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Rubin EB, Schmidt AM, Koff MF, Kogan F, Gao K, Majumdar S, Potter H, Gold GE. Advanced MRI Approaches for Evaluating Common Lower Extremity Injuries in Basketball Players: Current and Emerging Techniques. J Magn Reson Imaging 2024; 59:1902-1913. [PMID: 37854004 DOI: 10.1002/jmri.29019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 10/20/2023] Open
Abstract
Magnetic resonance imaging (MRI) can provide accurate and non-invasive diagnoses of lower extremity injuries in athletes. Sport-related injuries commonly occur in and around the knee and can affect the articular cartilage, patellar tendon, hamstring muscles, and bone. Sports medicine physicians utilize MRI to evaluate and diagnose injury, track recovery, estimate return to sport timelines, and assess the risk of recurrent injury. This article reviews the current literature and describes novel developments of quantitative MRI tools that can further advance our understanding of sports injury diagnosis, prevention, and treatment while minimizing injury risk and rehabilitation time. Innovative approaches for enhancing the early diagnosis and treatment of musculoskeletal injuries in basketball players span a spectrum of techniques. These encompass the utilization of T2, T1ρ, and T2* quantitative MRI, along with dGEMRIC and Na-MRI to assess articular cartilage injuries, 3D-Ultrashort echo time MRI for patellar tendon injuries, diffusion tensor imaging for acute myotendinous injuries, and sagittal short tau inversion recovery and axial long-axis T1-weighted, and 3D Cube sequences for bone stress imaging. Future studies should further refine and validate these MR-based quantitative techniques while exploring the lifelong cumulative impact of basketball on players' knees. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Elka B Rubin
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Andrew M Schmidt
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Matthew F Koff
- Department of Radiology and Imaging, Hospital for Special Surgery, New York City, New York, USA
| | - Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Kenneth Gao
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Hollis Potter
- Department of Radiology and Imaging, Hospital for Special Surgery, New York City, New York, USA
| | - Garry E Gold
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
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2
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Magdalena PG, Bartłomiej B, Robert T, Małgorzata S, Hsing-Kuo W, Sebastian K. Acute fatigue-induced alterations in hamstring muscle properties after repeated Nordic hamstring exercises. Sci Prog 2024; 107:368504241242934. [PMID: 38592327 PMCID: PMC11005512 DOI: 10.1177/00368504241242934] [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: 04/10/2024]
Abstract
This study aimed to investigate the impact of the Nordic hamstring exercises (NHE) on acute fatigue-induced alterations in the mechanical and morphological properties of hamstring muscles. The second aim was to define the blood flow and perfusion after NHE in recreational active volunteers. Twenty-two individuals volunteered to participate in the study. This study investigated fatigue outcomes: rate of perceived exertion (RPE) scale and average force generated during NHE; mechanical properties (stiffness); morphological properties (thickness, pennation angle, and fascicle length), and vascularity index (VI) of the semitendinosus (ST) and biceps femoris long head (BFLH) at baseline, immediately post-exercise and 1-h post-exercise. The NHE fatigue procedure consisted of six bouts of five repetitions. The results showed an increase in thickness and pennation angle of BFLH and ST immediately post-exercise and a decrease in thickness and pennation angle of BFLH and ST 1-h post-exercise. While the fascicle length of BFLH and ST decreased immediately post-exercise and increased 1-h post-exercise. The VI for two muscles increased immediately post-exercise and after 1-h post-exercise. Moreover, we found a relationship between RPE and average force, that is, as RPE increased during NHE, average force decreased. In conclusion, eccentric NHE exercises significantly and acutely affect BFLH and ST. The NHE fatigue protocol significantly affected the mechanical and morphological properties of BFLH and ST muscles, changing their thickness, fascicle length, pennation angle, and VI.
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Affiliation(s)
| | - Bogdański Bartłomiej
- Doctoral School, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Trybulski Robert
- ProvitaZory Medical Center, Zory, Poland
- Department of Medical Sciences, The Wojciech Korfanty Upper Silesian Academy, Katowice, Poland
| | - Smoter Małgorzata
- Department of Basic Physiotherapy, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Wang Hsing-Kuo
- School and Graduate Institute of Physical Therapy, National Taiwan University, Taipei, Taiwan
- Center of Physical Therapy, National Taiwan University Hospital, Taipei, Taiwan
| | - Klich Sebastian
- Department of Paralympic Sport, Wrocław University of Health and Sport Sciences, Wrocław, Poland
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Loturco I, Zabaloy S, Pereira LA, Moura TBMA, Mercer VP, Victor F, Zając A, Matusinski A, Freitas TT, Bishop C. Resistance Training Practices of Brazilian Olympic Sprint and Jump Coaches: Toward a Deeper Understanding of Their Choices and Insights (Part III). J Hum Kinet 2024; 90:183-214. [PMID: 38380293 PMCID: PMC10875694 DOI: 10.5114/jhk/182888] [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: 01/02/2024] [Accepted: 01/20/2024] [Indexed: 02/22/2024] Open
Abstract
In the final part of this three-article collection on the training strategies of Brazilian Olympic sprint and jump coaches, we provide a detailed description of the resistance training methods and exercises most commonly employed by these speed experts. Always with the objective of maximizing the sprint and jump capabilities of their athletes, these experienced coaches primarily utilize variable, eccentric, concentric, machine-based, isometric, complex, and isoinertial resistance training methods in their daily practices. Squats (in their different forms), Olympic weightlifting, ballistics, hip thrusts, lunges, calf raises, core exercises, leg curls, stiff-leg deadlifts, and leg extension are the most commonly prescribed exercises in their training programs, during both the preparatory and competitive periods. Therefore, the current manuscript comprehensively describes and examines these methods, with the additional aim of extrapolating their application to other sports, especially those where sprint speed is a key performance factor.
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Affiliation(s)
- Irineu Loturco
- NAR—Nucleus of High Performance in Sport, São Paulo, Brazil
- Department of Human Movement Sciences, Federal University of São Paulo, São Paulo, Brazil
- Department of Sport, Health, and Exercise Science, University of South Wales, Pontypridd, Wales, United Kingdom
| | - Santiago Zabaloy
- Faculty of Physical Activity and Sports, University of Flores, Buenos Aires, Argentina
| | | | | | | | | | - Adam Zając
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Aleksander Matusinski
- Department of Exercise and Sport Performance, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Tomás T. Freitas
- NAR—Nucleus of High Performance in Sport, São Paulo, Brazil
- UCAM Research Center for High Performance Sport, UCAM Universidad Católica de Murcia, Murcia, Spain
- Facultad de Deporte, UCAM Universidad Católica de Murcia, Murcia, Spain
| | - Chris Bishop
- London Sport Institute, Middlesex University, London, United Kingdom
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Siddle J, Weaver K, Greig M, Harper D, Brogden CM. A low-volume Nordic hamstring curl programme improves change of direction ability, despite no architectural, strength or speed adaptations in elite youth soccer players. Res Sports Med 2024; 32:49-60. [PMID: 35642790 DOI: 10.1080/15438627.2022.2079984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/26/2022] [Indexed: 10/18/2022]
Abstract
Nordic hamstring curls (NHC) are a commonly used injury intervention method in amateur team sports. Seventeen elite male academy soccer players performed an 8-week low volume NHC programme. Pre-post intervention measures of isokinetic eccentric knee flexor (KF) strength, linear speed, COD performance, hamstring muscle thickness, pennation angle and fascicle length were recorded. No significant main effects were observed for measures of isokinetic KF strength (P ≥ 0.19), linear sprint speed (P ≥ 0.47) or hamstring muscle architecture (P ≥ 0.30). However, significance was noted for improved COD performance (P < 0.01; mean difference, -0.06, p = 0.001, 95% CI = 0.03 to 0.09; d = 0.80), exceeding the minimal detectable difference (MDD = 0.05 s). A low-volume NHC intervention may contribute to significant improvements in COD ability, independent of no significant changes in eccentric KF strength, linear sprint speed or muscle architectural properties in elite youth soccer players.
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Affiliation(s)
- James Siddle
- Sports Injuries Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk, UK
| | - Kristian Weaver
- Sports Injuries Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk, UK
| | - Matt Greig
- Sports Injuries Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk, UK
| | - Damian Harper
- Institute of Coaching and Performance, University of Central Lancashire, Preston, UK
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Suskens JJM, Maas H, van Dieën JH, Kerkhoffs GMMJ, Goedhart EA, Tol JL, Reurink G. The Effect of the Nordic Hamstring Exercise on Muscle Activity: A Multichannel Electromyography Randomized Controlled Trial. J Appl Biomech 2023; 39:377-387. [PMID: 37567580 DOI: 10.1123/jab.2023-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/08/2023] [Accepted: 06/23/2023] [Indexed: 08/13/2023]
Abstract
The aim of this study was to evaluate the effect of a Nordic hamstring exercise intervention on biceps femoris long head, semitendinosus, and semimembranosus muscle's activity and relative contributions through multichannel electromyography. Twenty-four injury-free male basketball players (mean age 20 [3] y) were randomly assigned to a 12-week intervention (n = 13) or control group (n = 11). The primary outcome measures were normalized muscle activity (percentage of maximal voluntary isometric contraction, %MVIC) and relative contribution of hamstring muscles over 12 weeks. No effects were found on any of the primary outcome measures. Between-group differences over 12 weeks were 2.7%MVIC (95% confidence interval 95% CI, -0.7 to 6.1) for the biceps femoris long head, 3.4%MVIC (95% CI, -1.4 to 8.2) for the semitendinosus, and 0.8%MVIC (95% CI, -3.0 to 4.6) for the semimembranosus, P = .366. Between-group differences over 12 weeks were 1.0% relative contribution (%con; 95% CI, -3.0 to 5.1) for the biceps femoris long head, 2.2% relative contribution (95% CI, -2.8 to 7.2) for the semitendinosus, and -3.3% relative contribution (95% CI, -6.4 to -0.1) for the semimembranosus P = .258. A positive value implies a higher value for the Nordic group. A Nordic hamstring exercise intervention did not affect the level of muscle activity and relative contribution of hamstring muscles in performance of the Nordic hamstring exercise.
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Affiliation(s)
- Jozef J M Suskens
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam,The Netherlands
- Amsterdam Movement Sciences, Sports, Amsterdam,The Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam,The Netherlands
| | - Huub Maas
- Amsterdam Movement Sciences, Sports, Amsterdam,The Netherlands
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Amsterdam Movement Sciences (AMS), Vrije Universiteit, Amsterdam,The Netherlands
| | - Jaap H van Dieën
- Amsterdam Movement Sciences, Sports, Amsterdam,The Netherlands
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Amsterdam Movement Sciences (AMS), Vrije Universiteit, Amsterdam,The Netherlands
| | - Gino M M J Kerkhoffs
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam,The Netherlands
- Amsterdam Movement Sciences, Sports, Amsterdam,The Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam,The Netherlands
| | - Edwin A Goedhart
- FIFA Medical Center, Royal Netherlands Football Association, Zeist,The Netherlands
| | - Johannes L Tol
- Amsterdam Movement Sciences, Sports, Amsterdam,The Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam,The Netherlands
- Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
| | - Gustaaf Reurink
- Amsterdam Movement Sciences, Sports, Amsterdam,The Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam,The Netherlands
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Suskens JJM, Secondulfo L, Kiliç Ö, Hooijmans MT, Reurink G, Froeling M, Nederveen AJ, Strijkers GJ, Tol JL. Effect of two eccentric hamstring exercises on muscle architectural characteristics assessed with diffusion tensor MRI. Scand J Med Sci Sports 2023; 33:393-406. [PMID: 36514886 DOI: 10.1111/sms.14283] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 11/08/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To evaluate the effect of a Nordic hamstring exercise or Diver hamstring exercise intervention on biceps femoris long head, semitendinosus and semimembranosus muscle's fascicle length and orientation through diffusion tensor imaging (DTI) with magnetic resonance imaging. METHODS In this three-arm, single-center, randomized controlled trial, injury-free male basketball players were randomly assigned to a Nordic, Diver hamstring exercise intervention or control group. The primary outcome was the DTI-derived fascicle length and orientation of muscles over 12 weeks. RESULTS Fifty-three participants were included for analysis (mean age 22 ± 7 years). Fascicle length in the semitendinosus over 12 weeks significantly increased in the Nordic-group (mean [M]: 20.8 mm, 95% confidence interval [95% CI]: 7.8 to 33.8) compared with the Control-group (M: 0.9 mm, 95% CI: -7.1 to 8.9), mean between-groups difference: 19.9 mm, 95% CI: 1.9 to 37.9, p = 0.026. Fascicle orientation in the biceps femoris long head over 12 weeks significantly decreased in the Diver-group (mean: -2.6°, 95% CI: -4.1 to -1.0) compared with the Control-group (mean: -0.2°, 95% CI: -1.4 to 1.0), mean between-groups difference: -2.4°, 95% CI: -4.7 to -0.1, p = 0.039. CONCLUSION The Nordic hamstring exercise intervention did significantly increase the fascicle length of the semitendinosus and the Diver hamstring exercise intervention did significantly change the orientation of fascicles of the biceps femoris long head. As both exercises are complementary to each other, the combination is relevant for preventing hamstring injuries.
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Affiliation(s)
- Jozef J M Suskens
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, Netherlands
| | - Laura Secondulfo
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,Department of Biomedical Engineering & Physics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Özgür Kiliç
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, Netherlands
| | - Melissa T Hooijmans
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Gustaaf Reurink
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, Netherlands
| | - Martijn Froeling
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Aart J Nederveen
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Gustav J Strijkers
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,Department of Biomedical Engineering & Physics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes L Tol
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, Netherlands.,Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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Carmichael DS, Hickey JT, Tofari PJ, Bourne MN, Ward MR, Timmins RG. Effect of an Isometric or Eccentric Hip Extension Exercise Intervention on Hamstring Strength, Architecture, and Morphology. Med Sci Sports Exerc 2022; 54:2196-2207. [PMID: 35941515 DOI: 10.1249/mss.0000000000003012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to investigate hamstring architectural, strength, and morphological adaptations after an eccentric or isometric hip extension exercise intervention. METHODS Twenty-four recreationally active males performed either an eccentric ( n = 12) or an isometric hip extension ( n = 12) exercise intervention, twice per week for 6 wk, followed by a 4-wk detraining period. Biceps femoris long head (BFlh) architecture was assessed pre-intervention, mid-intervention, post-intervention, and post-detraining via two-dimensional ultrasound. Strength was assessed pre-intervention, post-intervention, and post-detraining during an isokinetic knee flexion, an isometric hip extension, a Nordic hamstring exercise, and a single-leg hamstring bridge repetition to fatigue test. Hamstring muscle morphology was assessed via magnetic resonance imaging before strength testing sessions. RESULTS The eccentric hip extension exercise intervention significantly lengthened BFlh fascicles (+19.7%, P < 0.001, d = 1.57), increased eccentric knee flexion torque (ECC 60°·s -1 , +12%, P < 0.005, d = 0.66; ECC 180°·s -1 , +8.3%, P < 0.05, d = 0.41), and increased BFlh (+13.3%, P < 0.001, d = 1.96) and semimembranosus (SM) muscle volume (+12.5%, P < 0.001, d = 2.25). After 4 wk of detraining, BFlh fascicles were significantly shortened in the eccentric group (-14.8%, P < 0.005, d = -1.25), whereas eccentric knee flexion torque and BFlh and SM volumes were unchanged. The isometric hip extension exercise intervention significantly increased isometric knee flexion torque (+10.4%, P < 0.05, d = 0.54), isometric hip extension force (+12.4%, P < 0.05, d = 0.41), and semitendinosus volume (+15%, P = 0.054, d = 1.57). All other outcome measures saw no significant changes. After 4 wk of detraining, no significant changes to any variables were observed in the isometric group. CONCLUSIONS The eccentric but not isometric hip extension exercise intervention significantly increased BFlh fascicle length. Both exercise interventions demonstrated contraction mode-specific increases in strength. However, the eccentric hip extension exercise intervention resulted in preferential hypertrophy of BFlh and SM, and the isometric hip extension exercise intervention led to selective hypertrophy of semitendinosus.
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Affiliation(s)
- Declan S Carmichael
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, AUSTRALIA
| | | | - Paul J Tofari
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, AUSTRALIA
| | - Matthew N Bourne
- School of Health Sciences and Social Work, Griffith University, Gold Coast, AUSTRALIA
| | - Mark R Ward
- Imaging @ Olympic Park, Melbourne, AUSTRALIA
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Brusco CM, Pinto RS, Blazevich AJ. Reliability and Comparison of Sonographic Methods for In Vivo Measurement of Human Biceps Femoris Long-Head Architecture. Med Sci Sports Exerc 2022; 54:2216-2226. [PMID: 35941523 DOI: 10.1249/mss.0000000000003015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Biceps femoris long-head fascicle length ( Lf ), fascicle angle (FA), and muscle thickness (MT) estimates obtained across 2 d from extended field-of-view (EFOV) sonographic images were compared with those measured from a collage of single ultrasound images (to visualize entire fascicles) as well as a range of geometric equations and extrapolation methods used on single images. Both test validity and intraday reliability were determined. METHODS Twenty healthy adults (10 men and 10 women) were tested on two occasions (day 1 and day 2), 7 d apart at the same time of day for test-retest measurements. Ultrasound imaging was performed using EFOV and static image acquisition sequences; in the latter, four single images were acquired in-series along the muscle. From these images, Lf was assessed using seven methods: EFOV, collage, manual linear extrapolation, and four different trigonometric equations (termed equations A, B, C, and D), and FA and MT were measured in EFOV, collage, and single images. RESULTS Lf , FA, and MT measured on days 1 and 2 were not different ( P > 0.05) for any method, reliabilities were very high (intraclass correlation coefficient, 0.91-0.98), and correlations were strong (≥0.84). Significant correlations ( P < 0.05; r = 0.67-0.98) were found between EFOV and the other measurement techniques for Lf , FA, and MT. The collage method had the highest reliability for Lf , and highest rank order and correlation with EFOV. CONCLUSIONS Although the six different techniques used to estimate Lf provided values similar to EFOV, higher between-subject measurement variability was observed with trigonometric equations, and the collage method described herein provided the most accurate and reliable results and is therefore recommended for biceps femoris long-head architectural analysis when EFOV is not available.
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Affiliation(s)
| | - Ronei S Pinto
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BRAZIL
| | - Anthony J Blazevich
- Centre for Exercise and Sports Science Research, School of Exercise and Health Sciences, Edith Cowan University, Joondalup, AUSTRALIA
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Hamstring muscle architecture assessed sonographically using wide field of view: A reliability study. PLoS One 2022; 17:e0277400. [DOI: 10.1371/journal.pone.0277400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/26/2022] [Indexed: 11/12/2022] Open
Abstract
Purpose
To assess the intra-rater reliability of static wide field of view ultrasound to quantify the architectural characteristics of the hamstring muscles.
Methods
Twenty amateur male athletes were recruited. Their left hamstring muscles were assessed using static wide field of view ultrasound on two separate occasions. Static ultrasound images were acquired by a single sonographer using a 92mm linear transducer. The architectural characteristics (muscle length, fascicle length, pennation angle and muscle thickness) from two distinct locations of the bicep femoris long head and semimembranosus were evaluated. Muscle length and thickness of the bicep femoris short head and semitendinosus muscle were also evaluated. Intraclass correlation coefficient analyses were performed to determine the intra-rater reliability of the performed measurements.
Results
Both muscle (intraclass correlation coefficient = 0.99; standard error of measurement = 4.3 to 6.6mm) and fascicle (intraclass correlation coefficient = 0.92 to 0.98; standard error measurement = 1.1 to 2.4mm) length were measured with excellent intra-rater reliability. Muscle thickness was measured with excellent reliability (intraclass correlation coefficient = 0.9 to 0.96; standard error of measurement = 0.91mm to 1.4mm) for all hamstring muscles except for the proximal segments of the bicep femoris short head (intraclass correlation coefficient = 0.85; standard error of measurement = 0.84mm) and semitendinosus (intraclass correlation coefficient = 0.88; standard error of measurement = 0.82mm), which were measured with good reliability. Pennation angle was measured with good reliability (intraclass correlation coefficient = 0.77 to 0.87; standard error of measurement = 1 to 1.6°).
Conclusion
The architectural characteristics of the hamstring muscles of male amateur athletes can be reliably quantified using static wide field of view ultrasound.
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Miyazaki T, Fujii N. Effects of changes in optimal muscle fibre length in the biceps femoris long head on muscle force during the late swing phase of maximal speed sprinting: a simulation study. Sports Biomech 2022:1-16. [PMID: 36346916 DOI: 10.1080/14763141.2022.2140070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022]
Abstract
Hamstring strain injuries would frequently occur during the late swing phase of sprinting, while increasing biceps femoris long head's (BFlh) fascicle length induced by eccentric contraction exercises can reduce the risk of strain injuries. Thus, using a musculoskeletal modelling simulation, we examined how manipulating BFlh optimal muscle fibre length would change muscle force during the late swing phase of sprinting for providing knowledge preventing hamstring strain injuries. A motion capture system was used to collect kinematic data from 40 male athletes during maximal speed sprinting. Muscle force and force-generating capabilities determined by force-length-velocity properties were estimated with three BFlh optimal muscle fibre lengths (90%, 110% and 120%), which were perturbed from the nominal (100%). During the late swing phase of sprinting, the muscle force and force-generating capabilities, induced by the force-length property rather than the force-velocity property, were increased by increases in BFlh optimal muscle fibre length. Moreover, magnitudes of the simulated increases in muscle force and force-generating capabilities were correlated with the peak BFlh muscle-tendon unit length. These results demonstrate that lengthening BFlh optimal muscle fibre might increase muscle force during the late swing phase, and the magnitude of increment would be associated with increasing muscle-tendon unit length.
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Affiliation(s)
| | - Norihisa Fujii
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
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11
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Alt T, Severin J, Schmidt M. Quo Vadis Nordic Hamstring Exercise-Related Research?-A Scoping Review Revealing the Need for Improved Methodology and Reporting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11225. [PMID: 36141503 PMCID: PMC9517005 DOI: 10.3390/ijerph191811225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Abstract
The objective of this scoping review is to assess Nordic Hamstring Exercise quality (ANHEQ) of assessments and interventions according to the ANHEQ rating scales and to present practical recommendations for the expedient design and reporting of future studies. A total of 71 Nordic Hamstring Exercise (NHE) assessments and 83 NHE interventions were selected from the data sources PubMed, Scopus, and SPORTDiscus. Research studies which were presented in peer-reviewed academic journals and implemented the NHE during laboratory-based assessments or multi-week interventions met the eligibility criteria. NHE assessments analyzed force (51%), muscle activation (41%), knee angle kinematics (38%), and bilateral symmetry (37%). NHE interventions lasted 4-8 weeks (56%) and implied an exercise volume of two sessions per week (66%) with two sets per session (41%) and ≥8 repetitions per set (39%). The total ANHEQ scores of the included NHE assessments and interventions were 5.0 ± 2.0 and 2.0 ± 2.0 (median ± interquartile range), respectively. The largest deficits became apparent for consequences of impaired technique (87% 0-point-scores for assessments) and kneeling height (94% 0-point-scores for interventions). The 0-point-scores were generally higher for interventions compared to assessments for rigid fixation (87% vs. 34%), knee position (83% vs. 48%), kneeling height (94% vs. 63%), and separate familiarization (75% vs. 61%). The single ANHEQ criteria, which received the highest score most frequently, were rigid fixation (66% of assessments) and compliance (33% of interventions). The quality of NHE assessments and interventions was generally 'below average' or rather 'poor'. Both NHE assessments and interventions suffered from imprecise reporting or lacking information regarding NHE execution modalities and subsequent analyses. Based on the findings, this scoping review aggregates practical guidelines how to improve the design and reporting of future NHE-related research.
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Affiliation(s)
- Tobias Alt
- Department of Biomechanics, Performance Analysis and Strength & Conditioning, Olympic Training and Testing Centre Westphalia, 44139 Dortmund, Germany
| | - Jannik Severin
- Institute of Movement and Neuroscience, German Sport University, 50933 Cologne, Germany
| | - Marcus Schmidt
- Institute for Sport and Sport Science, TU Dortmund University, 44227 Dortmund, Germany
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Van Hooren B, Vanwanseele B, van Rossom S, Teratsias P, Willems P, Drost M, Meijer K. Muscle forces and fascicle behavior during three hamstring exercises. Scand J Med Sci Sports 2022; 32:997-1012. [PMID: 35307884 PMCID: PMC9314024 DOI: 10.1111/sms.14158] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/12/2022] [Accepted: 03/14/2022] [Indexed: 01/05/2023]
Abstract
Knowledge about muscular forces and fascicle behavior during hamstring exercises can optimize exercise prescription, but information on these outcomes across different exercises is lacking. We aimed to characterize and compare lower‐limb muscle forces and biceps femoris long head muscle fascicle behavior between three hamstring exercises: the Nordic hamstring curl (NHC), single‐leg Roman chair (RCH), and single‐leg deadlift (DL). Ten male participants performed the exercises while full‐body kinematics, ground reaction forces, surface muscle activation, and biceps femoris long head fascicle behavior were measured. Mean fascicle length was highest in the DL, followed by the RCH and NHC. Fascicle lengthening was higher in the NHC compared with the RCH and DL, with no difference between the RCH and DL. Biceps femoris short and long head, semitendinosus, and semimembranosus peak forces were generally higher in the NHC compared with the RCH and DL, while mean forces during the eccentric phase were generally not different between the NHC and RCH. Peak forces in the NHC coincided with low biceps femoris long head and semimembranosus muscle activation. The NHC generally has the highest peak hamstring muscle forces and results in more fascicle lengthening when compared to the DL and RCH. The NHC may therefore be most effective to promote increases in fascicle length. While the NHC may be effective to promote biceps femoris short head and semitendinosus strength adaptations, the RCH and DL may be more effective to promote strength increases in the biceps femoris long head and semimembranosus.
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Affiliation(s)
- Bas Van Hooren
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Benedicte Vanwanseele
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Sam van Rossom
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Panayiotis Teratsias
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Paul Willems
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Maarten Drost
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Kenneth Meijer
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
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Alonso-Fernández D, Fernández-Rodríguez R, Taboada-Iglesias Y, Gutiérrez-Sánchez Á. Effects of Copenhagen Adduction Exercise on Muscle Architecture and Adductor Flexibility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116563. [PMID: 35682148 PMCID: PMC9180184 DOI: 10.3390/ijerph19116563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 02/04/2023]
Abstract
Groin injuries are one of the most prevalent in sports, especially due to the hip adductor muscles’ weakness, which is considered as a risk factor. The Copenhagen adduction exercise (CAE) has been demonstrated to increase the strength of adductor muscles, but its effects on the architectural characteristics and flexibility of the adductors has been little studied. The aim of the present study was to analyse the impact on the muscular architecture and flexibility of the adductor musculature after 8 weeks of CAE-based training and after 4 weeks of subsequent detraining. A sample of 45 active subjects (26.1 ± 2.8 years old) were randomly divided into a control group with no intervention and an experimental group with an intervention based on 8 weeks of CAE training and 4 weeks of subsequent detraining. The muscle thickness of adductors was measured before and after training and detraining using ultrasound imaging and hip abduction range with goniometry. A significant increase in muscle thickness (left leg: +17.83%, d = 1.77, p < 0.001//right leg: +18.38%, d = 1.82, p < 0.001) and adductor flexibility was found in the experimental group (left leg: +7.3%, d = 0.96, p < 0.05//right leg: +7.15%, d = 0.94, p < 0.05), and after detraining, both variables returned to their initial values. These results could indicate that CAE would be a suitable strategy to modify the architecture of the adductors and thus form part of training protocols designed for the prevention and rehabilitation of muscle injuries.
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Affiliation(s)
- Diego Alonso-Fernández
- Department of Special Didactics, Faculty of Education and Sport Sciences, University of Vigo, 36005 Pontevedra, Spain; (R.F.-R.); (Y.T.-I.); (Á.G.-S.)
- Education, Physical Activity and Health Research Group (Gies-10-DE3), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36208 Vigo, Spain
- Correspondence:
| | - Rosana Fernández-Rodríguez
- Department of Special Didactics, Faculty of Education and Sport Sciences, University of Vigo, 36005 Pontevedra, Spain; (R.F.-R.); (Y.T.-I.); (Á.G.-S.)
| | - Yaiza Taboada-Iglesias
- Department of Special Didactics, Faculty of Education and Sport Sciences, University of Vigo, 36005 Pontevedra, Spain; (R.F.-R.); (Y.T.-I.); (Á.G.-S.)
- Education, Physical Activity and Health Research Group (Gies-10-DE3), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36208 Vigo, Spain
| | - Águeda Gutiérrez-Sánchez
- Department of Special Didactics, Faculty of Education and Sport Sciences, University of Vigo, 36005 Pontevedra, Spain; (R.F.-R.); (Y.T.-I.); (Á.G.-S.)
- Education, Physical Activity and Health Research Group (Gies-10-DE3), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36208 Vigo, Spain
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The Dose-Response of the Nordic Hamstring Exercise on Biceps Femoris Architecture and Eccentric Knee Flexor Strength: A Randomized Interventional Trial. Int J Sports Physiol Perform 2022; 17:646-654. [PMID: 35176727 DOI: 10.1123/ijspp.2021-0276] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/24/2021] [Accepted: 09/16/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE To examine the dose-response of the Nordic hamstring exercise (NHE) on biceps femoris long head (BFlh) architecture and eccentric knee flexor strength. DESIGN Randomized interventional trial. METHODS Forty recreationally active males completed a 6-week NHE training program consisting of either intermittent low volumes (group 1; n = 10), low volumes (group 2; n = 10), initial high volumes followed by low volumes (group 3; n = 10), or progressively increasing volumes (group 4; n = 10). A 4-week detraining period followed each program. Muscle architecture was assessed weekly during training and after 2 and 4 weeks of detraining. Eccentric knee flexor strength was assessed preintervention and postintervention and after 2 and 4 weeks of detraining. RESULTS Following 6 weeks of training, BFlh fascicle length (FL) increased in group 3 (mean difference = 0.83 cm, d = 0.45, P = .027, +7%) and group 4 (mean difference = 1.48 cm, d = 0.94, P = .004, +14%). FL returned to baseline following detraining in groups 3 and 4. Strength increased in group 2 (mean difference = 53.6 N, d = 0.55, P = .002, +14%), group 3 (mean difference = 63.4 N, d = 0.72, P = .027, +17%), and group 4 (mean difference = 74.7, d = 0.83, P = .006, +19%) following training. Strength returned to baseline following detraining in groups 2 and 3 but not in group 4. CONCLUSIONS Initial high volumes of the NHE followed by lower volumes, as well as progressively increasing volumes, can elicit increases in BFlh FL and eccentric knee flexor strength. Low volumes of the NHE were insufficient to increase FL, although as few as 48 repetitions in 6 weeks did increase strength.
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Alonso-Calvete A, Lorenzo-Martínez M, Padrón-Cabo A, Rey E. Effects of Copenhagen Adduction Exercise on the Architectural Characteristics of Adductors in U-17 Male Soccer Players: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412956. [PMID: 34948565 PMCID: PMC8701296 DOI: 10.3390/ijerph182412956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/30/2021] [Accepted: 11/30/2021] [Indexed: 12/14/2022]
Abstract
Groin injuries are one of the most prevalent in male soccer players, especially due to the hip adductor muscles’ weakness which is considered as a risk factor in these injuries. The Copenhagen adduction (CA) exercise has been demonstrated to increase the strength of adductor muscles, but its effects on the architectural characteristics of adductor muscles have not been studied yet. This study aimed to analyze the effects of the CA exercise on the muscle thickness of the adductors. Twelve male U-17 soccer players were randomized into two groups: the control group with no intervention and the experimental group with an intervention based on an eight-week training with CA exercise. The muscle thickness of adductors was measured before and after the intervention using ultrasound imaging. A significant increase in muscle thickness was found in both control (p = 0.002) and experimental group (p < 0.001), but the experimental group did not show additional effects in comparison with the control group. In conclusion, an 8-week CA exercise intervention does not increase the muscle thickness of adductors in U-17 soccer players more than their regular training.
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Affiliation(s)
- Alejandra Alonso-Calvete
- Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36310 Pontevedra, Spain; (A.A.-C.); (M.L.-M.); (E.R.)
| | - Miguel Lorenzo-Martínez
- Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36310 Pontevedra, Spain; (A.A.-C.); (M.L.-M.); (E.R.)
| | - Alexis Padrón-Cabo
- Department of Physical Education and Sport Science, Faculty of Sports Sciences and Physical Education, University of Coruña, 15001 A Coruña, Spain
- Correspondence: ; Tel.: +34-670-088-148
| | - Ezequiel Rey
- Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36310 Pontevedra, Spain; (A.A.-C.); (M.L.-M.); (E.R.)
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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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Alonso-Fernandez D, Lopez-Barreiro J, Garganta R, Taboada-Iglesias Y. Acute impact of Nordic hamstring exercise on sprint performance after 24, 48 and 72 hours. Sports Biomech 2021:1-15. [PMID: 34748450 DOI: 10.1080/14763141.2021.1992493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/07/2021] [Indexed: 10/19/2022]
Abstract
The Nordic Hamstring Exercise (NHE) improves the strength of the hamstring muscles, as well as prevents and rehabilitates the injuries of said muscles. However, the eccentric demand of NHE may influence the athlete's performance, making compliance with these programmes difficult. The aim is to analyse the acute impact on sprint performance after the passing of 24, 48, and 72 hours respectively since an NHE-based session (4 sets of 10 repetitions) had taken place. Participants were randomly divided into an experimental group (EG) (n = 12 male participants) who carried out an NHE session and a measurement of their 30 m sprint performance in each of the three subsequent days, and a control group (CG) (n = 12 male participants) who did not take part in the NHE session. The results show a significant reduction of maximum power within 24 hours (t = 3.57, d = 0.22, P < .0273) as well of the production of high speed horizontal force up to after 48 hours (t = 4.82, d = 0.22, P < .0001) in the EG. These results may suggest separating weekly NHE sessions from competition or demanding training in which sprint performance should not be affected by at least 72 hours.
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Affiliation(s)
- D Alonso-Fernandez
- Department of Special Didactics, Faculty of Science Education and Sport, University of Vigo, Pontevedra, Spain
- Education, Physical Activity and Health Research Group (Gies10-, SERGAS-UVIGO (Spain), Pontevedra, Spain
| | - J Lopez-Barreiro
- Faculty of Science Education and Sport, University of Vigo, Pontevedra, Spain
| | - R Garganta
- Department of Kinanthropometry, Faculty of Sport, University of Porto, Porto, Portugal
| | - Y Taboada-Iglesias
- Department of Special Didactics, Faculty of Science Education and Sport, University of Vigo, Pontevedra, Spain
- Department of Functional Biology and Health Sciences, Faculty of Physiotherapy, University of Vigo, Pontevedra, Spain
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Ripley NJ, Cuthbert M, Ross S, Comfort P, McMahon JJ. The Effect of Exercise Compliance on Risk Reduction for Hamstring Strain Injury: A Systematic Review and Meta-Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11260. [PMID: 34769778 PMCID: PMC8583500 DOI: 10.3390/ijerph182111260] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 01/21/2023]
Abstract
Eccentric strength training can reduce the risk of hamstring strain injury (HSI) occurrence; however, its implementation can be impacted by athlete compliance and prescription. The aim of this review was to investigate the effects of intervention compliance, consistency and modality, on the prevention of HSIs among athletes. A literature search was conducted. 868 studies were identified prior to the application of the exclusion criteria which resulted in 13 studies identified. Random effects models were used to produce log odds ratios and 95% confidence intervals. Very high (>75.1%), moderate-high (50.1-75%), low-moderate (25.1-50%) and very low (<25%) and <1-, 1.01-3.00-, >3.01-weeks/session were used as thresholds of compliance and consistency, respectively. Modality was also observed. A positive effect on HSI incidence -0.61 (-1.05 to -0.17), favoring the intervention treatments (Z = -2.70, p = 0.007). There were non-significant, large differences between compliance (p = 0.203, Z = -1.272) and consistency (p = 0.137, Z = -1.488), with increased compliance and consistency showing greater effectiveness. A significant difference between intervention modalities was observed (p < 0.001, Z = -4.136), with eccentric interventions being superiorly effective. Compliance of >50.1% and consistent application with <3 weeks/session having positive effects on HSI incidence. Training interventions that can achieve high levels of compliance, and can be consistently performed, should be the objective of future practice.
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Affiliation(s)
- Nicholas Joel Ripley
- Human Performance Laboratory, University of Salford, Salford M5 4BR, UK; (M.C.); (S.R.); (P.C.); (J.J.M.)
| | - Matthew Cuthbert
- Human Performance Laboratory, University of Salford, Salford M5 4BR, UK; (M.C.); (S.R.); (P.C.); (J.J.M.)
- The FA Group, St George’s Park, Burton-upon-Trent, Staffordshire DE13 9RN, UK
| | - Steven Ross
- Human Performance Laboratory, University of Salford, Salford M5 4BR, UK; (M.C.); (S.R.); (P.C.); (J.J.M.)
- Department of Sport and Physical Activity, Edge Hill University, Ormskirk L39 4QP, UK
| | - Paul Comfort
- Human Performance Laboratory, University of Salford, Salford M5 4BR, UK; (M.C.); (S.R.); (P.C.); (J.J.M.)
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett, Leeds LS1 3HE, UK
| | - John James McMahon
- Human Performance Laboratory, University of Salford, Salford M5 4BR, UK; (M.C.); (S.R.); (P.C.); (J.J.M.)
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Kruse A, Rivares C, Weide G, Tilp M, Jaspers RT. Stimuli for Adaptations in Muscle Length and the Length Range of Active Force Exertion-A Narrative Review. Front Physiol 2021; 12:742034. [PMID: 34690815 PMCID: PMC8531727 DOI: 10.3389/fphys.2021.742034] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/08/2021] [Indexed: 12/03/2022] Open
Abstract
Treatment strategies and training regimens, which induce longitudinal muscle growth and increase the muscles’ length range of active force exertion, are important to improve muscle function and to reduce muscle strain injuries in clinical populations and in athletes with limited muscle extensibility. Animal studies have shown several specific loading strategies resulting in longitudinal muscle fiber growth by addition of sarcomeres in series. Currently, such strategies are also applied to humans in order to induce similar adaptations. However, there is no clear scientific evidence that specific strategies result in longitudinal growth of human muscles. Therefore, the question remains what triggers longitudinal muscle growth in humans. The aim of this review was to identify strategies that induce longitudinal human muscle growth. For this purpose, literature was reviewed and summarized with regard to the following topics: (1) Key determinants of typical muscle length and the length range of active force exertion; (2) Information on typical muscle growth and the effects of mechanical loading on growth and adaptation of muscle and tendinous tissues in healthy animals and humans; (3) The current knowledge and research gaps on the regulation of longitudinal muscle growth; and (4) Potential strategies to induce longitudinal muscle growth. The following potential strategies and important aspects that may positively affect longitudinal muscle growth were deduced: (1) Muscle length at which the loading is performed seems to be decisive, i.e., greater elongations after active or passive mechanical loading at long muscle length are expected; (2) Concentric, isometric and eccentric exercises may induce longitudinal muscle growth by stimulating different muscular adaptations (i.e., increases in fiber cross-sectional area and/or fiber length). Mechanical loading intensity also plays an important role. All three training strategies may increase tendon stiffness, but whether and how these changes may influence muscle growth remains to be elucidated. (3) The approach to combine stretching with activation seems promising (e.g., static stretching and electrical stimulation, loaded inter-set stretching) and warrants further research. Finally, our work shows the need for detailed investigation of the mechanisms of growth of pennate muscles, as those may longitudinally grow by both trophy and addition of sarcomeres in series.
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Affiliation(s)
- Annika Kruse
- Department of Biomechanics, Training, and Movement Science, Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Cintia Rivares
- Laboratory for Myology, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Guido Weide
- Laboratory for Myology, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.,Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, University Hospital Leuven, Leuven, Belgium
| | - Markus Tilp
- Department of Biomechanics, Training, and Movement Science, Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Richard T Jaspers
- Laboratory for Myology, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
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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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SARTO FABIO, MONTI ELENA, ŠIMUNIČ BOŠTJAN, PIŠOT RADO, NARICI MARCOV, FRANCHI MARTINOV. Changes in Biceps Femoris Long Head Fascicle Length after 10-d Bed Rest Assessed with Different Ultrasound Methods. Med Sci Sports Exerc 2021; 53:1529-1536. [PMID: 34127637 PMCID: PMC10115490 DOI: 10.1249/mss.0000000000002614] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE This study aimed to investigate the changes in fascicle length (Lf) of biceps femoris long head (BFlh) after 10 d of bed rest (BR) by comparing four different ultrasound (US) methods. METHODS Ten healthy men participated in 10-d BR. Before (BR0) and after (BR10) the BR period, BFlh Lf values were obtained using 1) extended-field-of-view (EFOV) technique, 2) the manual linear extrapolation (MLE) method, and 3) two trigonometric equations (equations A and B) from a single US image. RESULTS After BR10, decreased Lf values were observed by EFOV (P < 0.001; Hedges' g = 0.29) and MLE (P = 0.0082; g = 0.22) methods, but not with equations A and B. Differences between equation A and the other US methods were detected at both time points. The percentage of changes in Lf between BR0 and BR10 was influenced by the US methods applied, with difference detected between the changes measured by EFOV and the ones estimated by equation A (P = 0.04; g = 0.53). Bland-Altman analyses revealed relevant average absolute biases in Lf between EFOV and other methods at both time points (range BR0-BR10: MLE, 0.3-0.37 cm (3.4%-4.32%); equation B, 0.3-0.48 cm (3.24%-5.41%); equation A, 2.44-2.97 cm (24.05%-29.2%)). A significant correlation (r = 0.83) in percentage of change in Lf values was observed only between EFOV and MLE. CONCLUSIONS We showed that four distinct US methods lead to different results in the assessment of BFlh Lf changes after a short-term period of unloading. The implementation of EFOV technique (or alternatively MLE) to assess Lf changes in BFlh during longitudinal studies is warranted.
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Affiliation(s)
- FABIO SARTO
- Department of Biomedical Sciences, University of Padova, Padova, ITALY
| | - ELENA MONTI
- Department of Biomedical Sciences, University of Padova, Padova, ITALY
| | | | - RADO PIŠOT
- Science and Research Centre Koper, Koper, SLOVENIA
| | - MARCO V. NARICI
- Department of Biomedical Sciences, University of Padova, Padova, ITALY
- Science and Research Centre Koper, Koper, SLOVENIA
- CIR-MYO Myology Center, University of Padova, Padova, ITALY
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Specificity of eccentric hamstring training and the lack of consistency between strength assessments using conventional test devices. Sci Rep 2021; 11:13417. [PMID: 34183742 PMCID: PMC8239011 DOI: 10.1038/s41598-021-92929-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 06/16/2021] [Indexed: 12/11/2022] Open
Abstract
Hamstring injuries are endemic, but influences of test-specific training and the application of different test methods on decision making remain elusive. Sport-students were randomised to isokinetic (IG) or Nordic hamstring (NG) exercise or a control group (CG) for six weeks. Training and testing procedures were matched to biomechanical parameters. Hamstring strength (EPT), work, muscle soreness (visual analogue scale (VAS)), biceps femoris (BFlh) muscle size and architecture were assessed. Anthropometrics and strength parameters did not differ at baseline. Yet, body mass normalised EPT, and work revealed a significant group × time × device effect, with a significant main effect for devices. Experimental conditions triggered meaningful increases in EPT compared to the control group, but the effects were higher when recorded on the training device. Despite significant group × time interactions, normalised average work on the NHD was only higher in the NG compared to CG of the left leg (+ 35%). No effects were found for BFlh parameters. Hamstrings showed a high training specificity, but adaptations likely remain undetected owing to the low sensitivity of conventional test devices. Moreover, strength increase of ~ 15% does not necessarily have to be reflected in BFlh parameters.
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Raiteri BJ, Beller R, Hahn D. Biceps Femoris Long Head Muscle Fascicles Actively Lengthen During the Nordic Hamstring Exercise. Front Sports Act Living 2021; 3:669813. [PMID: 34179775 PMCID: PMC8219857 DOI: 10.3389/fspor.2021.669813] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/21/2021] [Indexed: 11/28/2022] Open
Abstract
Current debate exists around whether a presumed eccentric exercise, the Nordic hamstring exercise (NHE), actually causes active hamstring muscle lengthening. This is because of the decoupling that can occur between the muscle fascicle and muscle-tendon unit (MTU) length changes in relatively compliant human lower-limb MTUs, which results in MTU lengthening not necessarily causing muscle fascicle lengthening. This missing knowledge complicates the interpretation of why the NHE is effective at reducing running-related hamstring muscle injury risk in athletes previously unfamiliar with performing this exercise. The purpose of the study was therefore to investigate if the most-commonly injured hamstring muscle, the biceps femoris long head (BF), exhibits active muscle lengthening (i.e. an eccentric muscle action) during the NHE up until peak force in Nordic novices. External reaction force at the ankle, knee flexion angle, and BF and semitendinosus muscle activities were recorded from the left leg of 14 participants during the NHE. Simultaneously, BF muscle architecture was imaged using B-mode ultrasound imaging, and muscle architecture changes were tracked using two different tracking algorithms. From ~85 to 100% of peak NHE force, both tracking algorithms detected that BF muscle fascicles (n = 10) significantly lengthened (p < 0.01) and had a mean positive lengthening velocity (p ≤ 0.02), while knee extension velocity remained positive (17°·s−1) over knee flexion angles from 53 to 37° and a duration of 1.6 s. Despite some individual cases of brief isometric fascicle behavior and brief fascicle shortening during BF MTU lengthening, the predominant muscle action was eccentric under a relatively high muscle activity level (59% of maximum). Eccentric hamstring muscle action therefore does occur during the NHE in relatively strong (429 N) Nordic novices, which might contribute to the increase in resting BF muscle fascicle length and reduction in running-related injury risk, which have previously been reported following NHE training. Whether an eccentric BF muscle action occurs in individuals accustomed to the NHE remains to be tested.
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Affiliation(s)
- Brent J Raiteri
- Human Movement Science, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
| | - Ronja Beller
- Human Movement Science, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany.,Department of Pediatric Hematology/Oncology, Center for Child and Adolescent Medicine, Essen University Hospital, Essen, Germany
| | - Daniel Hahn
- Human Movement Science, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany.,School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
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Prevalence of Hamstring Strain Injury Risk Factors in Professional and Under-20 Male Football (Soccer) Players. J Sport Rehabil 2021; 29:339-345. [PMID: 30747574 DOI: 10.1123/jsr.2018-0084] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 11/03/2018] [Accepted: 01/21/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT Hamstring strain injury (HSI) is the most prevalent injury in football (soccer), and a few intrinsic factors have been associated with higher injury rates. OBJECTIVE To describe the prevalence of the main intrinsic risk factors for HSI in professional and under-20 football players. DESIGN Cross-sectional study. SETTING Physiotherapy laboratory, Federal University of Health Sciences of Porto Alegre (Brazil). PARTICIPANTS A total of 101 football players (52 professional and 49 under-20 players). INTERVENTION An evidence-based testing protocol for screening HSI risk factors. MAIN OUTCOME MEASURES Anamnesis, ultrasonography of the hamstrings, passive straight-leg raise test, Functional Movement Screen, and isokinetic dynamometry were performed. Eleven HSI risk factors for each leg were assessed, besides the player's age as a systemic risk factor. Reports were delivered to the coaching staff. RESULTS Professionals had greater prevalence of HSI history compared with under-20 players (40% vs 18%). No between-group differences were found for the other screening tests. Altogether, 30% of players had already sustained at least one HSI; 58% had a history of injuries in adjacent regions; 49% had short biceps femoris fascicles; 66% and 21% had poor passive and active flexibility, respectively; 42% and 29% had deficits in functional movements and core stability, respectively; 7% and 26% presented bilateral imbalance for hamstring concentric and eccentric strength, respectively; 87% and 94% obtained low values for hamstring-to-quadriceps conventional and functional ratios, respectively. Two-thirds of players had 3 to 5 risk factors per leg. None of the players was fully free of HSI risk factors. CONCLUSION Most football players present multiple risk factors for sustaining an HSI. Hamstring weakness is the most prevalent risk factor, but the teams should also be aware of deficits in flexibility, core stability, functional movements, and hamstring fascicle length.
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Oleksy Ł, Mika A, Pacana J, Markowska O, Stolarczyk A, Kielnar R. Why Is Hamstring Strain Injury so Common in Sport Despite Numerous Prevention Methods? Are There Any Missing Pieces to This Puzzle? Front Physiol 2021; 12:586624. [PMID: 34054562 PMCID: PMC8155520 DOI: 10.3389/fphys.2021.586624] [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: 07/23/2020] [Accepted: 04/08/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Łukasz Oleksy
- Orthopaedic and Rehabilitation Department, Medical University of Warsaw, Warsaw, Poland.,Oleksy Medical and Sports Sciences, Łańcut, Poland.,Polish Strength and Conditioning Association, Wrocław, Poland
| | - Anna Mika
- Institute of Clinical Rehabilitation, University of Physical Education in Kraków, Kraków, Poland
| | - Jacek Pacana
- Faculty of Mechanical Engineering and Aeronautics, Rzeszów University of Technology, Rzeszów, Poland
| | - Olimpia Markowska
- Faculty of Mechanical Engineering and Aeronautics, Rzeszów University of Technology, Rzeszów, Poland
| | - Artur Stolarczyk
- Orthopaedic and Rehabilitation Department, Medical University of Warsaw, Warsaw, Poland
| | - Renata Kielnar
- Institute of Health Sciences, Medical College of Rzeszów University, Rzeszów, Poland
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Opar DA, Timmins RG, Behan FP, Hickey JT, van Dyk N, Price K, Maniar N. Is Pre-season Eccentric Strength Testing During the Nordic Hamstring Exercise Associated with Future Hamstring Strain Injury? A Systematic Review and Meta-analysis. Sports Med 2021; 51:1935-1945. [PMID: 33914283 DOI: 10.1007/s40279-021-01474-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Interventions utilising the Nordic hamstring exercise (NHE) have resulted in reductions in the incidence of hamstring strain injury (HSI). Subsequently, quantifying eccentric knee flexor strength during performance of the NHE to identify an association with the occurrence of future HSI has become increasingly common; however, the data to date are equivocal. OBJECTIVE To systematically review the association between pre-season eccentric knee flexor strength quantified during performance of the NHE and the occurrence of future HSI. DESIGN Systematic review and meta-analysis. DATA SOURCES CINAHL, Cochrane Library, Medline Complete, Embase, Web of Science and SPORTDiscus databases were searched from January 2013 to January 10, 2020. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Prospective cohort studies which assessed the association between pre-season eccentric knee flexor strength quantified during performance of the NHE and the occurrence of future HSI. METHODS Following database search, article retrieval and title and abstract screening, articles were assessed for eligibility against pre-defined criteria then assessed for risk of bias. Meta-analysis was used to pool data across studies, with meta-regression utilised where possible. RESULTS A total of six articles were included in the meta-analysis, encompassing 1100 participants. Comparison of eccentric knee flexor strength during performance of the NHE in 156 injured participants and the 944 uninjured participants revealed no significant differences, regardless of whether strength was expressed as absolute (N), relative to body mass (N kg-1) or between-limb asymmetry (%). Meta-regression analysis revealed that the observed effect sizes were generally not moderated by age, mass, height, strength, or sport played. CONCLUSION Eccentric knee flexor strength quantified during performance of the NHE during pre-season provides limited information about the occurrence of a future HSI.
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Affiliation(s)
- David A Opar
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia. .,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, VIC, Australia.
| | - Ryan G Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, VIC, Australia
| | - Fearghal P Behan
- Musculoskeletal Mechanics Group, Imperial College London, London, UK
| | - Jack T Hickey
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia
| | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.,Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Kara Price
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia
| | - Nirav Maniar
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia
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Fascial therapy, strength exercises and taping in soccer players with recurrent ankle sprains: A randomized controlled trial. J Bodyw Mov Ther 2021; 27:256-264. [PMID: 34391242 DOI: 10.1016/j.jbmt.2021.03.022] [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: 09/21/2020] [Revised: 03/10/2021] [Accepted: 03/28/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Recurrent ankle sprains are common in soccer players, characterized by restricted range of motion, pain, and decreased proprioception, strength, and postural control. The objective was to evaluate the effectiveness of a fascial therapy and strength training program, combined with kinesiotaping, in improving ankle range of motion, pain, strength and stability in footballers with recurrent sprains. METHOD A simple blind randomized clinical trial was conducted on soccer players. Thirty-six federated footballers were recruited and randomized to the two study groups. The experimental group received an intervention using myofascial techniques applied to the subastragaline joint, eccentric training with an isoinertial device and neuromuscular taping. The control group was administered an intervention using myofascial techniques on the subastragaline joint and eccentric training with an isoinertial device. The results were recorded for all players at baseline, after 4 weeks of intervention, and at the end of the 4-week follow-up period. RESULTS Subsequent to intervention and follow-up, we found statistically significant improvements in the experimental group in ankle mobility, strength and stability. The control group exhibited improvements in all study variables. No differences in the improvement of variables were found based on the allocation of athletes to one group or another. CONCLUSION The combination of fascial therapy and eccentric strength training with an isoinertial device improves ankle mobility, strength and stability in footballers with recurrent ankle sprains. The use of taping techniques failed to provide a greater improvement of the study variables when combined with manual therapy and strength techniques.
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Severo-Silveira L, Dornelles MP, Lima-E-Silva FX, Marchiori CL, Medeiros TM, Pappas E, Baroni BM. Progressive Workload Periodization Maximizes Effects of Nordic Hamstring Exercise on Muscle Injury Risk Factors. J Strength Cond Res 2021; 35:1006-1013. [PMID: 30363038 DOI: 10.1519/jsc.0000000000002849] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Severo-Silveira, L, Dornelles, MP, Lima-e-Silva, FX, Marchiori, CL, Medeiros, TM, Pappas, E, and Baroni, BM. Progressive workload periodization maximizes effects of Nordic hamstring exercise on muscle injury risk factors. J Strength Cond Res 35(4): 1006-1013, 2021-This study aimed to investigate the effect of 2 different Nordic hamstring exercise (NHE) training programs (constant workload vs. progressive workload) on multiple risk factors for hamstring strain injury in high competitive level athletes. Twenty-one premier league rugby union players (∼26 years) were randomized into 1 of 2 experimental groups and completed an 8-week NHE training program: constant training group (CTG) or progressive training group (PTG). Knee flexor/extensor strength and biceps femoris long head (BFLH) muscle architecture were assessed through isokinetic dynamometry and ultrasonography, respectively, before and after the training programs. Increased hamstring concentric (Δ = 8%, p = 0.004, d = 0.42) and eccentric (Δ = 7%, p = 0.041, d = 0.39) peak torques, as well as H:Q conventional (Δ = 7%, p = 0.015, d = 0.54) and functional (Δ = 6%, p = 0.026, d = 0.62) ratios were observed in the follow-up compared with baseline for the PTG group only. Nordic hamstring exercise training significantly increased BFLH muscle thickness (CTG: Δ = 7%, p = 0.001, d = 0.60; PTG: Δ = 7%, p < 0.001, d = 0.54) and fascicle length (CTG: Δ = 8%, p < 0.001, d = 0.29; PTG: Δ = 10%, p < 0.001, d = 0.35) in both groups. Training adaptations on hamstring peak torque (concentric and eccentric) and H:Q ratio (conventional and functional) "likely favor" PTG, whereas changes in BFLH fascicle length "possibly favor" PTG. In conclusion, only PTG enhanced hamstring strength; both NHE training programs increased BFLH muscle thickness and fascicle length, but progressive training generated greater changes on fascicle length than constant training. Medical/coaching staff should be aware that NHE with adequate training periodization with workload progression to maximize its benefits.
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Affiliation(s)
- Lucas Severo-Silveira
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; and
| | - Maurício P Dornelles
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; and
| | - Felipe X Lima-E-Silva
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; and
| | - César L Marchiori
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; and
| | - Thales M Medeiros
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; and
| | | | - Bruno M Baroni
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; and
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30
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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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Raya-Gonzalez J, Castillo D, Clemente FM. Injury prevention of hamstring injuries through exercise interventions. J Sports Med Phys Fitness 2021; 61:1242-1251. [PMID: 33480508 DOI: 10.23736/s0022-4707.21.11670-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Hamstring injuries are the most prevalent time-loss injuries in sport, mainly in those modalities characterized by high-intensity and short-term actions, especially accelerations and decelerations during high-speed running. Expanding the knowledge about this type of injury and its preventive programs could be a key strategy to reduce the hamstring injury incidence. Thus, this review aimed to study the effectiveness of different preventive programs based on exercise interventions on reducing the hamstring injury incidence in athletes. EVIDENCE ACQUISITION An umbrella review was conducted through of PubMed/MEDLINE, Scopus, SPORTDiscus, Web of Science, Cochrane Library and Physiotherapy Evidence Database databases. The methodological quality of the included systematic reviews was assessed through the Assessing the Methodological Quality of Systematic Reviews 2 and the quality of the evidence was evaluated using the modified Grading of Recommendations Assessment, Development and Evaluation principles. EVIDENCE SYNTHESIS Eight systematic reviews and meta-analysis (40 primary studies) met the inclusion criteria, which included interventions based on eccentric strength, Nordic hamstring, proprioceptive training, stretching, FIFA11 and combined programs. From the qualitative synthesizes, three studies showed that eccentric-based training programs were effective; seventeen studies reported that Nordic hamstring-based programs were effective; three studies observed that stability training-based interventions were effective; two studies indicated that flexibility were effective; three studies claimed that FIFA11+based programs were effective; and two studies reported that combined programs were effective. CONCLUSIONS Exercise is a key strategy to reduce the hamstring injury incidence, being programs based on eccentric strength mainly by means of Nordic hamstring exercise, and on stability training, those programs which reported greater effectiveness.
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Affiliation(s)
| | | | - Filipe M Clemente
- School of Sport and Leisure, Polytechnic Institute of Viana do Castelo, Viana do Castelo, Portugal
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Effect of Inter-Repetition Rest vs. Traditional Strength Training on Lower Body Strength, Rate of Force Development, and Muscle Architecture. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app11010045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The purpose of the study was to investigate the effect of seven weeks inter-repetition rest vs. traditional strength training on lower body strength, rate of force development (RFD), and vastus lateralis (VL) muscle architecture. Sixteen male participants were assigned into two groups: the inter-repetition rest (IRRG) and the traditional (TG) group. Both groups performed the leg press exercise with four sets of six maximum repetitions (RM) for two training sessions per week. IRRG added a 20 s inter-repetition rest period between single repetitions. Before and after the training period, 1-RM in leg press, isometric leg press RFD, and peak force (PF), VL muscle architecture, vastus intermedius (VI) thickness, and quadriceps’ cross sectional area (CSA) with ultrasonography, were measured. Two way ANOVA for repeated measures was used for statistics. One-RM strength increased similarly for both groups (p < 0.05), while percentage increases in RFD were greater for IRRG compared to TG (p < 0.05). Isometric PF was increased similarly for both groups (p < 0.05). VL and VI thickness as well as CSA of the quadriceps increased similarly in both groups, while VL fascicle length increased more following IRRG compared to TG (IRRG: 4.8 ± 6.1% vs. TG: −3.9 ± 5.4%, p = 0.001). These results suggest that 20 s inter-repetition rest during strength training may effectively increase lower body explosive strength and muscle fascicle length without compromising muscle hypertrophy.
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33
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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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The Effect of Nordic Hamstring Exercise Intervention Volume on Eccentric Strength and Muscle Architecture Adaptations: A Systematic Review and Meta-analyses. Sports Med 2020; 50:83-99. [PMID: 31502142 PMCID: PMC6942028 DOI: 10.1007/s40279-019-01178-7] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Although performance of the Nordic hamstring exercise (NHE) has been shown to elicit adaptations that may reduce hamstring strain injury (HSI) risk and occurrence, compliance in NHE interventions in professional soccer teams is low despite a high occurrence of HSI in soccer. A possible reason for low compliance is the high dosages prescribed within the recommended interventions. The aim of this review was to investigate the effect of NHE-training volume on eccentric hamstring strength and biceps femoris fascicle length adaptations. Methods A literature search was conducted using the SPORTDiscus, Ovid, and PubMed databases. A total of 293 studies were identified prior to application of the following inclusion criteria: (1) a minimum of 4 weeks of NHE training was completed; (2) mean ± standard deviation (SD) pre- and post-intervention were provided for the measured variables to allow for secondary analysis; and (3) biceps femoris muscle architecture was measured, which resulted in 13 studies identified for further analysis. The TESTEX criteria were used to assess the quality of studies with risk of bias assessment assessed using a fail-safe N (Rosenthal method). Consistency of studies was analysed using I2 as a test of heterogeneity and secondary analysis of studies included Hedges’ g effect sizes for strength and muscle architecture variables to provide comparison within studies, between-study differences were estimated using a random-effects model. Results A range of scores (3–11 out of 15) from the TESTEX criteria were reported, showing variation in study quality. A ‘low risk of bias’ was observed in the randomized controlled trials included, with no study bias shown for both strength or architecture (N = 250 and 663, respectively; p < 0.001). Study consistency was moderate to high for strength (I2 = 62.49%) and muscle architecture (I2 = 88.03%). Within-study differences showed that following interventions of ≥ 6 weeks, very large positive effect sizes were seen in eccentric strength following both high volume (g = 2.12) and low volume (g = 2.28) NHE interventions. Similar results were reported for changes in fascicle length (g ≥ 2.58) and a large-to-very large positive reduction in pennation angle (g ≥ 1.31). Between-study differences were estimated to be at a magnitude of 0.374 (p = 0.009) for strength and 0.793 (p < 0.001) for architecture. Conclusions Reducing NHE volume prescription does not negatively affect adaptations in eccentric strength and muscle architecture when compared with high dose interventions. These findings suggest that lower volumes of NHE may be more appropriate for athletes, with an aim to increase intervention compliance, potentially reducing the risk of HSI.
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Medeiros TM, Ribeiro-Alvares JB, Fritsch CG, Oliveira GS, Severo-Silveira L, Pappas E, Baroni BM. Effect of Weekly Training Frequency With the Nordic Hamstring Exercise on Muscle-Strain Risk Factors in Football Players: A Randomized Trial. Int J Sports Physiol Perform 2020; 15:1026-1033. [PMID: 32580161 DOI: 10.1123/ijspp.2018-0780] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 09/23/2019] [Accepted: 10/30/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To examine the differences between performing Nordic hamstring exercises once or twice a week on hamstring eccentric strength and other muscle-strain risk factors in high-level football players. METHODS In this randomized trial, 32 football players (18-23 y old) completed an 8-week Nordic hamstring exercise training program in 1 of 2 experimental groups: group 1 (once a week; n = 15) and group 2 (twice a week; n = 17). Knee-flexor/extensor peak torques and biceps femoris long-head muscle architecture were assessed through isokinetic dynamometry and ultrasonography, respectively, before and after the training programs. Analysis of covariance, effect sizes (ESs), and t tests for percentage change were used to assess the effect of the 2 interventions on the outcome measures. RESULTS Group 2 demonstrated higher hamstring concentric peak torque than group 1 posttraining (155-164 vs 149-158 N·m; P = .043; ES = 0.27), although there was also a statistical trend for higher hamstring eccentric peak torque (212-234 vs 198-221 N·m; P = .098; ES = 0.37), hamstring-to-quadriceps conventional ratio (0.56-0.59 vs 0.54-0.57; P = .089; ES = 0.31), and hamstring-to-quadriceps functional ratio (0.76-0.84 vs 0.71-0.79; P = .076; ES = 0.50). No between-groups differences were found for muscle thickness (P = .864; ES = 0.12), pennation angle (P = .289; ES = 0.18), fascicle length (P = .406; ES = 0.03), and quadriceps concentric peak torque (P = .340; ES = 0.02). CONCLUSION Only the Nordic hamstring exercise training program performed twice a week strengthened the hamstrings of high-level football players, while similar changes in muscle architecture occurred with both once- and twice-weekly sessions.
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Marušič J, Vatovec R, Marković G, Šarabon N. Effects of eccentric training at long-muscle length on architectural and functional characteristics of the hamstrings. Scand J Med Sci Sports 2020; 30:2130-2142. [PMID: 32706442 DOI: 10.1111/sms.13770] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 07/07/2020] [Accepted: 07/10/2020] [Indexed: 12/30/2022]
Abstract
Hamstring strain injuries during sprinting or stretching frequently occur at long-muscle length. Yet, previous research has mainly focused on studying the effectiveness of eccentric hamstring strengthening at shorter muscle length on hamstring performance, morphology, and hamstring strain injury risk factors. Here, we evaluated the effects of 6-week eccentric hamstring training at long-muscle length on functional and architectural characteristics of the hamstrings. Healthy and injury-free participants (n = 40; age 23.7 ± 2.5 years) were randomly assigned to control or intervention group. Training intervention consisted of 12 sessions with two eccentric hamstring exercises in a lengthened position. Outcome measures included isokinetic and isometric knee flexion peak torque, Nordic hamstring exercise peak torque, voluntary activation level, and countermovement jump performance. Ultrasonography was used to determine muscle thickness, pennation angle, and fascicle length of biceps femoris long head (BFlh). A significant time × group interaction effect was observed for all measured parameters except countermovement jump performance and muscle thickness. The training intervention resulted in increased concentric and eccentric knee flexion peak torque at 60°/s (d = 0.55-0.62, P = .02 and .03) and concentric peak torque at 180°/s (d = 0.99, P = .001), increased isometric knee flexion peak torque (d = 0.73, P = .008) and Nordic hamstring exercise peak torque (d = 1.19, P < .001), increased voluntary activation level (d = 1.29, P < .001), decreased pennation angle (d = 1.31, P < .001), and increased fascicle length (d = 1.12, P < .001) of BFlh. These results provide evidence that short-term eccentric hamstring strengthening at long-muscle length can have significant favorable effects on various architectural and functional characteristics of the hamstrings.
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Affiliation(s)
- Jan Marušič
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Rok Vatovec
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Goran Marković
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia.,Motus Melior Ltd., Zagreb, Croatia
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Laboratory for Motor Control and Motor Behavior, S2P, Science to practice, Ltd., Ljubljana, Slovenia
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Marušič J, Šarabon N. Comparison of electromyographic activity during Nordic hamstring exercise and exercise in lengthened position. Eur J Transl Myol 2020; 30:8957. [PMID: 32782761 PMCID: PMC7385688 DOI: 10.4081/ejtm.2019.8957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 03/26/2020] [Indexed: 01/08/2023] Open
Abstract
Hamstring strain injuries remain among the most problematic and most frequent sport injuries. Two of the most effective methods for prevention and rehabilitation of the hamstring strain injuries are: classic eccentric training using the Nordic hamstring exercise (NHE) and eccentric training in a lengthened position using the glider exercise. Both exercises have disadvantages that could be fixed by adding hip flexion during the NHE. Thus, the purpose of the study was to compare peak hamstring activity (measured by electromyography) between three eccentric exercises: the standard NHE, the modified NHE and the glider. Differences were statistically tested with the analysis of the variance for repeated measurements and the paired 2-tailed post-hoc t-test. Hamstring activity during the modified NHE was significantly lower compared to the NHE and significantly higher compared to the glider. The results indicate that implementing the modified NHE could increase the effectiveness of already established rehabilitation protocols and help reduce the risk of hamstring (re-)injury.
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Affiliation(s)
- Jan Marušič
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia
| | - Nejc Šarabon
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia.,S2P, Science to practice, Ltd., Laboratory for Motor Control and Motor Behavior, Ljubljana, Slovenia
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Marušič J, Šarabon N. Comparison of electromyographic activity during Nordic hamstring exercise and exercises in lengthened position. Eur J Transl Myol 2020. [DOI: 10.4081/ejtm.2020.8957] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Hamstring strain injuries remain among the most problematic and most frequent sport injuries. Two of the most effective methods for prevention and rehabilitation of the hamstring strain injuries are: classic eccentric training using the Nordic hamstring exercise (NHE) and eccentric training in a lengthened position using the glider exercise. Both exercises have disadvantages that could be fixed by adding hip flexion during the NHE. Thus, the purpose of the study was to compare peak hamstring activity (measured by electromyography) between three eccentric exercises: the standard NHE, the modified NHE and the glider. Differences were statistically tested with the analysis of the variance for repeated measurements and the paired 2-tailed post-hoc t-test. Hamstring activity during the modified NHE was significantly lower compared to the NHE and significantly higher compared to the glider. The results indicate that implementing the modified NHE could increase the effectiveness of already established rehabilitation protocols and help reduce the risk of hamstring (re-)injury.
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Cuthbert M, Ripley N, McMahon JJ, Evans M, Haff GG, Comfort P. Reply to: "Comment on: The Effect of Nordic Hamstring Exercise Intervention Volume on Eccentric Strength and Muscle Architecture Adaptations: A Systematic Review and Meta-analyses". Sports Med 2020; 50:223-225. [PMID: 31820375 DOI: 10.1007/s40279-019-01245-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Matthew Cuthbert
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Greater Manchester, UK. .,Technical Directorate Division, The FA Group, St George's Park, Burton-upon-Trent, Staffordshire, UK.
| | - Nicholas Ripley
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Greater Manchester, UK
| | - John J McMahon
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Greater Manchester, UK
| | - Martin Evans
- Technical Directorate Division, The FA Group, St George's Park, Burton-upon-Trent, Staffordshire, UK
| | - G Gregory Haff
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Greater Manchester, UK.,Centre for Exercise and Sports Sciences Research (CESSR), School of Exercise and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Paul Comfort
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Greater Manchester, UK.,Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
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Gérard R, Gojon L, Decleve P, Van Cant J. The Effects of Eccentric Training on Biceps Femoris Architecture and Strength: A Systematic Review With Meta-Analysis. J Athl Train 2020; 55:501-514. [PMID: 32216654 DOI: 10.4085/1062-6050-194-19] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine the effects of an eccentric hamstrings strength-training program, performed for at least 4 weeks by healthy adults, on muscle architecture and eccentric strength. DATA SOURCES A systematic search was performed up to October 2018 in the following electronic databases: PubMed, PEDro, CINAHL and SPORTDiscus. Combinations of the following search terms were used: eccentric strength training, eccentric loading, nordic hamstring, hamstring strength, fascicle length, pennation angle, muscle thickness, muscle architecture, biceps femoris long head, biceps femoris, and hamstring muscles. STUDY SELECTION Included articles were randomized controlled trials that allowed comparisons between isolated eccentric strength training of the biceps femoris muscle and other programs. DATA EXTRACTION Data from the included studies were extracted by 2 independent reviewers. These data included the study design, participant characteristics, inclusion and exclusion criteria of clinical studies, exercise and intervention characteristics, outcome measures, and the main results of the study. When meta-analysis was possible, we performed quantitative analysis. Ten randomized controlled trials were included. DATA SYNTHESIS Limited to moderate evidence indicated that eccentric strength training was associated with an increase in fascicle length (mean difference [MD] = 1.97; 95% confidence interval [CI] = 1.48, 2.46), an increase in muscle thickness (MD = 0.10; 95% CI = 0.06, 0.13), and a decrease in pennation angle (MD = 2.36; 95% CI = 1.61, 3.11). Conflicted to moderate evidence indicated that eccentric hamstrings strength was increased after eccentric strength training compared with concentric strength training (standardized mean difference [SMD] = 1.06; 95% CI = 0.26, 1.86), usual level of activity (SMD = 2.72; 95% CI = 1.68, 3.77), and static stretching (SMD = 0.39; 95% CI = -0.97, 1.75). CONCLUSIONS In healthy adults, an eccentric strength-training program produced architectural adaptations on the long head of the biceps femoris muscle and increased eccentric hamstrings strength.
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Affiliation(s)
- Rémy Gérard
- Department of Physical Therapy, Institut Parnasse-ISEI, Brussels, Belgium
| | - Léo Gojon
- Department of Physical Therapy, Institut Parnasse-ISEI, Brussels, Belgium
| | - Philippe Decleve
- Department of Physical Therapy, Institut Parnasse-ISEI, Brussels, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University Hospital Ghent, Belgium
| | - Joachim Van Cant
- Department of Physical Therapy, Institut Parnasse-ISEI, Brussels, Belgium
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Mendiguchia J, Conceição F, Edouard P, Fonseca M, Pereira R, Lopes H, Morin JB, Jiménez-Reyes P. Sprint versus isolated eccentric training: Comparative effects on hamstring architecture and performance in soccer players. PLoS One 2020; 15:e0228283. [PMID: 32045411 PMCID: PMC7012429 DOI: 10.1371/journal.pone.0228283] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 01/10/2020] [Indexed: 01/22/2023] Open
Abstract
AIMS The purpose of this study was to compare the effects of hamstring eccentric (NHE) strength training versus sprint training programmed as complements to regular soccer practice, on sprint performance and its mechanical underpinnings, as well as biceps femoris long head (BFlh) architecture. METHODS In this prospective interventional control study, sprint performance, sprint mechanics and BFlh architecture variables were compared before versus after six weeks of training during the first six preseason weeks, and between three different random match-pair groups of soccer players: "Soccer group" (n = 10), "Nordic group" (n = 12) and "Sprint group" (n = 10). RESULTS For sprint performance and mechanics, small to large pre-post improvements were reported in "Sprint group" (except maximal running velocity), whereas only trivial to small negative changes were reported in "Soccer group" and "Nordic group". For BFlh architecture variables, "Sprint" group showed moderate increase in fascicle length compared to smaller augment for the "Nordic" group with trivial changes for "Soccer group". Only "Nordic" group presented small increases at pennation angle. CONCLUSIONS The results suggest that sprint training was superior to NHE in order to increase BFlh fascicle length although only the sprint training was able to both provide a preventive stimulus (increase fascicle length) and at the same time improve both sprint performance and mechanics. Further studies with advanced imaging techniques are needed to confirm the validity of the findings.
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Affiliation(s)
- Jurdan Mendiguchia
- Department of Physical Therapy, ZENTRUM Rehab and Performance Center, Barañain, Spain
| | - Filipe Conceição
- Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sports, University of Porto, Porto, Portugal
- LABIOMEP—Porto Biomechanics Laboratory, University of Porto, Porto, Portugal
| | - Pascal Edouard
- Inter‐university Laboratory of Human Movement Biology (LIBM EA 7424), University of Lyon, University Jean Monnet, Saint Etienne, France
- Department of Clinical and Exercise Physiology, Faculty of medicine, Sports Medicine Unity, University Hospital of Saint-Etienne, Saint-Etienne, France
- Medical Commission, French Athletics Federation (FFA), Paris, France
| | - Marco Fonseca
- Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sports, University of Porto, Porto, Portugal
- LABIOMEP—Porto Biomechanics Laboratory, University of Porto, Porto, Portugal
- Health and Performance Unit of Portuguese Football Federation, Portugal
| | - Rogerio Pereira
- Clínica do Dragão, Espregueira-Mendes Sports Centre–FIFA Medical centre of Excellence, Porto, Portugal
| | - Hernani Lopes
- DEM-ISEP, School of Engineering, Polytechnic of Porto, Porto, Portugal
| | | | - Pedro Jiménez-Reyes
- Centre for Sport Studies, Rey Juan Carlos University, Madrid, Spain
- * E-mail: ,
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Pain-Free Versus Pain-Threshold Rehabilitation Following Acute Hamstring Strain Injury: A Randomized Controlled Trial. J Orthop Sports Phys Ther 2020; 50:91-103. [PMID: 32005093 DOI: 10.2519/jospt.2020.8895] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The primary aim was to compare time from acute hamstring strain injury (HSI) to return-to-play (RTP) clearance following a standardized rehabilitation protocol performed within either pain-free or pain-threshold limits. Secondary aims were to compare isometric knee flexor strength, biceps femoris long head (BFLH) fascicle length, fear of movement, and reinjury occurrence at the 6-month follow-up between pain-free and pain-threshold groups. DESIGN Randomized controlled trial. METHODS Forty-three men with acute HSIs were randomly allocated to a pain-free (n = 22) or pain-threshold (n = 21) rehabilitation group. Days from HSI to RTP clearance, isometric knee flexor strength, BFLH fascicle length, fear of movement, and reinjury occurrence at the 6-month follow-up were reported. RESULTS Median time from HSI to RTP clearance was 15 days (95% confidence interval [CI]: 13, 17) in the pain-free group and 17 days (95% CI: 11, 24) in the pain-threshold group, which was not significantly different (P = .37). Isometric knee flexor strength recovery at 90° of hip and 90° of knee flexion was greater in the pain-threshold group at RTP clearance by 15% (95% CI: 1%, 28%) and by 15% (95% CI: 1%, 29%) at 2-month follow-up, respectively. Improvement in BFLH fascicle length from baseline was 0.91 cm (95% CI: 0.34, 1.48) greater at 2-month follow-up in the pain-threshold group. Two reinjuries occurred in both the pain-free and pain-threshold groups between RTP clearance and the 6-month follow-up. CONCLUSION Pain-threshold rehabilitation did not accelerate RTP clearance, but resulted in greater recovery of isometric knee flexor strength and better maintenance of BFLH fascicle length, compared to pain-free rehabilitation. J Orthop Sports Phys Ther 2020;50(2):91-103. Epub 28 Jun 2019. doi:10.2519/jospt.2020.8895.
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Effects of the Functional Heel Drop Exercise on the Muscle Architecture of the Gastrocnemius. J Sport Rehabil 2019; 29:1053-1059. [PMID: 31810057 DOI: 10.1123/jsr.2019-0150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/10/2019] [Accepted: 09/20/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT The architectural characteristics of a muscle determine its function. OBJECTIVE To determine the architectural adaptations of the lateral gastrocnemius (LG) and medial gastrocnemius (MG) muscles after a functional eccentric strength training protocol consisting of heel drop exercises, followed by a subsequent detraining period. DESIGN Pretest and posttest. SETTING Training rooms and laboratory. PARTICIPANTS The participants (N = 45) who were randomly divided into an experimental group (EG, n = 25) and a control group (CG, n = 20). INTERVENTIONS The 13-week intervention included participants (N = 45) who were randomly divided into an EG (n = 25) and a CG (n = 20). The EG performed a week of control and training, 8 weeks of eccentric training, and 4 weeks of detraining. The CG did not perform any type of muscular training. The architectural characteristics of the LG and MG muscles were evaluated at rest in both groups using 2-D ultrasound before (pretest-week 1) and after (posttest-week 9) the training, and at the end of the detraining period (retest-week 13). MAIN OUTCOME MEASURES One-way repeated measures analysis of variance was used to determine training-induced changes in each of the variables of the muscle architecture. RESULTS After the training period, the members of the EG experienced a significant increase in the fascicle length of LG (t = -9.85, d = 2.78, P < .001) and MG (t = -8.98, d = 2.54, P < .001), muscle thickness (t = -6.71, d = 2.86, P < .001) and (t = -7.85, d = 2.22, P < .001), and the pennation angle (t = -10.21, d = 1.88, P < .05) and (t = -1.87, d = 0.53, P < .05), respectively. After the detraining period, fascicle length, muscle thickness, and pennation angle showed a significant decrease. In the CG, no significant changes were observed in any of the variables. CONCLUSIONS The heel drop exercise seems to generate adaptations in the architectural conditions of LG and MG, which are also reversible after a detraining period. These results may have practical implications for injury prevention and rehabilitation programs.
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Drury B, Ratel S, Clark CC, Fernandes JF, Moran J, Behm DG. Eccentric Resistance Training in Youth: Perspectives for Long-Term Athletic Development. J Funct Morphol Kinesiol 2019; 4:E70. [PMID: 33467385 PMCID: PMC7739302 DOI: 10.3390/jfmk4040070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/21/2019] [Accepted: 11/25/2019] [Indexed: 02/07/2023] Open
Abstract
The purpose of this narrative review is to discuss the role of eccentric resistance training in youth and how this training modality can be utilized within long-term physical development. Current literature on responses to eccentric exercise in youth has demonstrated that potential concerns, such as fatigue and muscle damage, compared to adults are not supported. Considering the importance of resistance training for youth athletes and the benefits of eccentric training in enhancing strength, power, speed, and resistance to injury, its inclusion throughout youth may be warranted. In this review we provide a brief overview of the physiological responses to exercise in youth with specific reference to the different responses to eccentric resistance training between children, adolescents, and adults. Thereafter, we discuss the importance of ensuring that force absorption qualities are trained throughout youth and how these may be influenced by growth and maturation. In particular, we propose practical methods on how eccentric resistance training methods can be implemented in youth via the inclusion of efficient landing mechanics, eccentric hamstrings strengthening and flywheel inertia training. This article proposes that the use of eccentric resistance training in youth should be considered a necessity to help develop both physical qualities that underpin sporting performance, as well as reducing injury risk. However, as with any other training modality implemented within youth, careful consideration should be given in accordance with an individual's maturity status, training history and technical competency as well as being underpinned by current long-term physical development guidelines.
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Affiliation(s)
- Benjamin Drury
- Department of Applied Sport Sciences, Hartpury University, Gloucestershire GL19 3BE, England, UK;
| | - Sébastien Ratel
- Laboratoire des Adaptations Métaboliques à l’Exercice en conditions Physiologiques et Pathologiques (AME2P, EA 3533), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France;
| | - Cain C.T. Clark
- Faculty of Health and Life Sciences, Coventry University, Coventry CV1 5RW, England, UK;
| | - John F.T. Fernandes
- Department of Applied Sport Sciences, Hartpury University, Gloucestershire GL19 3BE, England, UK;
| | - Jason Moran
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3WA, UK;
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s Newfoundland and Labrador, A1C 5S7C, Canada;
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Šarabon N, Marušič J, Marković G, Kozinc Ž. Kinematic and electromyographic analysis of variations in Nordic hamstring exercise. PLoS One 2019; 14:e0223437. [PMID: 31644582 PMCID: PMC6808554 DOI: 10.1371/journal.pone.0223437] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 09/20/2019] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to present and biomechanically evaluate several variations of the Nordic hamstring exercise (NHE), achieved by altering the slope of the lower leg support and by asumming different hip flexion angles. Electromyographic and 2D kinematic measurements were conducted to analyse muscle activity (biceps femoris, semitendinosus, gluteus maximus, erector spine and lateral head of the gastrocnemius), knee and hip joint torques during 6 variations of NHE. The study involved 18 adults (24.9 ± 3.7 years) with previous experience in resistance training, but with little or no experience with NHE. Increasing the slope of the lower leg support from 0° (standard NHE) to 20° and 40° enabled the participants to perform the exercise through a larger range of motion, while achieving similar peak knee and hip torques. Instructions for increased hip flexion from 0° (standard NHE) to 25°, 50° and 75° resulted in greater peak knee and hip torque, although the participants were not able to maintain the hip angle at 50° nor 75°. Muscle activity decreased or remained similar in all modified variations compared to the standard NHE for all measured muscles. Our results suggest that using the presented variations of NHE might contribute to optimization of hamstring injury prevention and rehabilitation programs, by providing appropriate difficulty for the individual’s strength level and also allow eccentric strengthening at longer hamstring lengths.
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Affiliation(s)
- Nejc Šarabon
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia
- S2P, Science to practice, Ltd., Laboratory for Motor Control and Motor Behavior, Ljubljana, Slovenia
- * E-mail:
| | - Jan Marušič
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia
| | - Goran Marković
- University of Zagreb, Faculty of Kinesiology, Zagreb, Croatia
- Motus Melior Ltd., Zagreb, Croatia
| | - Žiga Kozinc
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia
- University of Primorska, Andrej Marušič Institute, Koper, Slovenia
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FRANCHI MARTINOV, FITZE DANIELP, RAITERI BRENTJ, HAHN DANIEL, SPÖRRI JÖRG. Ultrasound-derived Biceps Femoris Long Head Fascicle Length: Extrapolation Pitfalls. Med Sci Sports Exerc 2019; 52:233-243. [DOI: 10.1249/mss.0000000000002123] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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47
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Milanese S, Eston R. Hamstring injuries and Australian Rules football: over-reliance on Nordic hamstring exercises as a preventive measure? Open Access J Sports Med 2019; 10:99-105. [PMID: 31413646 PMCID: PMC6662172 DOI: 10.2147/oajsm.s212008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 06/06/2019] [Indexed: 12/19/2022] Open
Abstract
Nordic hamstring exercises (NHE) are promoted as an evidence-based strategy for reducing the prevalence of hamstring injuries in football, with a number of studies showing a significant reduction in hamstring injury rates following implementation of a NHE-based program. However, most of the research to date has been undertaken in soccer with less research carried out in other football codes. Despite this lack of relevant evidence, NHE has recently become popular as a preventative measure in Australian Rules football (ARF) teams; however, hamstring injuries remain high. This paper reviews the literature associated with the use of NHE for ARF players and questions the appropriateness of this exercise approach as a preventative measure for hamstring injuries in this sport. When considering the use of a preventative exercise program, such as the NHE, the specific risks associated with the sporting activity should be considered and the evidence reviewed in light of this. Whilst NHE provides an easy way to do eccentric exercises, the movement does not replicate what is needed in the real world for ARF and should therefore be included in a hamstring injury prevention program in this code with caution.
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Affiliation(s)
- Steve Milanese
- International Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, Australia
| | - Roger Eston
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
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Hickey JT, Timmins RG, Maniar N, Rio E, Hickey PF, Pitcher CA, Williams MD, Opar DA. Pain-Free Versus Pain-Threshold Rehabilitation Following Acute Hamstring Strain Injury: A Randomized Controlled Trial. J Orthop Sports Phys Ther 2019:1-35. [PMID: 31253060 DOI: 10.2519/jospt.2019.8895] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Randomized controlled trial. BACKGROUND Conventional guidelines recommend hamstring strain injury (HSI) rehabilitation should only be performed and progressed in complete absence of pain, despite lack of comparison to alternative approaches. OBJECTIVES The primary aim of this study was to compare the number of days from acute HSI to return to play (RTP) clearance following a standardised rehabilitation protocol performed within either pain-free or pain-threshold limits. The secondary aims were to compare isometric knee flexor strength, biceps femoris long head (BFlh) fascicle length, fear of movement and re-injury during a six-month follow-up between pain-free and pain-threshold groups. METHODS Forty-three men with acute HSIs were randomly allocated to either a pain-free (n=22) or pain-threshold (n=21) rehabilitation group. Days from HSI to RTP clearance, isometric knee flexor strength, BFlh fascicle length, fear of movement and re-injuries within six-month follow-up were reported. RESULTS The median time from HSI to RTP clearance was 15 days (95% CI = 13 to 17) in the pain-free group and 17 days (95% CI = 11 to 24) in the pain-threshold group, which was not significantly different (p = 0.37). Recovery of isometric knee flexor strength at 90/90 degrees of hip/knee flexion was greater in the pain-threshold group at RTP clearance by 15% (95% CI = 1 to 28) and by 15% (95% CI = 1 to 29) at two-month follow-up. BFlh fascicles were 0.91cm (95% CI = 0.34 to 1.48) longer at two-month follow-up in the pain-threshold group. Two re-injuries occurred in both the pain-free and pain-threshold group during six-month follow-up. CONCLUSION Pain-threshold rehabilitation did not accelerate RTP clearance but did result in greater recovery of isometric knee flexor strength and better maintenance of BFlh fascicle length improvements compared to pain-free rehabilitation. J Orthop Sports Phys Ther, Epub 28 Jun 2019. doi:10.2519/jospt.2019.8895.
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Affiliation(s)
- Jack T Hickey
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Ryan G Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Nirav Maniar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Ebonie Rio
- La Trobe Centre for Sports and Exercise Medicine Research, Melbourne, Australia
| | - Peter F Hickey
- Epigenetics and Development Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
| | - Christian A Pitcher
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Morgan D Williams
- School of Health, Sport and Professional Practice, University of South Wales, Pontypridd, Wales, UK
| | - David A Opar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
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Pimenta R, Blazevich AJ, Freitas SR. Biceps Femoris Long-Head Architecture Assessed Using Different Sonographic Techniques. Med Sci Sports Exerc 2019; 50:2584-2594. [PMID: 30067589 DOI: 10.1249/mss.0000000000001731] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE To assess the repeatability of, and measurement agreement between, four sonographic techniques used to quantify biceps femoris long head (BFlh) architecture: (i) static-image with linear extrapolation; extended field-of-view (EFOV) with linear ultrasound probe path (linear-EFOV), using either (ii) straight or (iii) segmented analyses; and (iv) EFOV with nonlinear probe path and segmented analysis (nonlinear-EFOV) to follow the complex fascicle trajectories. METHODS Twenty individuals (24.4 ± 5.7 yr; 175 ± 0.8 cm; 73 ± 9.0 kg) without history of hamstrings strain injury were tested in two sessions separated by 1 h. An ultrasound scanner coupled with 6-cm linear probe was used to assess BFlh architecture in B-mode. RESULTS The ultrasound probe was positioned at 52.0% ± 5.0% of femur length and 57.0% ± 6.0% of BFlh length. We found an acceptable repeatability when assessing BFlh fascicle length (ICC3,k = 0.86-0.95; SEM = 1.9-3.2 mm) and angle (ICC3,k = 0.86-0.97; SEM = 0.8°-1.1) using all sonographic techniques. However, the nonlinear-EFOV technique showed the highest repeatability (fascicle length ICC3,k = 0.95; fascicle angle, ICC3,k = 0.97). The static-image technique, which estimated 35.4% ± 7.0% of the fascicle length, overestimated fascicle length (8%-11%) and underestimated fascicle angle (8%-9%) compared with EFOV techniques. Also, the rank order of individuals varied by approximately 15% between static-image and nonlinear-EFOV (segmented) when assessing the fascicle length. CONCLUSIONS Although all techniques showed good repeatability, absolute errors were observed using static-image (7.9 ± 6.1 mm for fascicle length) and linear-EFOV (between 3.7 ± 3.0 and 4.2 ± 3.7 mm), probably because the complex fascicle trajectories were not followed. The rank order of individuals for fascicle length and angle were also different between static-image and nonlinear-EFOV, so different muscle function and injury risk estimates could likely be made when using this technique.
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Affiliation(s)
- Ricardo Pimenta
- Faculty of Human Kinetic, University of Lisbon, Cruz-Quebrada, Dafundo, PORTUGAL
| | - Anthony J Blazevich
- Edith Cowan University, Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Joondalup, AUSTRALIA
| | - Sandro R Freitas
- Faculty of Human Kinetic, University of Lisbon, Cruz-Quebrada, Dafundo, PORTUGAL
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Pollard CW, Opar DA, Williams MD, Bourne MN, Timmins RG. Razor hamstring curl and Nordic hamstring exercise architectural adaptations: Impact of exercise selection and intensity. Scand J Med Sci Sports 2019; 29:706-715. [PMID: 30629773 DOI: 10.1111/sms.13381] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/20/2018] [Accepted: 01/07/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate knee flexor strength and biceps femoris long head (BFlh) architectural adaptations following two different Nordic hamstring exercise (NHE) interventions and one razor hamstring curl (RHC) intervention. METHODS Thirty recreationally active males performed a total of 128 reps of NHEbodyweight (n = 10), NHEweighted (n = 10), or RHCweighted training (n = 10) across 6 weeks. Following the intervention, participants avoided any eccentric training for 4 weeks (detraining period). Strength results during the NHE and RHC were recorded pre- and post-intervention, as well as following detraining. Architectural characteristics of the BFlh were assessed weekly throughout the intervention and detraining periods. RESULTS For the NHEweighted group, NHE strength increased (+81N, P = 0.044, d = 0.90) and BFlh fascicles lengthened (+1.57 cm, P < 0.001, d = 1.41) after 6 weeks of training. After 1 week of detraining, BFlh fascicle lengths shortened, with the largest reductions seen in the NHEweighted group (-0.96 cm, P = 0.021, d = -0.90). Comparatively, BFlh fascicle length and NHE strength responses were moderate in the NHEbodyweight group and negligible in the RHCweighted group. The greatest RHC strength changes (+82N, P = 0.038, d = 1.15) were seen in the RHCweighted group. CONCLUSIONS NHEweighted interventions induce large BFlh fascicle lengthening responses and these adaptations decay after just 1 week of detraining. NHEbodyweight training has a moderate impact on BFlh architecture while the RHCweighted group has the least. Weighted NHE and RHC training promoted exercise-specific increases in strength. These findings suggest that exercise selection and intensity should be considered when prescribing exercises aiming to increase eccentric strength and BFlh fascicle length.
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Affiliation(s)
- Christopher W Pollard
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - David A Opar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Morgan D Williams
- School of Health, Sport and Professional Practice, University of South Wales, Pontypridd, UK
| | - Matthew N Bourne
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Ryan G Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
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