, Hauser T, Wagner N, Sander AL, Marzi I, Kaltenbach B, Yel I, Vogl T, Eichler K. Assessment of muscle volume using magnetic resonance imaging (MRI) in football players after hamstring injuries. Eur J Sport Sci 2021; 22:1436-1444. [PMID: 34110980 DOI: 10.1080/17461391.2021.1942226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Muscle injuries of the hamstrings are among the most frequent in football and a main cause for significant time away from training and competition. The purpose of this study was to prospectively evaluate the loss of muscle volume in recreational football players three and six weeks after initial trauma. We hypothesized that significant muscle volume loss occurs within 6 weeks after the initial injury event. Twenty recreational football players (mean-age=25 ± 4years; mean-height=181 ± 8cm; mean-weight=81 ± 10kg) with type3a (minor partial muscle tear) and type3b (moderate partial muscle tear) injuries were included. Muscle volume was determined using established methods for the hamstrings and the quadriceps femoris muscle within 3 days and after 3 and 6 weeks following the initial injury. The injured hamstrings lost 6.5% (mean=64 cm3(95%CI=31-98 cm3), p<0.001), the healthy hamstrings lost 2.1% (mean=21 cm3(3-44 cm3),p=0.096) of muscle volume after six weeks. The quadriceps in the injured leg lost 3.8% (mean=78 cm3(51-104 cm3), p<0.001) and 4.5% (83 cm3 (45-121 cm3), p<0.001) in the healthy leg. Muscle volume loss inversely correlated with activity levels in the healthy leg for the quadriceps (r=0.96 (0.90-0.98); R2=0.92; p<0.001) and the hamstrings (r=0.72 (0.40-0.88); R2=0.51; p<0.001), as well as the quadriceps in the injured leg (r=0.70 (0.37-0.87); R2=0.49; p<0.001), but not the injured hamstrings. Muscle volume ratio of hamstrings to quadriceps in the control limb was 0.52 ± 0.06 and 0.53 ± 0.06 in the injured leg. The rehabilitation period of six weeks did not have a relevant negative or a positive effect on ratios. Significant muscle volume loss in the upper thigh occurs in recreational soccer players within three, and within six weeks after a hamstring injury and lies between 2% and 7%.Highlights This study found that significant muscle volume loss occurs within six weeks after sustaining hamstring muscle group injuries.Additionally, most of the non-professional football players in the present study demonstrated low hamstring-to-quadriceps volume ratios in both the injured, as well as the heathy leg. Low hamstring-to-quadriceps volume ratios may provide an opportunity to focus on muscle hypertrophy strategies to help reduce the risk for muscle imbalances and thus future injury.After three weeks of resting, reduced training activity, compared to the training activity before the injury, seems to be sufficient to preserve 99% of the remaining muscle volume in the quadriceps and as well as the healthy hamstrings. The number of training-minutes correlates statistically significant inversely with the muscle volume lost in a rehabilitation period.
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Affiliation(s)
- Nils Mühlenfeld
- Department of Trauma, Hand and Reconstructive Surgery, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Ida Bo Steendahl
- Institute of Sports and Preventive Medicine, Saarland University, Saarbruecken, Germany.,Deutscher Fußball-Bund (DFB), Frankfurt, Germany
| | - Daniel P Berthold
- Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbruecken, Germany
| | | | - Nils Wagner
- Department of Trauma, Hand and Reconstructive Surgery, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Anna-Lena Sander
- Department of Trauma, Hand and Reconstructive Surgery, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Ingo Marzi
- Department of Trauma, Hand and Reconstructive Surgery, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Benjamin Kaltenbach
- Institute for Diagnostic and Interventional Radiology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Ibrahim Yel
- Institute for Diagnostic and Interventional Radiology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Thomas Vogl
- Institute for Diagnostic and Interventional Radiology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Katrin Eichler
- Institute for Diagnostic and Interventional Radiology, Goethe University Frankfurt, Frankfurt am Main, Germany
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30
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Dalen-Lorentsen T, Ranvik A, Bjørneboe J, Clarsen B, Andersen TE. Facilitators and barriers for implementation of a load management intervention in football. BMJ Open Sport Exerc Med 2021; 7:e001046. [PMID: 34249374 PMCID: PMC8220530 DOI: 10.1136/bmjsem-2021-001046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 11/21/2022] Open
Abstract
Background In a recent randomised controlled trial, we found that a commonly used training load management approach was not effective in preventing injuries and illnesses in Norwegian elite youth footballers. Aim To investigate players’ and coaches’ barriers and facilitators to a load management approach to prevent injuries and illnesses and their attitudes and beliefs of load management and injuries and illnesses in general. Methods We asked players and coaches about their views on injury risk in football, the benefits and limitations of load management in general and implementation of load management in football. The questionnaires used were based on similar studies using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. Results We recorded answers from 250 players and 17 coaches. Most players (88%) reported that scientific evidence showing improved performance from the intervention measures is a key facilitator to completing the intervention. Similarly, coaches reported that the most important facilitator was scientific evidence that the preventive measures were effective (100%). Players reported that the coach’s attitude to preventive measures was important (86%), and similarly, 88% of coaches reported that the player’s attitude was important. Conclusions By having a mutual positive attitude towards the intervention, players and coaches can positively contribute to each other’s motivation and compliance. Both players and coaches reported scientific evidence for load management having injury-preventive and performance-enhancing effect and being time efficient as important facilitators. Trial registration number Trial registration number
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Affiliation(s)
- Torstein Dalen-Lorentsen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Andreas Ranvik
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - John Bjørneboe
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Benjamin Clarsen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Thor Einar Andersen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
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31
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Bourne MN, Pollard C, Messer D, Timmins RG, Opar DA, Williams MD, Shield AJ. Hamstring and gluteal activation during high-speed overground running: Impact of prior strain injury. J Sports Sci 2021; 39:2073-2079. [PMID: 33949909 DOI: 10.1080/02640414.2021.1917839] [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: 10/21/2022]
Abstract
This study examined the spatial patterns of hamstring and gluteal muscle activation during high-speed overground running in limbs with and without aprior hamstring strain injury. Ten active males with arecent (<18 month) unilateral biceps femoris long head (BFLH) strain injury underwent functional magnetic resonance imaging before and immediately after arepeat-sprint running protocol. Transverse relaxation (T2) time, an index of muscle activation, of the BFLH and short head (BFSH), semitendinosus (ST), semimembranosus (SM), gluteus maximus (GMAX) and medius (GMED) was assessed pre-post exercise. No significant between-limb differences in running-induced mean T2 changes were observed (p = 0.949), however, decision tree induction revealed that previously injured limbs were characterised by highly variable intramuscular activation of the ST (SD5.3). T2 times increased more for GMAX than all other muscles (all p< 0.001, d= 0.5-2.5). Further, T2 changes were greater for ST than BFSH, SM, GMED, and BFLH (all p≤ 0.001, d= 0.5-2.9); and were greater for BFLH than BFSH, SM, and GMED (all p< 0.001, d= 1.2-1.6). Athletes display heterogenous patterns of posterior thigh activation when sprinting (GMAX>ST>BFLH>GMED>SM>BFSH) and may exhibit altered intramuscular hamstring activation after returning to sport from BFLH strain injury.
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Affiliation(s)
- Matthew N Bourne
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia
| | - Chris Pollard
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Daniel Messer
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Ryan G Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - David A Opar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Morgan D Williams
- School of Health, Sport and Professional Practice, Faculty of Life Sciences and Education, University of South Wales, Wales, UK
| | - Anthony J Shield
- School of Exercise and Nutrition Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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32
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Tampere T, Victor J, Luyckx T, Vermue H, Arnout N, Witvrouw E, Schuermans J. Biceps Femoris Compensates for Semitendinosus After Anterior Cruciate Ligament Reconstruction With a Hamstring Autograft: A Muscle Functional Magnetic Resonance Imaging Study in Male Soccer Players. Am J Sports Med 2021; 49:1470-1481. [PMID: 33861671 DOI: 10.1177/03635465211003309] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Rates of reinjury, return to play (RTP) at the preinjury level, and hamstring strain injuries in male soccer players after anterior cruciate ligament reconstruction (ACLR) remain unsatisfactory, due to multifactorial causes. Recent insights on intramuscular hamstring coordination revealed the semitendinosus (ST) to be of crucial importance for hamstring functioning, especially during heavy eccentric hamstring loading. Scientific evidence on the consequences of ST tendon harvest for ACLR is scarce and inconsistent. This study intended to investigate the repercussions of ST harvest for ACLR on hamstring muscle function. HYPOTHESIS Harvest of the ST tendon for ACLR was expected to have a significant influence on hamstring muscle activation patterns during eccentric exercises, evaluated at RTP in a population of male soccer athletes. STUDY DESIGN Controlled laboratory study. METHODS A total of 30 male soccer players with a history of ACLR who were cleared for RTP and 30 healthy controls were allocated to this study during the 2018-2019 soccer season. The influence of ACLR on hamstring muscle activation patterns was assessed by comparing the change in T2 relaxation times [ΔT2 (%) = post-exercise-T2pre-exerciseT2pre-exercise] of the hamstring muscle tissue before and after an eccentric hamstring loading task between athletes with and without a recent history of ACLR through use of muscle functional magnetic resonance imaging, induced by an eccentric hamstring loading task between scans. RESULTS Significantly higher exercise-related activity was observed in the biceps femoris (BF) of athletes after ACLR compared with uninjured control athletes (13.92% vs 8.48%; P = .003), whereas the ST had significantly lower activity (19.97% vs 25.32%; P = .049). Significant differences were also established in a within-group comparison of the operated versus the contralateral leg in the ACLR group (operated vs nonoperated leg: 14.54% vs 11.63% for BF [P = .000], 17.31% vs 22.37% for ST [P = .000], and 15.64% vs 13.54% for semimembranosus [SM] [P = .014]). Neither the muscle activity of SM and gracilis muscles nor total posterior thigh muscle activity (sum of exercise-related ΔT2 of the BF, ST, and SM muscles) presented any differences in individuals who had undergone ACLR with an ST tendon autograft compared with healthy controls. CONCLUSION These findings indicate that ACLR with a ST tendon autograft might notably influence the function of the hamstring muscles and, in particular, their hierarchic dimensions under fatiguing loading circumstances, with increases in relative BF activity contribution and decreases in relative ST activity after ACLR. This between-group difference in hamstring muscle activation pattern suggests that the BF partly compensates for deficient ST function in eccentric loading. These alterations might have implications for athletic performance and injury risk and should probably be considered in rehabilitation and hamstring injury prevention after ACLR with a ST tendon autograft.
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Affiliation(s)
- Thomas Tampere
- Department of Orthopaedic Surgery, Ghent University Hospital, Ghent University, Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Jan Victor
- Department of Orthopaedic Surgery, Ghent University Hospital, Ghent University, Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Thomas Luyckx
- Department of Orthopaedic Surgery, AZ Delta, Roeselare, Belgium.,Department of Orthopaedic Surgery, Leuven University Hospital, Catholic University of Leuven, Faculty of Medicine and Health Sciences, Campus Gasthuisberg, Leuven, Belgium
| | - Hannes Vermue
- Department of Orthopaedic Surgery, Ghent University Hospital, Ghent University, Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Nele Arnout
- Department of Orthopaedic Surgery, Ghent University Hospital, Ghent University, Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Erik Witvrouw
- Department of Rehabilitation Sciences, Ghent University, Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Joke Schuermans
- Department of Rehabilitation Sciences, Ghent University, Faculty of Medicine and Health Sciences, Ghent, Belgium
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33
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Freitas SR, Mendes B, Firmino T, Correia JP, Witvrouw EE, Raúl Oliveira E, Vaz JR. Semitendinosus and biceps femoris long head active stiffness response until failure in professional footballers with vs. without previous hamstring injury. Eur J Sport Sci 2021; 22:1132-1140. [PMID: 33787449 DOI: 10.1080/17461391.2021.1910347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study sought to examine the active stiffness of semitendinosus (ST) and biceps femoris long head (BFlh) during a knee flexor isometric contraction at 20% of maximal voluntary isometric contraction until failure in elite footballers (n=50, age: 22.3±5.3 years; height: 1.82±0.08 m; body mass: 74.7±9.0 kg). Active stiffness was assessed using ultrasound-based shear wave elastography by means of shear modulus quantification. Comparisons were performed between limbs with (n=11) vs. without (n=89) previous hamstring injury. Similar time until failure in the knee flexor fatigue task was observed between groups (p=0.401). At the start of the task, lower limbs with previous hamstring injury showed a lower BFlh active stiffness (31.0.1±10.4 kPa, p=0.023) and BFlh/ST active stiffness ratio (0.50±0.29), and no differences for ST (72.8±26.8 kPa, p=0.221) compared to lower limbs without previous hamstring injuries (BFlh: 38.0±9.6 kPa; ST: 64.0±18.4 kPa; BFlh/ST: 0.65±0.27). During the task, the ST active stiffness in both groups decreased from 80% of task time (p=0.032), in the absence of changes in BFlh active stiffness (p=0.534), resulting in an increase in BFlh/ST active stiffness from 80% of task time (p=0.029). No differences between limbs were observed during the fatigue task for all parameters (p>0.099). Future research is warranted to verify if the differences found represent an increased risk of hamstring injury.
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Affiliation(s)
- Sandro R Freitas
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Bruno Mendes
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Telmo Firmino
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal.,Sport Lisboa e Benfica, Human Performance Department - Health Performance, Av. Eusébio da Silva Ferreira, 1500-313 Lisboa, Lisboa, Portugal.,Escola Superior de Saúde do Alcoitão, Rua Conde Barão, 2649-506 Alcabideche, Cascais, Portugal
| | - José Pedro Correia
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | | | - E Raúl Oliveira
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - João R Vaz
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
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Soga T, Nishiumi D, Furusho A, Akiyama K, Hirose N. Effect of Different Slopes of the Lower Leg during the Nordic Hamstring Exercise on Hamstring Electromyography Activity. JOURNAL OF SPORTS SCIENCE AND MEDICINE 2021; 20:216-221. [PMID: 33948099 DOI: 10.52082/jssm.2021.216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 02/02/2021] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to examine whether the NHE with an increased lower leg slope angle would enhance hamstring EMG activity in the final phase of the descend. The hamstring EMG activity was measured, the biceps femoris long head (BFlh) and the semitendinosus (ST). Fifteen male volunteers participated in this study. Subjects performed a prone leg curl with maximal voluntary isometric contraction to normalize the hamstring EMG activity. Subsequently, subjects performed the NHE, with the help of a certified strength and conditioning specialist, while the lower leg slope angle were randomly set at 0° (NH), 20° (N20), and 40° (N40). To compare hamstring EMG activity during the NHE variations, the knee flexion angle was set in the range from 0° to 50°, divided into five phases (0-10°, 10-20°, 20-30°, 30-40° and 40-50°), where 0° indicated that the knee was fully extended. To calculate the knee extension angular velocity, the knee flexion angle divided by time, and break point angle (BPA) was the angle at which 10°/s was exceeded. In the statistical analysis, a two-way repeated measures ANOVA was used for the hamstring EMG activity and a one-way repeated measures ANOVA was used for the BPA. The EMG activity of the BFlh and the ST in N20 and N40 was significantly higher than in NH at knee flexion angle of 0-20° (p < 0.05). For the BPA, NH (57.75° ± 13.28°), N20 (36.27° ± 9.89°) and N40 (16.26° ± 9.58°) were significantly higher in that order (p < 0.05). The results of this study revealed that the NHE with an increased lower leg slope angle shifted the BPA to the lower knee flexion angle and enhanced the hamstring EMG activity in the final phase of the descent.
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Affiliation(s)
- Toshiaki Soga
- Graduate School of Sport Sciences, Waseda University, Tokyo, Japan
| | - Daichi Nishiumi
- Graduate School of Sport Sciences, Waseda University, Tokyo, Japan
| | - Atsuya Furusho
- Graduate School of Sport Sciences, Waseda University, Tokyo, Japan
| | - Kei Akiyama
- Faculty of Sport Sciences, Waseda University, Tokyo, Japan
| | - Norikazu Hirose
- Graduate School of Sport Sciences, Waseda University, Tokyo, Japan.,Faculty of Sport Sciences, Waseda University, Tokyo, Japan
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Effect of Knee Joint Angle on Regional Hamstrings Activation During Isometric Knee-Flexion Exercise. J Sport Rehabil 2021; 30:905-910. [PMID: 33571961 DOI: 10.1123/jsr.2020-0181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 11/28/2020] [Accepted: 11/29/2020] [Indexed: 12/16/2022]
Abstract
CONTEXT Each hamstring muscle is subdivided into several regions by multiple motor nerve branches, which implies each region has different muscle activation properties. However, little is known about the muscle activation of each region with a change in the knee joint angle. Understanding of regional activation of the hamstrings could be helpful for designing rehabilitation and training programs targeted at strengthening a specific region. OBJECTIVE To investigate the effect of knee joint angle on the activity level of several regions within the individual hamstring muscles during isometric knee-flexion exercise with maximal effort (MVCKF). DESIGN Within-subjects repeated measures. SETTING University laboratory. PARTICIPANTS Sixteen young males with previous participation in sports competition and resistance training experience. INTERVENTION The participants performed 2 MVCKF trials at each knee joint angle of 30°, 60°, and 90°. OUTCOME MEASURES Surface electromyography was used to measure muscle activity in the proximal, middle, and distal regions of the biceps femoris long head (BFlh), semitendinosus, and semimembranosus of hamstrings at 30°, 60°, and 90° of knee flexion during MVCKF. RESULTS Muscle activity levels in the proximal and middle regions of the BFlh were higher at 30° and 60° of knee flexion than at 90° during MVCKF (all: P < .05). Meanwhile, the activity levels in the distal region of the BFlh were not different among all of the evaluated knee joint angles. In semitendinosus and semimembranosus, the activity levels were higher at 30° and 60° than at 90°, regardless of region (all: P < .05). CONCLUSION These findings suggest that the effect of knee joint angle on muscle activity level differs between regions of the BFlh, whereas that is similar among regions of semitendinosus and semimembranosus during MVCKF.
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Alonso-Fernandez D, Abalo-Núñez R, Mateos-Padorno C, Martínez-Patiño M. Effects of eccentric exercise on the quadriceps architecture. Sci Sports 2021. [DOI: 10.1016/j.scispo.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Verstappen S, van Rijn RM, Cost R, Stubbe JH. The Association Between Training Load and Injury Risk in Elite Youth Soccer Players: a Systematic Review and Best Evidence Synthesis. SPORTS MEDICINE-OPEN 2021; 7:6. [PMID: 33428001 PMCID: PMC7801562 DOI: 10.1186/s40798-020-00296-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/20/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Injury risk in elite youth soccer players is high. Implementing an optimal training load is of utmost importance to reduce the risk of injuries. OBJECTIVE To conduct a systematic review and best evidence synthesis to explore the effects of internal and external training load on injury risk in elite youth soccer players. METHODS MEDLINE, Embase, Web of Science, CENTRAL, and CINAHL were searched up until 17 January 2020. Each article had to meet all of the following criteria: (1) the study population consisted of male elite youth soccer players aged between 12 and 21 years; (2) a longitudinal, prospective study design was used; (3) soccer-related injuries were registered (i.e., self-reported or by medical staff); (4) external and/or internal load parameters were described; and (5) the article was published in an English peer-reviewed scientific journal. The quality of the included articles was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). A best evidence synthesis was performed to rank the level of evidence. RESULTS Five studies (2 high quality, 3 low quality) were included. Best evidence synthesis highlighted that there was moderate evidence for (1) no association between 2-, 3-, and 4-week cumulative loads for total distance covered; (2) no association between 1-week workloads (sRPE × duration); and (3) no association between A:C workload ratios (4 weeks) and injury risk. For all other comparisons, only insufficient or conflicting evidence was found. CONCLUSION There is a paucity of evidence for an association between internal and external training load parameters and injury risk in elite youth soccer players.
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Affiliation(s)
- Sven Verstappen
- Codarts, University of the Arts, Kruisplein 26, 3012 CC, Rotterdam, The Netherlands.,PErforming artist and Athlete Research Lab (PEARL), Rotterdam, The Netherlands.,Feyenoord Academy, Rotterdam, The Netherlands
| | - Rogier M van Rijn
- Codarts, University of the Arts, Kruisplein 26, 3012 CC, Rotterdam, The Netherlands.,PErforming artist and Athlete Research Lab (PEARL), Rotterdam, The Netherlands
| | - Rick Cost
- Feyenoord, Rotterdam, The Netherlands
| | - Janine H Stubbe
- Codarts, University of the Arts, Kruisplein 26, 3012 CC, Rotterdam, The Netherlands. .,PErforming artist and Athlete Research Lab (PEARL), Rotterdam, The Netherlands. .,Erasmus MC University Medical Center, Department of General Practice, Rotterdam, The Netherlands. .,Rotterdam Arts and Science Lab (RASL), Rotterdam, The Netherlands.
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Rojas-Valverde D, Gutiérrez-Vargas JC, Sánchez-Ureña B. Sport Readaptation: Where Do We Draw the Lines Between Professionals? Front Sports Act Living 2020; 1:62. [PMID: 33344985 PMCID: PMC7739741 DOI: 10.3389/fspor.2019.00062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/04/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia, Costa Rica.,Grupo de Avances en Entrenamiento Deportivo y Acondicionamiento Físico, Facultad Ciencias del Deporte, Universidad de Extremadura, Cáceres, Spain
| | - Juan Carlos Gutiérrez-Vargas
- Centro de Estudios para el Desarrollo y Rehabilitación en Salud, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia, Costa Rica
| | - Braulio Sánchez-Ureña
- Programa de Ciencias del Ejercicio y la Salud, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia, Costa Rica
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Recommendations for Hamstring Function Recovery After ACL Reconstruction. Sports Med 2020; 51:607-624. [PMID: 33332017 DOI: 10.1007/s40279-020-01400-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2020] [Indexed: 01/09/2023]
Abstract
It is important to optimise the functional recovery process to enhance patient outcomes after major injury such as anterior cruciate ligament reconstruction (ACLR). This requires in part more high-quality original research, but also an approach to translate existing research into practice to overcome the research to implementation barriers. This includes research on ACLR athletes, but also research on other pathologies, which with some modification can be valuable to the ACLR patient. One important consideration after ACLR is the recovery of hamstring muscle function, particularly when using ipsilateral hamstring autograft. Deficits in knee flexor function after ACLR are associated with increased risk of knee osteoarthritis, altered gait and sport-type movement quality, and elevated risk of re-injury upon return to sport. After ACLR and the early post-operative period, there are often considerable deficits in hamstring function which need to be overcome as part of the functional recovery process. To achieve this requires consideration of many factors including the types of strength to recover (e.g., maximal and explosive, multiplanar not just uniplanar), specific programming principles (e.g., periodised resistance programme) and exercise selection. There is a need to know how to train the hamstrings, but also apply this to the ACLR athlete. In this paper, the authors discuss the deficits in hamstring function after ACLR, the considerations on how to restore these deficits and align this information to the ACLR functional recovery process, providing recommendation on how to recover hamstring function after ACLR.
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40
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Pieters D, Witvrouw E, Wezenbeek E, Schuermans J. Value of isokinetic strength testing for hamstring injury risk assessment: Should the 'strongest' mates stay ashore? Eur J Sport Sci 2020; 22:257-268. [PMID: 33191856 DOI: 10.1080/17461391.2020.1851774] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although isokinetic strength testing is commonly used in hamstring strain injury (HSI) rehabilitation and prevention, research findings concerning its predictive value remain inconclusive. Existing research focuses on peak torque (PT) and angle of PT, not analysing the torque behaviour throughout the testing range of motion (ROM). This study intended to assess the value of isokinetic curve evaluation in association with HSI. A sample of 116 male football players with and without a recent HSI history was submitted to bilateral isokinetic assessment of the knee and hip muscles. Raw isokinetic data were filtered and normalized prior to curve analysis submission in MATLAB. Torque development of each muscle group throughout the entire testing ROM was assessed using HSI history as an independent variable. Curve analysis revealed significant differences in torque behaviour in function of injury history. Players with an HSI history demonstrated significantly stronger concentric knee flexion and extension, eccentric knee extension and concentric hip extension patterns compared to the controls and their uninjured limb. HSI history was also associated with lower concentric hip flexion torques and lower mixed H:Q ratios compared to the control group and their contralateral limb. HSI history was associated with altered knee and hip muscle strength profiles, potentially due to isolated focus on local strength training in rehabilitation or mechanisms of neuromuscular inhibition. Because the differences in torque amplitude were range-dependent and did not systematically concur with the point of PT achievement, isokinetic strength evaluation should most probably be conducted using curve analysis.
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Affiliation(s)
- Dries Pieters
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Erik Witvrouw
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Evi Wezenbeek
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Joke Schuermans
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
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SPRINT PERFORMANCE IN FOOTBALL (SOCCER) PLAYERS WITH AND WITHOUT A PREVIOUS HAMSTRING STRAIN INJURY: AN EXPLORATIVE CROSS-SECTIONAL STUDY. Int J Sports Phys Ther 2020; 15:947-957. [PMID: 33344011 DOI: 10.26603/ijspt20200947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Hamstring strain injuries are common in many sports. Following a hamstring injury, deficits in peak and explosive strength may persist after return to sport potentially affecting sprint performance. Assessment of repeated-sprint ability is recognized as an important part of the return to sport evaluation after a hamstring injury.Purpose: This purpose of this exploratory cross-sectional study was to compare sprinting performance obtained during a repeated-sprint test between football players with and without a previous hamstring strain injury. Methods Forty-four fully active sub-elite football players, 11 with a previous hamstring strain injury during the preceding 12 months (cases; mean age, SD: 25.6 ± 4.4) and 33 demographically similar controls (mean age, SD: 23.2 ± 3.7), were included from six clubs. All players underwent a repeated-sprint test, consisting of six 30-meter maximal sprints with 90 seconds of recovery between sprints. Sprint performance was captured using high-speed video-recording and subsequently assessed by a blinded tester to calculate maximal sprint velocity, maximal horizontal force, maximal horizontal power, and mechanical effectiveness. Results A significant between-group difference was seen in favor of players having a previous hamstring injury over 6 sprints for maximal velocity (mean difference: 0.457 m/s, 95% CI: 0.059-0.849, p = 0.025) and mechanical effectiveness (mean difference: 0.009, 95% CI: 0.001-0.016, p = 0.020). Conclusion Repeated-sprint performance was not impaired in football players with a previous hamstring strain injury; in fact, higher mean maximal sprinting velocity and better mechanical effectiveness were found in players with compared to without a previous hamstring injury. The higher sprinting velocity, which likely increases biomechanical load on the hamstring muscles, in previously injured players may increase the risk of recurrent injuries. Level of evidence 3b.
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Abstract
Injuries to the quadriceps muscle group are commonly seen in sporting activities that involve repetitive kicking and high-speed sprinting, including football (soccer), rugby and athletics. The proximal rectus femoris is prone to avulsion injuries as rapid eccentric muscle contraction leads to asynchronous muscle activation and different force vectors through the straight and reflected heads. Risk factors for injury include previous rectus femoris muscle or hamstring injury, reduced flexibility of the quadriceps complex, injury to the dominant leg, and dry field playing conditions. Magnetic resonance imaging (MRI) is the preferred imaging modality as it enables the site of injury to be accurately located, concurrent injuries to be identified, preoperative grading of the injury, and aids surgical planning. Non-operative management is associated with highly variable periods of convalescence, poor return to preinjury level of function and high risk of injury recurrence. Operative treatment of proximal rectus femoris avulsion injuries with surgical repair or surgical tenodesis enables return to preinjury level of sporting activity and high functional outcomes. Surgical tenodesis of proximal rectus femoris avulsion injuries may offer an avenue for further reducing recurrence rates compared to direct suture anchor repair of these injuries.
Cite this article: EFORT Open Rev 2020;5:828-834. DOI: 10.1302/2058-5241.5.200055
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Affiliation(s)
- Fahima A Begum
- Department of Trauma and Orthopaedic Surgery, University College Hospital, UK
| | - Babar Kayani
- Department of Trauma and Orthopaedic Surgery, University College Hospital, UK
| | - Justin S Chang
- Department of Trauma and Orthopaedic Surgery, University College Hospital, UK
| | - Rosamond J Tansey
- Department of Trauma and Orthopaedic Surgery, University College Hospital, UK
| | - Fares S Haddad
- Department of Trauma and Orthopaedic Surgery, University College Hospital, UK
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Ehiogu UD, Stephens G, Jones G, Schöffl V. Acute Hamstring Muscle Tears in Climbers-Current Rehabilitation Concepts. Wilderness Environ Med 2020; 31:441-453. [PMID: 33189522 DOI: 10.1016/j.wem.2020.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 07/11/2020] [Accepted: 07/14/2020] [Indexed: 10/23/2022]
Abstract
Acute hamstring injuries are often caused by the heel hook technique. This technique is unique to climbing and causes injury to muscular and inert tissues of the posterior thigh. The heel hook is used by climbers during strenuous ascent on overhanging walls and when crossing difficult terrain. The technique reduces the amount of upper body strength required during strenuous climbing because the climber's center of mass is retained within the base of support. The heel hook is stressful collectively for the hamstring muscle group and musculotendinous junction. Depending on injury severity, both conservative and surgical methods exist for the management of hamstring injuries. Contemporary approaches to rehabilitation primarily advocate the use of eccentric muscle strengthening strategies because of high rates of elongation stress associated with sprinting and team sports. However, there is reason to doubt whether this alone is sufficient to rehabilitate the climbing athlete in light of the high degree of concentric muscle strength required in the heel hook maneuver. This review examines the contemporary rehabilitation and strength and conditioning literature in relation to the management of acute hamstring musculotendinous injuries for the climbing athlete. The review provides a comprehensive approach for the rehabilitation and athletic preparation of the climbing athlete from the initial injury to full return to sports participation.
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Affiliation(s)
- Uzo Dimma Ehiogu
- Birmingham Royal Orthopaedic Hospital, Research and Training Department, Birmingham, United Kingdom; Birmingham Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, United Kingdom.
| | - Gareth Stephens
- Birmingham Royal Orthopaedic Hospital, Research and Training Department, Birmingham, United Kingdom
| | - Gareth Jones
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, United Kingdom
| | - Volker Schöffl
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, United Kingdom; Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany; Section of Sports Medicine, Department of Orthopedic Surgery, Klinikum Bamberg, Germany; Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
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44
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Green B, Lin M, McClelland JA, Semciw AI, Schache AG, Rotstein AH, Cook J, Pizzari T. Return to Play and Recurrence After Calf Muscle Strain Injuries in Elite Australian Football Players. Am J Sports Med 2020; 48:3306-3315. [PMID: 33030961 DOI: 10.1177/0363546520959327] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Calf muscle strain injuries (CMSI) are prevalent in sport, but information about factors associated with time to return to play (RTP) and recurrence is limited. PURPOSE To determine whether clinical and magnetic resonance imaging (MRI) data are associated with RTP and recurrence after CMSI. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS Data of 149 CMSI reported to the Soft Tissue injury Registry of the Australian Football League were explored to evaluate the impact of clinical data and index injury MRI findings on RTP and recurrence. Clinical data included age, previous injury history, ethnicity, and the mechanism of injury. RESULTS Irrespective of the anatomical location, players with CMSI with severe aponeurotic disruption (AD) took longer to RTP than players with CMSI with no AD: 31.3 ± 12.6 days vs 19.4 ± 10.8 days (mean ± SD; P = .003). A running-related mechanism of injury was associated with a longer RTP period for CMSI overall (adjusted hazard ratio [AHR], 0.59; P = .02). The presence of AD was associated with a longer RTP period for soleus injuries (AHR, 0.6; P = .025). Early recurrence (ie, ≤2 months of the index injury) was associated with older age (AHR, 1.3; P = .001) and a history of ankle injury (AHR, 3.9; P = .032). Older age (AHR, 1.1; P = .013) and a history of CMSI (AHR, 6.7; P = .002) increased the risk of recurrence within 2 seasons. The index injury MRI findings were not associated with risk of recurrence. CONCLUSION A running-related mechanism of injury and the presence of AD on MRI were associated with a longer RTP period. Clinical rather than MRI data best indicate the risk of recurrent CMSI.
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Affiliation(s)
- Brady Green
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia
| | - Monica Lin
- Victoria House Medical Imaging, Melbourne, Australia
| | - Jodie A McClelland
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia
| | - Adam I Semciw
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia.,Northern Centre for Health Education and Research, Northern Health, Victoria, Australia
| | - Anthony G Schache
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia
| | | | - Jill Cook
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia
| | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia
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Dalen-Lorentsen T, Bjørneboe J, Clarsen B, Vagle M, Fagerland MW, Andersen TE. Does load management using the acute:chronic workload ratio prevent health problems? A cluster randomised trial of 482 elite youth footballers of both sexes. Br J Sports Med 2020; 55:108-114. [PMID: 33036995 DOI: 10.1136/bjsports-2020-103003] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The acute:chronic workload ratio (ACWR) is commonly used to manage training load in sports, particularly to reduce injury risk. However, despite its extensive application as a prevention intervention, the effectiveness of load management using ACWR has never been evaluated in an experimental study. AIM To evaluate the effectiveness of a load management intervention designed to reduce the prevalence of health problems among elite youth football players of both sexes. METHODS We cluster-randomised 34 elite youth football teams (16 females, 18 males) to an intervention group (18 teams) and a control group (16 teams). Intervention group coaches planned all training based on published ACWR load management principles using a commercially available athlete management system for a complete 10-month season. Control group coaches continued to plan training as normal. The prevalence of health problems was measured monthly in both groups using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. RESULTS The between-group difference in health problem prevalence (primary outcome) was 1.8%-points (-4.1 to 7.7 %-points; p=0.55) with no reduction in the likelihood of reporting a health problem in the intervention group (relative risk 1.01 (95% CI 0.91 to 1.12); p=0.84) compared with the control group. CONCLUSIONS We observed no between-group difference, suggesting that this specific load management intervention was not successful in preventing health problems in elite youth footballers. TRIAL REGISTRATION NUMBER ISRCTN18177140.
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Affiliation(s)
- Torstein Dalen-Lorentsen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - John Bjørneboe
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Benjamin Clarsen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,Department for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Markus Vagle
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,Department of Sports, Physical Education and Outdoor Studies, University of South-Eastern Norway, Horten, Norway
| | - Morten Wang Fagerland
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Thor Einar Andersen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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Maestroni L, Read P, Bishop C, Turner A. Strength and Power Training in Rehabilitation: Underpinning Principles and Practical Strategies to Return Athletes to High Performance. Sports Med 2020; 50:239-252. [PMID: 31559567 DOI: 10.1007/s40279-019-01195-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Injuries have a detrimental impact on team and individual athletic performance. Deficits in maximal strength, rate of force development (RFD), and reactive strength are commonly reported following several musculoskeletal injuries. This article first examines the available literature to identify common deficits in fundamental physical qualities following injury, specifically strength, rate of force development and reactive strength. Secondly, evidence-based strategies to target a resolution of these residual deficits will be discussed to reduce the risk of future injury. Examples to enhance practical application and training programmes have also been provided to show how these can be addressed.
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Affiliation(s)
- Luca Maestroni
- Smuoviti, Viale Giulio Cesare, 29, 24121, Bergamo, BG, Italy.
- StudioErre, Via della Badia, 18, 25127, Brescia, BS, Italy.
| | - Paul Read
- Athlete Health and Performance Research Center, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Chris Bishop
- London Sport Institute, School of Science and Technology, Middlesex University, Greenlands Lane, London, UK
| | - Anthony Turner
- London Sport Institute, School of Science and Technology, Middlesex University, Greenlands Lane, London, UK
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47
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Vicens-Bordas J, Esteve E, Fort-Vanmeerhaeghe A, Casals M, Bandholm T, Ishøi L, Opar D, Shield A, Thorborg K. Performance changes during the off-season period in football players - Effects of age and previous hamstring injury. J Sports Sci 2020; 38:2489-2499. [PMID: 32658565 DOI: 10.1080/02640414.2020.1792160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aims of this study were to investigate changes in selected performance measures during an off-season period, their association, and the potential role of age and previous hamstring injury in semi-professional and amateur football players. Seventy-four male players (age: 25 ± 4 years, stature: 178.0 ± 6.6 cm, body mass: 74.9 ± 8.1 kg) were assessed at the beginning and end of the off-season summer-period for sprint, change-of-direction performance and eccentric hamstring strength. Small to medium increases in sprint times were observed at 5 (d = 0.26, p = 0.057), 10 (d = 0.42, p < 0.001) and 30 m (d = 0.64, p < 0.001). Small (d = -0.23, p = 0.033) improvements were observed for COD performance, and no changes in eccentric hamstring strength (d = 0.10, p = 0.317). The changes in the outcomes were not affected by age (p = 0.449 to 0.928) or previous hamstring injury (p = 0.109 to 0.995). The impaired sprint performance was not related to changes in eccentric hamstring strength (r = -0.21 to 0.03, p = 0.213 to 0.856), instead, changes in COD performance were associated with changes in eccentric hamstring strength (r = -0.42, p = 0.008).
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Affiliation(s)
- Jordi Vicens-Bordas
- Sportclínic. Physiotherapy and Sports Training Centre , Girona, Spain.,School of Health and Sport Sciences (EUSES), Universitat de Girona , Salt, Spain.,Research Group of Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, Universitat de Girona , Girona, Spain.,Sport and Physical Activity Studies Centre (CEEAF), University of Vic - Central University of Catalonia (UVic-UCC) , Spain
| | - Ernest Esteve
- Sportclínic. Physiotherapy and Sports Training Centre , Girona, Spain.,School of Health and Sport Sciences (EUSES), Universitat de Girona , Salt, Spain
| | | | - Martí Casals
- Sport and Physical Activity Studies Centre (CEEAF), University of Vic - Central University of Catalonia (UVic-UCC) , Spain.,Sport Performance Analysis Research Group, University of Vic , Barcelona, Spain.,Medical Department, Futbol Club Barcelona , Barcelona, Spain
| | - Thomas Bandholm
- Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Department of Orthopedic Surgery, Clinical Research Center, Amager-Hvidovre Hospital, Copenhagen University , Hvidovre, Denmark
| | - Lasse Ishøi
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital , Copenhagen, Denmark
| | - David Opar
- School of Behavioural and Health Sciences, Australian Catholic University , Melbourne, Australia
| | - Anthony Shield
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology , Brisbane, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology , Brisbane, Australia
| | - Kristian Thorborg
- Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Department of Orthopedic Surgery, Clinical Research Center, Amager-Hvidovre Hospital, Copenhagen University , Hvidovre, Denmark.,Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital , Copenhagen, Denmark
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48
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Higashihara A, Nakagawa K, Inami T, Fukano M, Iizuka S, Maemichi T, Hashizume S, Narita T, Hirose N. Regional differences in hamstring muscle damage after a marathon. PLoS One 2020; 15:e0234401. [PMID: 32584826 PMCID: PMC7316338 DOI: 10.1371/journal.pone.0234401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 05/24/2020] [Indexed: 02/04/2023] Open
Abstract
Previous studies suggest that marathon running induces lower extremity muscle damage. This study aimed to examine inter- and intramuscular differences in hamstring muscle damage after a marathon using transverse relaxation time (T2)–weighted magnetic resonance images (MRI). 20 healthy collegiate marathon runners (15 males) were recruited for this study. T2-MRI was performed before (PRE) and at 1 (D1), 3 (D3), and 8 days (D8) after marathon, and the T2 values of each hamstring muscle at the distal, middle, and proximal sites were calculated. Results indicated that no significant intermuscular differences in T2 changes were observed and that, regardless of muscle, the T2 values of the distal and middle sites increased significantly at D1 and D3 and recovered at D8, although those values of the proximal site remained constant. T2 significantly increased at distal and middle sites of the biceps femoris long head on D1 (p = 0.030 and p = 0.004, respectively) and D3 (p = 0.007 and p = 0.041, respectively), distal biceps femoris short head on D1 (p = 0.036), distal semitendinosus on D1 (p = 0.047) and D3 (p = 0.010), middle semitendinosus on D1 (p = 0.005), and distal and middle sites of the semimembranosus on D1 (p = 0.008 and p = 0.040, respectively) and D3 (p = 0.002 and p = 0.018, respectively). These results suggest that the distal and middle sites of the hamstring muscles are more susceptible to damage induced by running a full marathon. Conditioning that focuses on the distal and middle sites of the hamstring muscles may be more useful in improving recovery strategies after prolonged running.
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Affiliation(s)
- Ayako Higashihara
- Institute of Physical Education, Keio University, Kanagawa, Japan
- * E-mail:
| | - Kento Nakagawa
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Takayuki Inami
- Institute of Physical Education, Keio University, Kanagawa, Japan
| | - Mako Fukano
- Shibaura Institute of Technology, Tokyo, Japan
| | - Satoshi Iizuka
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | | | - Satoru Hashizume
- National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Takaya Narita
- Department of Sport Technology, Toin University of Yokohama, Kanagawa, Japan
| | - Norikazu Hirose
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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49
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Burrows AP, Cleather D, Mahaffey R, Cimadoro G. Kinetic and Electromyographic Responses to Traditional and Assisted Nordic Hamstring Exercise. J Strength Cond Res 2020; 34:2715-2724. [DOI: 10.1519/jsc.0000000000003689] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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50
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Wing C, Bishop C. Hamstring Strain Injuries: Incidence, Mechanisms, Risk Factors, and Training Recommendations. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000538] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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