Interactions between fascicles and tendinous tissues in gastrocnemius medialis and vastus lateralis during drop landing

Impact of different landing heights on the contact force in the medial tibiofemoral compartment and the surrounding muscle force characteristics in drop jumps

This study explored the impact of landing height on the tibiofemoral joint's medial compartment force (MCF) during drop jumps to help athletes prevent knee injury. Experienced male participants (N = 16) performed drop jumps with landing heights from 0.15 m to 0.75 m. Kinematic/kinetic parameters were collected using a motion capture system and a three-dimensional force platform. The Med-Lat Knee model was used to calculate biomechanical indicators of the knee joint, and data were analyzed using one-way analysis of variance and one-dimensional statistical parametric mapping (SPM1d). Findings indicated that landing height significantly affected the anterior-posterior and vertical MCF, flexion-extension torque, internal-external rotation torque, and vertical ground reaction force (p<0.05)-all increasing with elevated landing height-and significantly impacted the generated force of the vastus medialis, vastus lateralis, and vastus intermedius (p<0.05). SPM1d analysis confirmed these results within specific time intervals. Thus, both the knee moment and the MCF exhibited similar coordinated changes during drop jumps, indicating that these may be adaptive movement strategy. The impact of varying drop jump heights on muscle groups around the knee joint varied suggests that different heights induce specific muscular responses and improve muscle coordination to prevent knee joint injuries.

Running 40 Minutes under Temperate or Hot Environment Does Not Affect Operating Fascicle Length

PURPOSE

Muscle mechanics is paramount in our understanding of motor performance. However, little is known regarding the sensitivity of fascicle dynamics and connective tissues stiffness to exercise duration and ambient temperature during running, both increasing muscle temperature. This study aimed to determine gastrocnemius medialis (GM) fascicle dynamics in vivo during running in temperate and hot conditions, as well as muscle-tendon unit responses.

METHODS

Using ultrafast ultrasound, 15 participants (8 men, 7 women; 26 ± 3 yr) were tested before, during (2 and 40 min), and after a running task (40 min at 10 km·h -1 ) in temperate (TEMP; ~23°C) and hot (HOT: ~38°C) conditions.

RESULTS

Although core, skin temperatures, and heart rate increased from the beginning to the end of the exercise and in a larger extent in HOT than TEMP ( P < 0.001), the physiological stress elicited did not alter running temporal parameters and GM fascicle operating lengths, with similar behavior of the fascicles on their force-length relationship, over time (2 vs 40 min) or across condition (TEMP vs HOT; P ≥ 0.248). Maximal voluntary force production did not reported statistical changes after exercise ( P = 0.060), and the connective tissues stiffness measured (i.e., passive muscle and stiffness of the series-elastic elements) did not show neither time ( P ≥ 0.281), condition ( P ≥ 0.256) nor time-condition interaction ( P ≥ 0.465) effect.

CONCLUSIONS

This study revealed that prolonged running exercise does not alter muscle-tendon unit properties and interplay, which are not influenced by ambient temperature. These findings may rule out potential detrimental effects of heat on muscle properties and encourage further investigations on longer and more intense running exercise.

Biomechanical behavior of the lower limbs and of the joints when landing from different heights

Landing from a jump is a challenging task as the energy accumulated during the aerial phase of the jump must be fully dissipated by the lower limbs during landing; the higher the jump height, the greater the amount of energy to be dissipated. In the present study, we aim to understand (1) how the biomechanical behavior is tuned as a function of the mechanical demand, and (2) the relationship between the self-selected landing strategy and the behavior of the joints. Fourteen subjects were asked to drop off a box of 10 to 60 cm height and land on the ground. The ground reaction forces and the kinematics were recorded using force plates and a motion capture system. A model was used to estimate the properties, i.e. stiffness and damping, of the lower limbs and of the joints. Our results show that, whatever the amount of energy to be dissipated (i.e. height of the jump), the lower limbs and the anke and knee joints behave first as a spring, then as a spring-damper system. However each joint plays a specific role: during the spring phase, the behaviour of the lower limb is associated with the stiffness of the ankle and with the landing constraints (i.e. force peak and loading rate), while during the spring-damper phase, it is associated with the stiffness of the knee and with the amount of energy to be dissipated. Our findings suggest that constraints and performance result from a distinct control of biomechanical parameters at the joints.

Prepared for landing: A simple activation strategy scales muscle force to landing height

Before landing from a jump or fall, animals preactivate muscles to stiffen their limb joints but it is unclear how muscles tune limb stiffness and how collision forcefulness is anticipated. We measured electromyography and force from the lateral gastrocnemius muscle during landings in turkeys, an animal model that allows for direct measurements of muscle force. Many studies of landings in humans and other animals have found the duration of muscle preactivation to be constant, starting approximately 100 ms before impact, irrespective of fall duration. Therefore, we hypothesized a lack of relationship between fall duration (as dictated by drop height), muscle activity onset-time, and force at toe-down. Contrary to our expectations, both muscle activity and force rose from briefly after fall initiation until toe-down. Preactivation duration was proportional to fall height, while the rate of force rise was consistent across drop heights, resulting in force at landing and leg stiffness being proportional to fall height. Onset of muscle activity lagged 22 ± 7 ms (mean ± S.E.M.) from fall initiation, consistent with a reflex response initiation of the force ramp-up. Together, our results suggest that a constant (clock-like) rate of motor unit recruitment, initiated at fall initiation provides a preactivation that is proportional to drop height. The result is a tuning of pre-landing muscle force, providing a limb stiffening that is proportional to impact intensity, possibly without using information about fall distance.

Regional differences in behaviors of fascicle and tendinous tissue of the biceps femoris long head during hamstring exercises

The biceps femoris long head (BFLH) gains its properties from internal elements (fascicles and tendinous tissues) which behaviors remain poorly understood across BFLH regions and dynamic tasks. The aim of this study was to assess the in vivo behaviors of fascicles and tendinous tissue in the proximal and distal regions of BFLH during different dynamic knee and hip tasks. Twenty males performed the Nordic hamstring exercise (NHE) (n = 9) and Romanian deadlift (RDL) (n = 11). Activation of the BFLH was assessed using surface electromyography signals. Ultrasound images of BFLH and kinematic data were used to estimate the interaction between fascicle and tendinous tissue. The fascicles changed less in length (p < 0.05) and contributed less to BFLH length change (p < 0.05) in NHE with higher activation (p < 0.05) relative to RDL. The higher pennation angle changes of BFLH were found in distal region compared to proximal region in both tasks (p < 0.05), while the activation of distal region was higher than activation of proximal region in NHE (p < 0.05). The BFLH length change was primarily contributed by the tendinous tissue during dynamic resistance tasks, and was contributed less by fascicles which operated more isometrically in knee-dominant NHE with higher activation relative to hip-dominant RDL. Regional differences in pennation angle change and activation during dynamic tasks suggest potential regional differences in the mechanical function of BFLH, warranting further investigation.

Human in vivo medial gastrocnemius gear during active and passive muscle lengthening: effect of inconsistent methods and nomenclature on data interpretation

'Muscle gear' is calculated as the ratio of fascicle-to-muscle length change, strain, or velocity. Inconsistencies in nomenclature and definitions of gear exist across disciplines partly due to differences in fascicle [curved (Lf) versus linear (Lf,straight)] and muscle [whole-muscle belly (Lb) versus belly segment (Lb,segment)] length calculation methods. We tested whether these differences affect gear magnitude during passive and active muscle lengthening of human medial gastrocnemius of young men (n=13, 26.3±5.0 years) using an isokinetic dynamometer. Lb, Lb,segment, Lf and Lf,straight were measured from motion analysis and ultrasound imaging data. Downshifts in belly gear but not belly segment gear occurred with muscle lengthening only during active lengthening. Muscle gear was unaffected by fascicle length measurement method (P=0.18) but differed when calculated as changes in Lb or Lb,segment (P<0.01) in a length-dependent manner. Caution is therefore advised for the use and interpretation of different muscle gear calculation methods and nomenclatures in animal and human comparative physiology.

Changes in gravity affect neuromuscular control, biomechanics, and muscle-tendon mechanics in energy storage and dissipation tasks

This study evaluates neuromechanical control and muscle-tendon interaction during energy storage and dissipation tasks in hypergravity. During parabolic flights, while 17 subjects performed drop jumps (DJs) and drop landings (DLs), electromyography (EMG) of the lower limb muscles was combined with in vivo fascicle dynamics of the gastrocnemius medialis, two-dimensional (2D) kinematics, and kinetics to measure and analyze changes in energy management. Comparisons were made between movement modalities executed in hypergravity (1.8 G) and gravity on ground (1 G). In 1.8 G, ankle dorsiflexion, knee joint flexion, and vertical center of mass (COM) displacement are lower in DJs than in DLs; within each movement modality, joint flexion amplitudes and COM displacement demonstrate higher values in 1.8 G than in 1 G. Concomitantly, negative peak ankle joint power, vertical ground reaction forces, and leg stiffness are similar between both movement modalities (1.8 G). In DJs, EMG activity in 1.8 G is lower during the COM deceleration phase than in 1 G, thus impairing quasi-isometric fascicle behavior. In DLs, EMG activity before and during the COM deceleration phase is higher, and fascicles are stretched less in 1.8 G than in 1 G. Compared with the situation in 1 G, highly task-specific neuromuscular activity is diminished in 1.8 G, resulting in fascicle lengthening in both movement modalities. Specifically, in DJs, a high magnitude of neuromuscular activity is impaired, resulting in altered energy storage. In contrast, in DLs, linear stiffening of the system due to higher neuromuscular activity combined with lower fascicle stretch enhances the buffering function of the tendon, and thus the capacity to safely dissipate energy.NEW & NOTEWORTHY For the first time, the neuromechanics of distinct movement modalities that fundamentally differ in their energy management function have been investigated during overload systematically induced by hypergravity. Parabolic flight provides a unique experimental setting that allows near-natural movement execution without the confounding effects typically associated with load variation. Our findings show that gravity-adjusted muscle activities are inversely affected within jumps and landings. Specifically, in 1.8 G, typical task-specific differences in neuromuscular activity are reduced during the center of mass deceleration phase, resulting in fascicle lengthening, which is associated with energy dissipation.

Deceleration Training in Team Sports: Another Potential 'Vaccine' for Sports-Related Injury?

High-intensity horizontal decelerations occur frequently in team sports and are typically performed to facilitate a reduction in momentum preceding a change of direction manoeuvre or following a sprinting action. The mechanical underpinnings of horizontal deceleration are unique compared to other high-intensity locomotive patterns (e.g., acceleration, maximal sprinting speed), and are characterised by a ground reaction force profile of high impact peaks and loading rates. The high mechanical loading conditions observed when performing rapid horizontal decelerations can lead to tissue damage and neuromuscular fatigue, which may diminish co-ordinative proficiency and an individual’s ability to skilfully dissipate braking loads. Furthermore, repetitive long-term deceleration loading cycles if not managed appropriately may propagate damage accumulation and offer an explanation for chronic aetiological consequences of the ‘mechanical fatigue failure’ phenomenon. Training strategies should look to enhance an athlete’s ability to skilfully dissipate braking loads, develop mechanically robust musculoskeletal structures, and ensure frequent high-intensity horizontal deceleration exposure in order to accustom individuals to the potentially damaging effects of intense decelerations that athletes will frequently perform in competition. Given the apparent importance of horizontal decelerations, in this Current Opinion article we provide considerations for sport science and medicine practitioners around the assessment, training and monitoring of horizontal deceleration. We feel these considerations could lead to new developments in injury-mitigation and physical development strategies in team sports.

Series elasticity facilitates safe plantar flexor muscle-tendon shock absorption during perturbed human hopping

In our everyday lives, we negotiate complex and unpredictable environments. Yet, much of our knowledge regarding locomotion has come from studies conducted under steady-state conditions. We have previously shown that humans rely on the ankle joint to absorb energy and recover from perturbations; however, the muscle-tendon unit (MTU) behaviour and motor control strategies that accompany these joint-level responses are not yet understood. In this study, we determined how neuromuscular control and plantar flexor MTU dynamics are modulated to maintain stability during unexpected vertical perturbations. Participants performed steady-state hopping and, at an unknown time, we elicited an unexpected perturbation via rapid removal of a platform. In addition to kinematics and kinetics, we measured gastrocnemius and soleus muscle activations using electromyography and in vivo fascicle dynamics using B-mode ultrasound. Here, we show that an unexpected drop in ground height introduces an automatic phase shift in the timing of plantar flexor muscle activity relative to MTU length changes. This altered timing initiates a cascade of responses including increased MTU and fascicle length changes and increased muscle forces which, when taken together, enables the plantar flexors to effectively dissipate energy. Our results also show another mechanism, whereby increased co-activation of the plantar- and dorsiflexors enables shortening of the plantar flexor fascicles prior to ground contact. This co-activation improves the capacity of the plantar flexors to rapidly absorb energy upon ground contact, and may also aid in the avoidance of potentially damaging muscle strains. Our study provides novel insight into how humans alter their neural control to modulate in vivo muscle-tendon interaction dynamics in response to unexpected perturbations. These data provide essential insight to help guide design of lower-limb assistive devices that can perform within varied and unpredictable environments.

Does Muscle-Tendon Unit Structure Predispose to Hamstring Strain Injury During Running? A Critical Review

Hamstring strain injury (HSI) remains the most common muscle injury in high-intensity running in humans. The majority of acute HSI occur specifically within the proximal region of the long head of biceps femoris and there is a sustained interest among researchers in understanding the factors that predispose to HSI. The present critical review describes the current understanding of biceps femoris long head (BFlh) structural features that might influence strain injury risk. Inter-individual differences in muscle-tendon architecture and interactions, muscle fiber type and region-specific innervation are likely to influence biceps femoris long head injury risk and might inform why some individuals are at an increased risk of sustaining a HSI during running. However, more research is needed, with future studies focusing on prospective data acquisition, improved computer simulations and direct imaging techniques to better understand the relationship between structural features, hamstring muscle function, and injury risk.

Force enhancement in the human vastus lateralis is muscle-length-dependent following stretch but not during stretch

Purpose

Force enhancement is the phenomenon of increased forces during (transient force enhancement; tFE) and after (residual force enhancement; rFE) eccentric muscle actions compared with fixed-end contractions. Although tFE and rFE have been observed at short and long muscle lengths, whether both are length-dependent remains unclear in vivo.

Methods

We determined maximal-effort vastus lateralis (VL) force-angle relationships of eleven healthy males and selected one knee joint angle at a short and long muscle lengths where VL produced approximately the same force (85% of maximum). We then examined tFE and rFE at these two lengths during and following the same amount of knee joint rotation.

Results

We found tFE at both short (11.7%, P = 0.017) and long (15.2%, P = 0.001) muscle lengths. rFE was only observed at the long (10.6%, P < 0.001; short: 1.3%, P = 0.439) muscle length. Ultrasound imaging revealed that VL muscle fascicle stretch magnitude was greater at long compared with short muscle lengths (mean difference: (tFE) 1.7 mm, (rFE) 1.9 mm, P ≤ 0.046), despite similar isometric VL forces across lengths (P ≥ 0.923). Greater fascicle stretch magnitude was likely to be due to greater preload forces at the long compared with short muscle length (P ≤ 0.001).

Conclusion

At a similar isometric VL force capacity, tFE was not muscle-length-dependent at the lengths we tested, whereas rFE was greater at longer muscle length. We speculate that the in vivo mechanical factors affecting tFE and rFE are different and that greater stretch of a passive component is likely contributing more to rFE at longer muscle lengths.

Electronic supplementary material

The online version of this article (10.1007/s00421-020-04488-1) contains supplementary material, which is available to authorized users.

Acute Static Stretching Results in Muscle-Specific Alterations amongst the Hamstring Muscles

This study aimed to explore the acute effects of static stretching on the musculotendinous properties of two hamstring muscles. Twelve male volunteers underwent two testing sessions. One session was dedicated to the evaluation of the semitendinosus muscle before (PRE) and after (POST) static stretching (five sets of 30-s stretching), and the other session similarly explored the long head of biceps femoris muscle. In addition to the displacement of the myotendinous junction (MTJ), passive torque and maximal voluntary isometric torque (MVIT) were evaluated. MVIT (-8.3 ± 10.2%, p = 0.0036, d = 0.497) and passive torque (-28.4 ± 16.9%, p = 0.0003, d = 1.017) were significantly decreased POST stretching. PRE stretching, MTJ displacement was significantly greater for semitendinosus muscle than biceps femoris muscle (27.0 ± 5.2 vs. 18.6 ± 3.6, p = 0.0011, d = 1.975). After the stretching procedure, greater MTJ displacement relative changes were observed for biceps femoris muscle as compared to semitendinosus muscle (22.4 ± 31.6 vs. -8.4 ± 17.9, p = 0.0167, d = 1.252). Because of the smaller MTJ displacement PRE stretching and greater alteration POST stretching in biceps femoris muscles, the present study demonstrated muscle-specific acute responses of hamstring muscles during stretching. Although stretching acutely impairs torque production, the passive torque reduction and alteration of MTJ displacement might impact hamstring injury prevention.

Individualized Muscle-Tendon Assessment and Training

The interaction of muscle and tendon is of major importance for movement performance and a balanced development of muscle strength and tendon stiffness could protect athletes from overuse injury. However, muscle and tendon do not necessarily adapt in a uniform manner during a training process. The development of a diagnostic routine to assess both the strength capacity of muscle and the mechanical properties of tendons would enable the detection of muscle-tendon imbalances, indicate if the training should target muscle strength or tendon stiffness development and allow for the precise prescription of training loads to optimize tendon adaptation. This perspective article discusses a framework of individualized muscle-tendon assessment and training and outlines a methodological approach for the patellar tendon.

Skeletal Muscle Shape Change in Relation to Varying Force Requirements Across Locomotor Conditions

Contractions of skeletal muscles to generate in vivo movement involve dynamic changes in contractile and elastic tissue strains that likely interact to influence the force and work of a muscle. However, studies of the in vivo dynamics of skeletal muscle and tendon strains remain largely limited to bipedal animals, and rarely cover the broad spectra of movement requirements met by muscles that operate as motors, struts, or brakes across the various gaits that animals commonly use and conditions they encounter. Using high-speed bi-planar fluoromicrometry, we analyze in vivo strains within the rat medial gastrocnemius (MG) across a range of gait and slope conditions. These conditions require changes in muscle force ranging from decline walk (low) to incline gallop (high). Measurements are made from implanted (0.5–0.8 mm) tantalum spheres marking MG mid-belly width, mid-belly thickness, as well as strains of distal fascicles, the muscle belly, and the Achilles tendon. During stance, as the muscle contracts, muscle force increases linearly with respect to gait–slope combinations, and both shortening and lengthening fiber strains increase from approximately 5 to 15% resting length. Contractile change in muscle thickness (thickness strain) decreases (r² = 0.86; p = 0.001); whereas, the change in muscle width (width strain) increases (r² = 0.88; p = 0.001) and tendon strain increases (r² = 0.77; p = 0.015). Our results demonstrate force-dependency of contractile and tendinous tissue strains with compensatory changes in shape for a key locomotor muscle in the hind limb of a small quadruped. These dynamic changes are linked to the ability of a muscle to tune its force and work output as requirements change with locomotor speed and environmental conditions.

Ultrasound imaging to assess skeletal muscle architecture during movements: a systematic review of methods, reliability, and challenges

B-mode ultrasound is often used to quantify muscle architecture during movements. Our objectives were to 1) systematically review the reliability of fascicle length (FL) and pennation angles (PA) measured using ultrasound during movements involving voluntary contractions; 2) systematically review the methods used in studies reporting reliability, discuss associated challenges, and provide recommendations to improve the reliability and validity of dynamic ultrasound measurements; and 3) provide an overview of computational approaches for quantifying fascicle architecture, their validity, agreement with manual quantification of fascicle architecture, and advantages and drawbacks. Three databases were searched until June 2019. Studies among healthy human individuals aged 17-85 yr that investigated the reliability of FL or PA in lower-extremity muscles during isoinertial movements and that were written in English were included. Thirty studies (n = 340 participants) were included for reliability analyses. Between-session reliability as measured by coefficient of multiple correlations (CMC), and coefficient of variation (CV) was FL CMC: 0.89-0.96; CV: 8.3% and PA CMC: 0.87-0.90; CV: 4.5-9.6%. Within-session reliability was FL CMC: 0.82-0.99; CV: 0.0-6.7% and PA CMC: 0.91; CV: 0.0-15.0%. Manual analysis reliability was FL CMC: 0.89-0.96; CV: 0.0-15.9%; PA CMC: 0.84-0.90; and CV: 2.0-9.8%. Computational analysis FL CMC was 0.82-0.99, and PA CV was 14.0-15.0%. Eighteen computational approaches were identified, and these generally showed high agreement with manual analysis and high validity compared with phantoms or synthetic images. B-mode ultrasound is a reliable method to quantify fascicle architecture during movement. Additionally, computational approaches can provide a reliable and valid estimation of fascicle architecture.

Do Stretch-Shortening Cycles Really Occur in the Medial Gastrocnemius? A Detailed Bilateral Analysis of the Muscle-Tendon Interaction During Jumping

The effect of stretch-shortening cycles (SSCs) is often studied in laboratory settings, yet it remains unclear whether highly active muscle SSCs actually occur during in vivo movement. Nine highly trained jumping athletes performed single-leg pre-hop forward jumps at maximal effort. We hypothesized that these jumps would induce a SSC at the level of the muscle in the medial gastrocnemius. Kinematic and kinetic data were collected together with electromyography signals (EMG) and muscle fascicle length and pennation angle changes of the medial gastrocnemius of both legs and combined with a musculoskeletal model to calculate the stretch-shortening behavior of the muscle (fascicles) and tendon (series-elastic element). The length changes of the fascicles, longitudinal muscle displacement, series-elastic element, and whole muscle-tendon unit further allowed for a detailed analysis of the architectural gearing ratio between different phases of the SSC within a single movement. We found a SSC at the level of the joint, muscle-tendon unit and tendon but not at the muscle. We further found that the average architectural gearing ratio was higher during the stretching of the series-elastic element as compared to when the series-elastic element was shortening, yet this was not statistically tested because of low sample size for this parameter. However, we found no correlation when plotting the architectural gearing ratio as a function of the fascicle velocities at each instance in time. Despite the athletes having a clear preferred leg for jumping, we found no differences in any kinematic or kinetic parameter between the preferred and non-preferred leg or any parameter from the muscle-tendon interaction analysis other than a reduced longitudinal muscle shortening in the non-preferred leg (p = 0.008). We conclude that, although common at the level of the joints, MTUs, and tendon (series-elastic element), highly active SSCs very rarely occur in the medial gastrocnemius, even in movements that induce high loading. This has important implications for the translation of ex vivo findings on SSC effects, such as residual force enhancement, in this muscle. We further conclude that there is no precise tuning of the architectural gearing ratio in the medial gastrocnemius throughout the whole movement.

Surface properties affect the interplay between fascicles and tendinous tissues during landing

PURPOSE

Muscle-tendon units are forcefully stretched during rapid deceleration events such as landing. Consequently, tendons act as shock absorbers by buffering the negative work produced by muscle fascicles likely to prevent muscle damage. Landing surface properties can also modulate the amount of energy dissipated by the body, potentially effecting injury risk. This study aimed to evaluate the influence of three different surfaces on the muscle-tendon interactions of gastrocnemius medialis (GM), and vastus lateralis (VL) during single- and double-leg landings from 50 cm.

METHODS

Ultrasound images, muscle activity and joint kinematics were collected for 12 participants. Surface testing was also performed, revealing large differences in mechanical behavior.

RESULTS

During single-leg landing, stiffer surfaces increased VL fascicle lengthening and velocity, and muscle activity independent of joint kinematics while GM length changes showed no difference between surfaces. Double-leg landing resulted in similar fascicle and tendon behavior despite greater knee flexion angles on stiffer surfaces.

CONCLUSION

This demonstrates that VL fascicle lengthening is greater when the surface stiffness increases, when performing single-leg landing. This is due to the combination of limited knee joint flexion and lower surface absorption ability which resulted in greater mechanical demand mainly withstood by fascicles. GM muscle-tendon interactions remain similar between landing surfaces and types. Together, this suggests that surface damping properties primarily affect the VL muscle-tendon unit with a potentially higher risk of injury as a result of increased surface stiffness when performing single-leg landing tasks.

Hamstring rehabilitation in elite track and field athletes: applying the British Athletics Muscle Injury Classification in clinical practice

Rationale

Hamstring injuries are common in elite sports. Muscle injury classification systems aim to provide a framework for diagnosis. The British Athletics Muscle Injury Classification (BAMIC) describes an MRI classification system with clearly defined, anatomically focused classes based on the site of injury: (a) myofascial, (b) muscle–tendon junction or (c) intratendinous; and the extent of the injury, graded from 0 to 4. However, there are no clinical guidelines that link the specific diagnosis (as above) with a focused rehabilitation plan.

Objective

We present an overview of the general principles of, and rationale for, exercise-based hamstring injury rehabilitation in British Athletics. We describe how British Athletics clinicians use the BAMIC to help manage elite track and field athletes with hamstring injury. Within each class of injury, we discuss four topics: clinical presentation, healing physiology, how we prescribe and progress rehabilitation and how we make the shared decision to return to full training. We recommend a structured and targeted diagnostic and rehabilitation approach to improve outcomes after hamstring injury.

Distinct muscle-tendon interaction during running at different speeds and in different loading conditions

The interaction between the Achilles tendon and the triceps surae muscles seems to be modulated differently with various task configurations. Here we tested the hypothesis that the increased forces and ankle joint work during running under contrasting conditions (altered speed or load) would be met by different, time-dependent adjustments at the muscle-tendon level. Ultrasonography, electromyography, kinematics, and ground reaction force measurements were used to examine Achilles tendon, gastrocnemius, and soleus muscle mechanics in 16 runners in four different running conditions, consisting of a combination of two different speeds (preferred and +20% of preferred speed) and two loading conditions (unloaded and +20% of body mass). Positive ankle joint work increased similarly (+13%) with speed and load. Gastrocnemius and soleus muscle fascicle length and peak velocity were not altered by either condition, suggesting that contractile conditions are mostly preserved despite the constraints imposed in this experimental design. However, at higher running speed, tendon length changes were unaltered but mean muscle electromyographic activity increased in gastrocnemius (+10%, P < 0.01) and soleus (+14%, P < 0.01). Conversely, when loading was increased, mean muscle activity remained similar to unloaded conditions but the mean velocity of gastrocnemius fascicles was reduced and tendon recoil increased (+29%, P < 0.01). Collectively, these results suggest that the neuromuscular system meets increased mechanical demands by favoring economical force production when enough time is available. NEW & NOTEWORTHY We demonstrate that muscle-tendon mechanics are adjusted differently when running under constraints imposed by speed or load, despite comparable increases in work. The neuromuscular system likely modulates the way force is produced as a function of availability of time and potential energy.

Training-induced increase in Achilles tendon stiffness affects tendon strain pattern during running

Background

During the stance phase of running, the elasticity of the Achilles tendon enables the utilisation of elastic energy and allows beneficial contractile conditions for the triceps surae muscles. However, the effect of changes in tendon mechanical properties induced by chronic loading is still poorly understood. We tested the hypothesis that a training-induced increase in Achilles tendon stiffness would result in reduced tendon strain during the stance phase of running, which would reduce fascicle strains in the triceps surae muscles, particularly in the mono-articular soleus.

Methods

Eleven subjects were assigned to a training group performing isometric single-leg plantarflexion contractions three times per week for ten weeks, and another ten subjects formed a control group. Before and after the training period, Achilles tendon stiffness was estimated, and muscle-tendon mechanics were assessed during running at preferred speed using ultrasonography, kinematics and kinetics.

Results

Achilles tendon stiffness increased by 18% (P < 0.01) in the training group, but the associated reduction in strain seen during isometric contractions was not statistically significant. Tendon elongation during the stance phase of running was similar after training, but tendon recoil was reduced by 30% (P < 0.01), while estimated tendon force remained unchanged. Neither gastrocnemius medialis nor soleus fascicle shortening during stance was affected by training.

Discussion

These results show that a training-induced increase in Achilles tendon stiffness altered tendon behaviour during running. Despite training-induced changes in tendon mechanical properties and recoil behaviour, the data suggest that fascicle shortening patterns were preserved for the running speed that we examined. The asymmetrical changes in tendon strain patterns supports the notion that simple in-series models do not fully explain the mechanical output of the muscle-tendon unit during a complex task like running.