1
|
Nuzzo JL, Pinto MD, Kirk BJC, Nosaka K. Resistance Exercise Minimal Dose Strategies for Increasing Muscle Strength in the General Population: an Overview. Sports Med 2024; 54:1139-1162. [PMID: 38509414 PMCID: PMC11127831 DOI: 10.1007/s40279-024-02009-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 03/22/2024]
Abstract
Many individuals do not participate in resistance exercise, with perceived lack of time being a key barrier. Minimal dose strategies, which generally reduce weekly exercise volumes to less than recommended guidelines, might improve muscle strength with minimal time investment. However, minimal dose strategies and their effects on muscle strength are still unclear. Here our aims are to define and characterize minimal dose resistance exercise strategies and summarize their effects on muscle strength in individuals who are not currently engaged in resistance exercise. The minimal dose strategies overviewed were: "Weekend Warrior," single-set resistance exercise, resistance exercise "snacking," practicing the strength test, and eccentric minimal doses. "Weekend Warrior," which minimizes training frequency, is resistance exercise performed in one weekly session. Single-set resistance exercise, which minimizes set number and session duration, is one set of multiple exercises performed multiple times per week. "Snacks," which minimize exercise number and session duration, are brief bouts (few minutes) of resistance exercise performed once or more daily. Practicing the strength test, which minimizes repetition number and session duration, is one maximal repetition performed in one or more sets, multiple days per week. Eccentric minimal doses, which eliminate or minimize concentric phase muscle actions, are low weekly volumes of submaximal or maximal eccentric-only repetitions. All approaches increase muscle strength, and some approaches improve other outcomes of health and fitness. "Weekend Warrior" and single-set resistance exercise are the approaches most strongly supported by current research, while snacking and eccentric minimal doses are emerging concepts with promising results. Public health programs can promote small volumes of resistance exercise as being better for muscle strength than no resistance exercise at all.
Collapse
Affiliation(s)
- James L Nuzzo
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
| | - Matheus D Pinto
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Benjamin J C Kirk
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Kazunori Nosaka
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| |
Collapse
|
2
|
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.
Collapse
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
| | | |
Collapse
|
3
|
Augustsson J, Alt T, Andersson H. Speed Matters in Nordic Hamstring Exercise: Higher Peak Knee Flexor Force during Fast Stretch-Shortening Variant Compared to Standard Slow Eccentric Execution in Elite Athletes. Sports (Basel) 2023; 11:130. [PMID: 37505617 PMCID: PMC10383276 DOI: 10.3390/sports11070130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 07/29/2023] Open
Abstract
Hamstring strain injuries are prevalent in many sports. Research has demonstrated that the Nordic hamstring exercise (NHE), a knee-dominant exercise addressing the posterior chain muscles, can aid in reducing the risk of hamstring injuries in athletes. However, most research on hamstring injury prevention has focused on performing the eccentric version of the NHE (NHEECC). In contrast, in sports, it is quite frequent for athletes to use an eccentric-concentric version of the NHE. Additionally, eccentric NHE is typically performed using a slow, controlled tempo. The effect of a fast stretch-shortening cycle NHE (NHESSC) compared to standard slow NHEECC on peak knee flexor force has not been investigated. The aim of the study was therefore to investigate fast NHESSC vs. standard slow NHEECC. Our hypothesis posited that peak knee flexor force would be greater for fast NHESSC compared with standard slow NHEECC. The study involved 22 elite athletes (actively competing in both national and international events) consisting of female (n = 10) and male (n = 7) track and field athletes and male football players (n = 5), aged 17-31 years. The participants performed maximum trials of slow NHEECC and fast NHESSC repetitions in which measurement of bilateral peak knee flexor force was conducted at the ankle with the use of a load cell. During the NHEs, a linear encoder was used to measure both the position where the peak knee flexor force was recorded and the average eccentric velocity. SSC contributed to an enhanced NHE performance, where bilateral absolute peak knee flexor force was 13% higher for fast NHESSC vs. standard slow NHEECC (822 vs. 726 N, p < 0.01, ES = 0.54). Participants achieved a 32% greater forward distance at the breakpoint stage during NHEECC compared to the coupling phase for NHESSC (54 vs. 41 cm, p < 0.001, ES = 1.37). Eccentric average velocity was more than three times higher for NHESSC compared with NHEECC (0.38 vs. 0.12 m/s, p < 0.001, ES = 3.25). The key findings of this study were that SSC contributed to an enhanced NHE performance, where absolute peak knee flexor force was 13% greater for fast NHESSC compared to standard slow NHEECC. The fast NHESSC could therefore be an interesting alternative to the standard slow NHEECC execution, as it may offer potential advantages for sprint performance, as well as hamstring injury prevention and rehabilitation.
Collapse
Affiliation(s)
- Jesper Augustsson
- Department of Sport Science, Faculty of Social Sciences, Linnaeus University, 39182 Kalmar, Sweden
| | - Tobias Alt
- Department of Biomechanics, Performance Analysis and Strength & Conditioning, Olympic Training and Testing Centre Westphalia, 44139 Dortmund, Germany
| | - Håkan Andersson
- High Performance Center, Strength and Conditioning Institute, 35246 Vaxjo, Sweden
| |
Collapse
|
4
|
Differences in Peak Knee Flexor Force between Eccentric-Only and Combined Eccentric-Concentric Nordic Hamstring Exercise. Sports (Basel) 2023; 11:sports11020041. [PMID: 36828326 PMCID: PMC9961423 DOI: 10.3390/sports11020041] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
In many sports, the hamstring strain injury is a common injury. There is evidence that the Nordic hamstring exercise (NHE), a knee flexor exercise, can reduce hamstring injury risk in athletes. In research on hamstring injury prevention, eccentric-only NHE is typically performed, whereas in sports, it is relatively common for athletes to perform NHE eccentrically-concentrically. Further, NHE strength is generally assessed by measuring knee flexor force through an ankle brace, attached atop of a load cell. An alternative method might be to assess knee flexor force about the knee joint using a force plate. The aim of the study was to investigate differences in peak knee flexor force between eccentric-only and combined eccentric-concentric NHE. The purpose was also to determine the correlation between hamstring force measured at the ankle using a load cell (current gold standard) and force assessed about the knee joint using a force plate during NHE. Fifteen junior and senior elite soccer and track and field athletes (3 women and 12 men aged 17-27 years) performed eccentric NHE (ENHE) in which they leaned forward as far as possible until breakpoint and eccentric-concentric NHE (ECNHE) where they returned to the starting position. A linear encoder measured the position at which peak force occurred during the NHEs. Force assessed at the ankle differed significantly (678 vs. 600 N, p < 0.05), whereas force about the knee joint did not (640 vs. 607 N, p > 0.05) between ENHE and ECNHE (12 and 5% difference, respectively). The forward distance achieved by the participants in cm at breakpoint for ENHE was 37% higher than at the coupling phase for ECNHE (74 vs. 54 cm, p < 0.001). Very strong significant (p < 0.01) correlations were noted between peak force assessed at the ankle and about the knee joint for ENHE and ECNHE, r = 0.96 and r = 0.99, respectively. Our results suggest that ECNHE, where peak knee flexor force was reached with 37% less forward movement, may complement ENHE, i.e., during hamstring injury rehabilitation, where a position of great knee extension may not be well tolerated by the athlete. Further, assessing knee flexor force about the knee joint using a force plate may provide an alternative to measuring force at the ankle using a load cell when testing NHE strength.
Collapse
|
5
|
Moran J, Vali N, Drury B, Hammami R, Tallent J, Chaabene H, Ramirez-Campillo R. The effect of volume equated 1- versus 2-day formats of Nordic hamstring exercise training on fitness in youth soccer players: A randomised controlled trial. PLoS One 2022; 17:e0277437. [PMID: 36580466 PMCID: PMC9799302 DOI: 10.1371/journal.pone.0277437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/27/2022] [Indexed: 12/30/2022] Open
Abstract
PURPOSE This randomised controlled trial examined the effect of an 8-week volume-equated programme of Nordic hamstring exercise (NHE) training, executed at frequencies of 1- or 2-days per week, on fitness (10 m and 40 m sprint, '505' change of direction [COD] and standing long jump [SLJ]) in male youth soccer players (mean age: 16.4 ± 0.81 years). METHOD Players were divided into an experimental group (n = 16) which was further subdivided into 1-day (n = 8) and 2-day (n = 8) per week training groups and a control group (n = 8). RESULTS There were significant group-by-time interactions for 10-m sprint (p<0.001, η2 = 0.120, d = 2.05 [0.57 to 3.53]), 40-m sprint (p = 0.001, η2 = 0.041, d = 1.09 [-0.23 to 2.4]) and COD (p = 0.002, η2 = 0.063, d = 1.25 [-0.09 to 2.59). The experimental group demonstrated a 'very large' effect size (d = 3.02 [1.5 to 4.54]) in 10-m sprint, and 'large' effect sizes in 40-m sprint (d = 1.94 [0.98 to 2.90]) and COD (d = 1.84 [0.85 to 2.83). The control group showed no significant changes. There were no significant differences between the 1-day and 2-day training groups. In three of the four tests (40 m, COD, SLJ) the 2-day group demonstrated larger effect sizes. Ratings of perceived exertion (RPE) were significantly lower in the 2-day group (p<0.001, 3.46 [1.83 to 5.04). CONCLUSION The NHE increases fitness in youth soccer players and there may be advantages to spreading training over two days instead of one.
Collapse
Affiliation(s)
- Jason Moran
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Colchester, United Kingdom
- * E-mail:
| | - Norodin Vali
- Department of Exercise Physiology, Shahid Rajaee Teacher Training University, Tehran, Iran
| | - Ben Drury
- Department of Sport, Hartpury University, Gloucestershire, United Kingdom
| | - Raouf Hammami
- Higher Institute of Sport and Physical Education of Ksar-Said, Universite de La Manouba, Tunis, Tunisia
- Research Laboratory: Education, Motor Skills, Sports and Health, Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Jamie Tallent
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Colchester, United Kingdom
| | - Helmi Chaabene
- Department of Sports and Health Sciences, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany
- Higher Institute of Sports and Physical Education, Kef, University of Jendouba, Jendouba, Tunisia
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Laboratory, Faculty of Rehabilitation Sciences, School of Physical Therapy, Universidad Andres Bello, Santiago, Chile
| |
Collapse
|
6
|
Abdelkader M, Hammami R, Drury B, Clark N, Sandercock G, Shaw I, Shaw BS, Chortane SG, Moran J. A randomised controlled trial of 1- versus 2-day per week formats of Nordic hamstring training on explosive athletic tasks in prepubertal soccer players. J Sports Sci 2022; 40:2173-2181. [PMID: 36383389 DOI: 10.1080/02640414.2022.2145737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This randomised controlled trial examined the effect of volume-equated programmes of Nordic hamstring exercise (NHE) training, executed at frequencies of 1- or 2-days per week, on explosive athletic tasks (30 m sprint, 15 m manoeuvrability and standing long jump [SLJ]) in male youth soccer players (mean age: 10.3 ± 0.5 years). Players were divided into an experimental group (n = 31) which was further subdivided into 1-day (n = 16) and 2-days (n = 15) per week training conditions, and a control group (n = 14). There were significant group-by-time interactions for 30-m sprint (p < 0.001, d = 0.6), SLJ (p = 0.001, d = 1.27) and 15 m manoeuvrability (p < 0.001, d = 0.61). The experimental group demonstrated small to moderate effect sizes in 30-m sprint (d = 0.42, p = 0.077), SLJ (d = 0.97, p < 0.001) and 15 m manoeuvrability (d = 0.61, p < 0.001). The control group showed small significant performance decrements or no change in these variables. There were no significant differences between the 1-day and 2-day training groups. In two of the three tests (30 m sprint, SLJ) the 2-day group demonstrated larger effect sizes. The NHE enhances explosive athletic task performance in prepubertal youth soccer players and there may be only small advantages to spreading training over two days instead of one.
Collapse
Affiliation(s)
- Mahmoudi Abdelkader
- Research Unit Sports Performance, Health and Society, Higher Institute of Sport and Physical Education of Ksar-Said, Universite de La Manouba, Tunis, Tunisia
| | - Raouf Hammami
- Research Unit Sports Performance, Health and Society, Higher Institute of Sport and Physical Education of Ksar-Said, Universite de La Manouba, Tunis, Tunisia.,Research Laboratory: Education, Motor Skills, Sports and Health (EM2S, UR15JS01), Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Ben Drury
- Department of Sport, Hartpury University, Gloucestershire, UK
| | - Nicholas Clark
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Colchester, UK
| | - Gavin Sandercock
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Colchester, UK
| | - Ina Shaw
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Colchester, UK
| | - Brandon S Shaw
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Colchester, UK
| | - Sabri Gaied Chortane
- Research Unit Sports Performance, Health and Society, Higher Institute of Sport and Physical Education of Ksar-Said, Universite de La Manouba, Tunis, Tunisia
| | - Jason Moran
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Colchester, UK
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Amundsen R, Heimland JS, Thorarinsdottir S, Møller M, Bahr R. Effects of High and Low Training Volume with the Nordic Hamstring Exercise on Hamstring Strength, Jump Height, and Sprint Performance in Female Football Players: A Randomised Trial. TRANSLATIONAL SPORTS MEDICINE 2022; 2022:7133928. [PMID: 38655155 PMCID: PMC11022781 DOI: 10.1155/2022/7133928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/04/2022] [Accepted: 07/16/2022] [Indexed: 04/26/2024]
Abstract
The evidence-based hamstring strengthening programme for prevention of hamstring injuries is not adopted by football teams because of its high training volume. This study on female football players investigated if high-volume training with the Nordic hamstring exercise is more effective on hamstring strength, jump height, and sprint performance than low-volume training. We also examined the time course of changes in muscle strength during the intervention period. Forty-five female football players were randomised to a high- (21 sessions, 538 total reps) or low-volume group (10 sessions, 144 total reps) and performed an 8-week training intervention with the Nordic hamstring exercise during the preseason. We tested hamstring strength (maximal eccentric force with NordBord and maximal eccentric torque with isokinetic dynamometer), jump height, and 40 m sprint before and after the intervention. The NordBord test was also performed during training weeks 4 and 6. Both groups increased maximal eccentric force (high-volume: 29 N (10%), 95% CI: 19-38 N, p < 0.001, low-volume: 37 N (13%), 95% CI: 18-55 N, p = 0.001), but there were no between-group differences (p = 0.38). Maximal eccentric torque, jump height, and sprint performance did not change. Maximal eccentric force increased from the pretest to week 6 (20 N (7%), 95% CI: 8 to 31 N, p < 0.001), but not week 4 (8 N (3%), 95% CI: -2 to 18 N, p = 0.22). High training volume with the Nordic hamstrings exercise did not lead to greater adaptations in strength, jump height, or speed than a low-volume programme. Players in both groups had to train for at least 6 weeks to improve maximal eccentric force significantly.
Collapse
Affiliation(s)
- Roar Amundsen
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Janita Sæther Heimland
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Solveig Thorarinsdottir
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Merete Møller
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Roald Bahr
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| |
Collapse
|
9
|
A Very Low Volume of Nordic Hamstring Exercise Increases Maximal Eccentric Strength and Reduces Hamstring Injury Rate in Professional Soccer Players. J Sport Rehabil 2022; 31:1061-1066. [PMID: 35894913 DOI: 10.1123/jsr.2021-0445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/28/2022] [Accepted: 05/09/2022] [Indexed: 11/18/2022]
Abstract
The aim of this study was to determine whether the inclusion of a very low volume (1 set of 3 maximal repetitions) of eccentric-biased Nordic hamstring program of 21 weeks induced an increase in maximal eccentric strength and whether its magnitude was influenced by the compliance rate. The secondary aim of this study was to determine whether this eccentric-biased Nordic hamstring program was effective at reducing hamstring injury rate. Twenty-three professional soccer players formed the experimental group and undertook regular in-season hamstring strength training and monitoring for 21 weeks. Data from 23 players in the immediately preceding cohort (previous year) were included as a control group. The subdivision of the experimental group revealed that the high compliance subgroup (∼13 d between sessions) exhibited higher changes in maximal eccentric strength compared with the low compliance group (∼24 d between sessions; +26.5%; 95% confidence interval, 7.1%-45.9%; P < .001; g = 1.2). Five hamstring injuries (22%) were recorded in the experimental group and 9 (39%) in the control group, corresponding to a nonsignificant 2.7-fold lower risk (P = .12) of suffering hamstring injury in the experimental group. The current study demonstrates that the inclusion of a very low volume of eccentric-biased Nordic hamstring program for 21 weeks induced an increase in maximal eccentric strength (∼15%) in professional soccer players, the magnitude of which depended on the players' compliance. We also found that this program was efficient (2.7-fold lower risk), although nonsignificant, at reducing hamstring injury rate in professional soccer players.
Collapse
|
10
|
Rodrigues LG, Vianna KB, de Oliveira NT, Chaves ADC, Severo-Silveira L, Ribeiro-Alvares JB, Carvalho P, Baroni BM. Sex-related differences in muscular factors previously identified in the literature as potentially associated with hamstring strain injury in professional football players. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00965-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
11
|
Sganzerla G, Carregaro RL, Martinez PF, Oliveira-Junior SAD. Effectiveness of different weekly frequencies of nordic hamstring exercise on performance and injury-associated factors in intermittent sports athletes: protocol of a randomised clinical trial. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.1080/21679169.2022.2070663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Gianfranco Sganzerla
- Graduate Program in Health and Development in the Midwest Region of Brazil (PPGSD/UFMS), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, Brazil
| | - Rodrigo Luiz Carregaro
- Graduate Program in Rehabilitation Sciences (PPG-CR/UnB), University of Brasília (UnB), Brasília, Brazil
| | - Paula Felippe Martinez
- Graduate Program in Health and Development in the Midwest Region of Brazil (PPGSD/UFMS), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, Brazil
- Graduate Program in Movement Sciences (PPGCMOV/UFMS), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, Brazil
| | - Silvio Assis de Oliveira-Junior
- Graduate Program in Health and Development in the Midwest Region of Brazil (PPGSD/UFMS), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, Brazil
- Graduate Program in Movement Sciences (PPGCMOV/UFMS), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, Brazil
| |
Collapse
|
12
|
Rudisill SS, Varady NH, Kucharik MP, Eberlin CT, Martin SD. Evidence-Based Hamstring Injury Prevention and Risk Factor Management: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Sports Med 2022:3635465221083998. [PMID: 35384731 DOI: 10.1177/03635465221083998] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Hamstring injuries are common among athletes. Considering the potentially prolonged recovery and high rate of recurrence, effective methods of prevention and risk factor management are of great interest to athletes, trainers, coaches, and therapists, with substantial competitive and financial implications. PURPOSE To systematically review the literature concerning evidence-based hamstring training and quantitatively assess the effectiveness of training programs in (1) reducing injury incidence and (2) managing injury risk factors. STUDY DESIGN Systematic review and meta-analysis; Level of evidence, 1. METHODS A computerized search of MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, and SPORTDiscus with manual screening of selected reference lists was performed in October 2020. Randomized controlled trials investigating methods of hamstring injury prevention and risk factor management in recreational, semiprofessional, and professional adult athletes were included. RESULTS Of 2602 articles identified, 108 were included. Eccentric training reduced the incidence of hamstring injury by 56.8% to 70.0%. Concentric hamstring strength increased with eccentric (mean difference [MD], 14.29 N·m; 95% CI, 8.53-20.05 N·m), concentric, blood flow-restricted, whole-body vibration, heavy back squat, FIFA 11+ (Fédération Internationale de Football Association), and plyometric training methods, whereas eccentric strength benefited from eccentric (MD, 26.94 N·m; 95% CI, 15.59-38.30 N·m), concentric, and plyometric training. Static stretching produced greater flexibility gains (MD, 10.89°; 95% CI, 8.92°-12.86°) than proprioceptive neuromuscular facilitation (MD, 9.73°; 95% CI, 6.53°-12.93°) and dynamic stretching (MD, 6.25°; 95% CI, 2.84°-9.66°), although the effects of static techniques were more transient. Fascicle length increased with eccentric (MD, 0.90 cm; 95% CI, 0.53-1.27 cm) and sprint training and decreased with concentric training. Although the conventional hamstring/quadriceps (H/Q) ratio was unchanged (MD, 0.03; 95% CI, -0.01 to 0.06), the functional H/Q ratio significantly improved with eccentric training (MD, 0.10; 95% CI, 0.03-0.16). In addition, eccentric training reduced limb strength asymmetry, while H/Q ratio and flexibility imbalances were normalized via resistance training and static stretching. CONCLUSION Several strategies exist to prevent hamstring injury and address known risk factors. Eccentric strengthening reduces injury incidence and improves hamstring strength, fascicle length, H/Q ratio, and limb asymmetry, while stretching-based interventions can be implemented to improve flexibility. These results provide valuable insights to athletes, trainers, coaches, and therapists seeking to optimize hamstring training and prevent injury.
Collapse
Affiliation(s)
- Samuel S Rudisill
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA.,Rush Medical College of Rush University, Chicago, Illinois, USA
| | - Nathan H Varady
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA.,Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Michael P Kucharik
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA
| | - Christopher T Eberlin
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA
| | - Scott D Martin
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA
| |
Collapse
|
13
|
Augustsson J, Augustsson SR. Development of a Novel Nordic Hamstring Exercise Performance Test Device: A Reliability and Intervention Study. Sports (Basel) 2022; 10:sports10020026. [PMID: 35202065 PMCID: PMC8875831 DOI: 10.3390/sports10020026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/10/2022] [Accepted: 02/18/2022] [Indexed: 12/10/2022] Open
Abstract
There is evidence that a knee flexor exercise, the Nordic hamstring exercise (NHE), prevents hamstring injuries. The purpose of this study was therefore to develop, and to determine the reliability of, a novel NHE test device and, further, to determine the effectiveness of a 10-week low volume NHE program on NHE performance. Twenty female football (soccer) players, aged 16–30 years, participated in this study. From a kneeling position on the device, with the ankles secured under a heavy lifting sling, participants leaned forward in a controlled manner as far as possible (eccentric phase) and then returned to the starting position (concentric phase). A tape measure documented the forward distance achieved by the participants in cm. Participants completed three separate occasions to evaluate test-retest reliability. Additionally, 14 players performed a low volume (1 set of 5 repetitions) NHE program once weekly for 10 weeks. No significant test-retest differences in NHE performance were observed. The intra-class correlation coefficient was 0.95 and the coefficient of variation was 3.54% between tests. Mean improvement in the NHE performance test by the players following training was 22% (8.7 cm), p = 0.005. Our test device reliably measured NHE performance and is easy to perform in any setting. Further, NHE performance was improved by a 10-week low volume NHE program. This suggests that even a small dose (1 set of 5 repetitions once weekly) of the NHE may enhance NHE performance.
Collapse
|
14
|
Afonso J, Rocha-Rodrigues S, Clemente FM, Aquino M, Nikolaidis PT, Sarmento H, Fílter A, Olivares-Jabalera J, Ramirez-Campillo R. The Hamstrings: Anatomic and Physiologic Variations and Their Potential Relationships With Injury Risk. Front Physiol 2021; 12:694604. [PMID: 34305648 PMCID: PMC8294189 DOI: 10.3389/fphys.2021.694604] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/16/2021] [Indexed: 01/11/2023] Open
Abstract
The incidence and recurrence of hamstrings injuries are very high in sports, posing elevated performance and financial-related costs. Attempts to identify the risk factors involved in predicting vulnerability to hamstrings injury is important for designing exercise-based programs that aim to mitigate the rate and severity of hamstrings injuries and improve rehabilitation strategies. However, research has shown that non-modifiable risk factors may play a greater role than modifiable risk factors. Recognizing non-modifiable risk factors and understanding their implications will afford the prescription of better suited exercise programs, i.e., that are more respectful of the individual characteristics. In a nutshell, non-modifiable risk factors can still be acted upon, even if indirectly. In this context, an underexplored topic is how intra and inter- individual anatomic and physiologic variations in hamstrings (e.g., muscle bellies, fiber types, tendon length, aponeurosis width, attachment sites, sex- and age-related differences) concur to alter hamstrings injuries risk. Some anatomic and physiologic variations may be modifiable through exercise interventions (e.g., cross-sectional area), while others may not (e.g., supernumerary muscle bellies). This apparent dichotomy may hide a greater complexity, i.e., there may be risk factors that are partially modifiable. Therefore, we explored the available information on the anatomic variations of the hamstrings, providing a deeper insight into the individual risk factors for hamstrings injuries and contributing with better knowledge and potential applications toward a more individualized exercise prescription.
Collapse
Affiliation(s)
- José Afonso
- Centre for Research, Education, Innovation and Intervention in Sport, Faculty of Sport of the University of Porto, Porto, Portugal
| | - Sílvia Rocha-Rodrigues
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development, Vila Real, Portugal
- Tumor & Microenvironment Interactions Group, Instituto de Investigação e Inovação em Saúde, Porto, Portugal
| | - Filipe M. Clemente
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Instituto de Telecomunicações, Delegação da Covilhã, Covilhã, Portugal
| | - Michele Aquino
- Department of Health and Sport Sciences, Adelphi University, New York, NY, United States
| | | | - Hugo Sarmento
- Research Unit for Sport and Physical Activity, Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Alberto Fílter
- FSI Sport Research Lab, Football Science Institute, Granada, Spain
- Research Group Physical Activity, Health and Sport CTS-948, University of Pablo de Olavide, Seville, Spain
| | - Jesús Olivares-Jabalera
- FSI Sport Research Lab, Football Science Institute, Granada, Spain
- Sport and Health University Research Institute, Department of Physical and Sports Education, University of Granada, Granada, Spain
| | - Rodrigo Ramirez-Campillo
- Department of Physical Activity Sciences, Universidad de Los Lagos, Santiago, Chile
- Centro de Investigación en Fisiología del Ejercicio, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
| |
Collapse
|
15
|
Vianna KB, Rodrigues LG, Oliveira NT, Ribeiro-Alvares JB, Baroni BM. A Preseason Training Program With the Nordic Hamstring Exercise Increases Eccentric Knee Flexor Strength and Fascicle Length in Professional Female Soccer Players. Int J Sports Phys Ther 2021; 16:459-467. [PMID: 33842041 PMCID: PMC8016438 DOI: 10.26603/001c.19452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/04/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Training programs that include the Nordic hamstring exercise (NHE) have been shown to increase eccentric knee flexor strength and biceps femoris fascicle length in male athletes. However, the effect of NHE on female athletes remains unknown. PURPOSE To investigate the collective and individual responses of professional female soccer players engaged in a preseason training program with the NHE regarding eccentric knee flexor strength and biceps femoris long head fascicle length. STUDY DESIGN Quasi-experimental study. METHODS Sixteen amateur female soccer players (without a NHE training routine) were evaluated 8-weeks apart to: (1) assess reliability of eccentric knee flexor strength and biceps femoris fascicle length measures; and (2) determine the typical error of measures that would be used to discriminate training responders and non-responders. The NHE training group had 17 professional female soccer players who performed an 8-week training program with the NHE during preseason. Within-group analysis was performed with paired sample t-tests (pre- vs. post-training), and individual responses were determined using the typical error criteria. RESULTS The non-trained group's data demonstrated that measures of strength (ICC=0.82-0.87, typical error = 12-13 N) and fascicle length (ICC=0.92-0.97; typical error = 0.19-0.38 cm) were reliable. In the NHE training group, both limbs increased the eccentric knee flexor strength (~13%; ES=0.74-0.82) and the biceps femoris fascicle length (~6%; ES=0.44-0.65). Twelve players (~71%) were considered responders to the NHE training program for the eccentric knee flexor strength, while eight athletes (~47%) were responders for the biceps femoris fascicle length. CONCLUSION The 8-week preseason training program with the NHE increased both eccentric knee flexor strength and biceps femoris fascicle length in professional female soccer players. More than two-thirds of players demonstrated a meaningful increase in eccentric strength, while nearly half achieved consistent fascicle length increases with the NHE training.
Collapse
|
16
|
Evidence-Based Prevention of Sports Injuries: Is the Sports Medicine Community on the Right Track? J Orthop Sports Phys Ther 2021; 51:91-93. [PMID: 33645293 DOI: 10.2519/jospt.2021.0104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Sports injuries are multifactorial and have a complex web of risk factors. Thus, identifying risk factors plays a central role in designing prevention strategies. Following evidence-based practice principles, clinicians use the best available evidence to guide decisions about injury prevention. Here, we share a scenario familiar to the sports medicine community-risk factors for hamstring strain injury-and highlight some of the pitfalls that clinicians should watch out for when applying research to practice. J Orthop Sports Phys Ther 2021;51(3):91-93. doi:10.2519/jospt.2021.0104.
Collapse
|