1
|
Yagiz G, Fredianto M, Ulfa M, Ariani I, Agustin AD, Shida N, Moore EWG, Kubis HP. A retrospective comparison of the biceps femoris long head muscle structure in athletes with and without hamstring strain injury history. PLoS One 2024; 19:e0298146. [PMID: 38408057 PMCID: PMC10896514 DOI: 10.1371/journal.pone.0298146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/17/2024] [Indexed: 02/28/2024] Open
Abstract
INTRODUCTION Hamstring strain injuries (HSI) and re-injuries are endemic in high-speed running sports. The biceps femoris long head (BFlh) is the most frequently injured muscle among the hamstrings. Structural parameters of the hamstring muscle are stated to be susceptible to strain injuries at this location. This retrospective study targeted comparing the BFlh's structural parameters between previously injured and uninjured athletes. METHODS Nineteen male athletes with previous BFlh strain injury history and nineteen athletes without former lower extremity injury history were included in this study. Fascicle length, mid-muscle belly and distal musculotendinous (MTJ) passive stiffnesses of the biceps femoris long head (BFlh) were examined via b-mode panoramic ultrasound scanning and ultrasound-based shear-wave elastography. Parameter comparisons of both legs within and between athletes with and without injury history were performed. RESULTS Comparison of the BFlh fascicle length between the injured leg of the injured group and the legs of the controls revealed a trend to shorter fascicle lengths in the injured leg (p = 0.067, d = -0.62). However, the mid-muscle belly passive stiffness of the BFlh was significantly higher in the injured legs (p = 0.009, d = 0.7) compared with the controls. Additionally, the distal MTJ stiffness was much higher in the previously injured legs compared with controls (p < 0.001, d = 1.6). CONCLUSIONS Outcomes support the importance of BFlh properties related to stiffness, and fascicle length for injury susceptibility in athletes. Future prospective studies should determine whether the higher stiffness in the injured athletes is a cause or consequence of the HSI. Physical therapy and rehabilitation programmes after HSI should focus on BFlh muscle properties i.e., elasticity and fascicle length for reducing re-injury and increasing sports performance.
Collapse
Affiliation(s)
- Gokhan Yagiz
- Department of Kinesiology, College of Health and Human Performance, East Carolina University, Greenville, NC, United States of America
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Amasya University, Amasya, Republic of Türkiye
| | - Meiky Fredianto
- Faculty of Medicine and Health Sciences, Orthopaedics and Traumatology Division, Surgery Department, School of Medicine, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
- Department of Orthopaedic Surgery, Siloam Hospitals Yogyakarta, Yogyakarta, Indonesia
| | - Maria Ulfa
- Faculty of Medicine and Health Sciences, School of Medicine, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
- Master of Hospital Administration, Postgraduate Program, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Indira Ariani
- Department of Radiology, Siloam Hospitals Yogyakarta, Yogyakarta, Indonesia
| | | | - Nami Shida
- Faculty of Health Sciences, Department of Physical Therapy, Tokyo Metropolitan University, Tokyo, Japan
| | - E Whitney G Moore
- Department of Kinesiology, College of Health and Human Performance, East Carolina University, Greenville, NC, United States of America
| | - Hans-Peter Kubis
- Institute for Applied Human Physiology, School of Human and Behavioural Sciences, Bangor University, Bangor, Wales, United Kingdom
| |
Collapse
|
2
|
B Nielsen L, B Svensson R, U Fredskild N, H Mertz K, Magnusson SP, Kjaer M, Bayer ML. Chronic changes in muscle architecture and aponeurosis structure following calf muscle strain injuries. Scand J Med Sci Sports 2023; 33:2585-2597. [PMID: 37621063 DOI: 10.1111/sms.14472] [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: 03/02/2023] [Revised: 06/02/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Muscle strain injuries in the human calf muscles are frequent sports injuries with high recurrence. Potential structural and functional changes in the medial head of the musculus gastrocnemius (GM) and the associated aponeurosis are not well documented. PURPOSE To test whether a GM muscle strain injury affects muscle fascicle length, pennation angle, and the morphology of the deep aponeurosis at rest and during muscle contraction long time after the injury. Additionally, electromyography (EMG) of the GM and the soleus muscle during a unilateral heel rise was measured in the injured and uninjured calf. METHODS GM fascicle length, pennation angle, and aponeurosis thickness was analyzed on dynamic ultrasonography (US) recordings in 10 participants with a chronic calf strain. In addition, US images taken across the distal portion and mid-belly of the GM were analyzed at three different ankle positions. EMG recordings were obtained during a unilateral heel rise. RESULTS The pennation angle of the injured distal GM was significantly larger compared to the uninjured GM in the contracted, but not the relaxed state. Pennation angle increased more in the injured compared to the uninjured GM during contraction. Fascicle length was shorter in the most distal portion of the injured GM. Fascicles at the distal portion of the injured GM showed a pronounced curvilinear shape as the muscle contracted and the aponeurosis was enlarged in the injured compared to the uninjured GM. The ratio between GM and soleus EMG activity showed a significantly higher relative soleus activity in the injured compared to the healthy calf. CONCLUSION The greater change in pennation angle and curvilinear fascicle shape during contraction suggest that a long-term consequence after a muscle strain injury is that some muscle fibers at the distal GM are not actively engaged. The significantly enlarged aponeurosis indicates a substantial and long-lasting connective tissue involvement following strain injuries.
Collapse
Affiliation(s)
- Louise B Nielsen
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Copenhagen University Hospital - Bispebjerg Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rene B Svensson
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Copenhagen University Hospital - Bispebjerg Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels U Fredskild
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Copenhagen University Hospital - Bispebjerg Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kenneth H Mertz
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Copenhagen University Hospital - Bispebjerg Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - S Peter Magnusson
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Copenhagen University Hospital - Bispebjerg Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Physical Therapy, Copenhagen University Hospital - Bispebjerg Frederiksberg, Copenhagen, Denmark
| | - Michael Kjaer
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Copenhagen University Hospital - Bispebjerg Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Monika L Bayer
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Copenhagen University Hospital - Bispebjerg Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
3
|
Cronin K, Foley S, Cournane S, De Vito G, Kerin F, Farrell G, Delahunt E. The architectural characteristics of the hamstring muscles do not differ between male and female elite-level rugby union players. Front Physiol 2023; 14:1129061. [PMID: 36776970 PMCID: PMC9911870 DOI: 10.3389/fphys.2023.1129061] [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: 12/21/2022] [Accepted: 01/18/2023] [Indexed: 01/28/2023] Open
Abstract
Purpose: To determine whether differences exist in the architectural characteristics of the hamstring muscles of elite-level male and female rugby union players. Methods: Forty elite-level rugby union players (male n = 20, female n = 20) participated in this cross-sectional study. A sonographer acquired static ultrasound images using a 92 mm linear transducer to quantify (via a semi-automated tracing software tool) the architectural characteristics (muscle length, fascicle length, pennation angle, and muscle thickness) of the biceps femoris long head and semimembranosus muscles of participants' left limb. Muscle length and muscle thickness of the biceps femoris short head and semitendinosus muscles of participants' left limb were also quantified. Bonferroni adjusted independent samples t-tests were performed to evaluate whether differences exist in the architectural characteristics of the hamstring muscles of elite-level male and female rugby union players. Results: There were no significant differences in fascicle length or pennation angle of the hamstring muscles of elite-level male and female rugby union players. Some significant differences in muscle thickness (biceps femoris short head, and semimembranosus) and muscle length (biceps femoris short head, biceps femoris long head, semitendinosus, and semimembranosus) were observed; in all cases the male players had thicker and longer muscles. Conclusion: At a group level, hamstring muscle fascicle length and pennation angle are unlikely to be a sex-specific intrinsic risk factor for Hamstring strain injuries.
Collapse
Affiliation(s)
- Kevin Cronin
- School of Medicine, University College Dublin, Dublin, Ireland,*Correspondence: Kevin Cronin,
| | - Shane Foley
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Seán Cournane
- School of Physics, University College Dublin, Dublin, Ireland
| | - Giuseppe De Vito
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Fearghal Kerin
- Leinster Rugby, Dublin, Ireland,School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | | | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland,Institute for Sport and Health, University College Dublin, Dublin, Ireland
| |
Collapse
|