Architectural Changes of the Biceps Femoris Long Head after Concentric or Eccentric Training

The role of pennation angle and architectural gearing to rate of force development in dynamic and isometric muscle contractions

BACKGROUND

Associations between muscle architecture and rate of force development (RFD) have been largely studied during fixed-end (isometric) contractions. Fixed-end contractions may, however, limit muscle shape changes and thus alter the relationship between muscle architecture an RFD.

AIM

We compared the correlation between muscle architecture and architectural gearing and knee extensor RFD when assessed during dynamic versus fixed-end contractions.

METHODS

Twenty-two recreationally active male runners performed dynamic knee extensions at constant acceleration (2000°s-2) and isometric contractions at a fixed knee joint angle (fixed-end contractions). Torque, RFD, vastus lateralis muscle thickness, and fascicle dynamics were compared during 0-75 and 75-150 ms after contraction onset.

RESULTS

Resting fascicle angle was moderately and positively correlated with RFD during fixed-end contractions (r = 0.42 and 0.46 from 0-75 and 75-150 ms, respectively; p < 0.05), while more strongly (p < 0.05) correlated with RFD during dynamic contractions (r = 0.69 and 0.73 at 0-75 and 75-150 ms, respectively; p < 0.05). Resting fascicle angle was (very) strongly correlated with architectural gearing (r = 0.51 and 0.73 at 0-75 ms and 0.50 and 0.70 at 75-150 ms; p < 0.05), with gearing in turn also being moderately to strongly correlated with RFD in both contraction conditions (r = 0.38-0.68).

CONCLUSION

Resting fascicle angle was positively correlated with RFD, with a stronger relationship observed in dynamic than isometric contraction conditions. The stronger relationships observed during dynamic muscle actions likely result from different restrictions on the acute changes in muscle shape and architectural gearing imposed by isometric versus dynamic muscle contractions.

Biceps femoris long head muscle and aponeurosis geometry in males with and without a history of hamstring strain injury

OBJECTIVES

Hamstring strain injuries (HSIs) commonly affect the proximal biceps femoris long head (BFlh) musculotendinous junction. Biomechanical modeling suggests narrow proximal BFlh aponeuroses and large muscle-to-aponeurosis width ratios increase localized tissue strains and presumably risk of HSI. This study aimed to determine if BFlh muscle and proximal aponeurosis geometry differed between limbs with and without a history of HSI.

METHODS

Twenty-six recreationally active males with (n = 13) and without (n = 13) a history of unilateral HSI in the last 24 months underwent magnetic resonance imaging of both thighs. BFlh muscle and proximal aponeurosis cross-sectional areas, length, volume, and interface area between muscle and aponeurosis were extracted. Previously injured limbs were compared to uninjured contralateral and control limbs for discrete variables and ratios, and along the relative length of tissues using statistical parametric mapping.

RESULTS

Previously injured limbs displayed significantly smaller muscle-to-aponeurosis volume ratios (p = 0.029, Wilcoxon effect size (ES) = 0.43) and larger proximal BFlh aponeurosis volumes (p = 0.019, ES = 0.46) than control limbs with no history of HSI. No significant differences were found between previously injured and uninjured contralateral limbs for any outcome measure (p = 0.216-1.000, ES = 0.01-0.36).

CONCLUSIONS

Aponeurosis geometry differed between limbs with and without a history of HSI. The significantly larger BFlh proximal aponeuroses and smaller muscle-to-aponeurosis volume ratios in previously injured limbs could alter the strain experienced in muscle adjacent to the musculotendinous junction during active lengthening. Future research is required to determine if geometric differences influence the risk of re-injury and whether they can be altered via targeted training.

Eccentric exercise ≠ eccentric contraction

Whether eccentric exercise involves active fascicle stretch is unclear due to muscle-tendon unit (MTU) series compliance. Therefore, this study investigated the impact of changing the activation timing and level (i.e., preactivation) of the contraction on muscle fascicle kinematics and kinetics of the human tibialis anterior during dynamometer-controlled maximal voluntary MTU-stretch-hold contractions. B-mode ultrasound and surface electromyography were used to assess muscle fascicle kinematics and muscle activity levels, respectively. Although joint kinematics were similar among MTU-stretch-hold contractions (∼40° rotation amplitude), increasing preactivation increased fascicle shortening and stretch amplitudes (9.9-23.2 mm, P ≤ 0.015). This led to increasing positive and negative fascicle work with increasing preactivation. Despite significantly different fascicle kinematics, similar peak fascicle forces during stretch occurred at similar fascicle lengths and joint angles regardless of preactivation. Similarly, residual force enhancement (rFE) following MTU stretch was not significantly affected (6.5-7.6%, P = 0.559) by preactivation, but rFE was strongly correlated with peak fascicle force during stretch (rrm = 0.62, P = 0.003). These findings highlight that apparent eccentric exercise causes shortening-stretch contractions at the fascicle level rather than isolated eccentric contractions. The constant rFE despite different fascicle kinematics and kinetics suggests that a passive element was engaged at a common muscle length among conditions (e.g., optimal fascicle length). Although it remains unclear whether different fascicle mechanics trigger different adaptations to eccentric exercise, this study emphasizes the need to consider MTU series compliance to better understand the mechanical drivers of adaptation to exercise.NEW & NOTEWORTHY Apparent eccentric exercises do not result in isolated eccentric contractions, but shortening-stretch contractions at the fascicle level. The amount of fascicle shortening and stretch depends on the preactivation during the exercise and cannot be estimated from the muscle-tendon unit (MTU) or joint kinematics. As different fascicle mechanics might trigger different adaptations to eccentric exercise, muscle-tendon unit series compliance and muscle preactivation need to be considered when eccentric exercise protocols are designed.

Localized hamstring bioimpedance in marathon runners is related to muscle high-energy enzyme serum levels and predicts race time

Introduction: The aim was to analyze the response of serum levels of inflammatory, high-energy muscle biomarkers and hamstring localized bioimpedance (L-BIA) measurements to marathon running and to ascertain whether they correlate with each other or with race time. Methods: Blood samples and hamstrings tetra-polar L-BIA measurements from 14 Caucasian male recreational athletes at the Barcelona Marathon 2019 were collected at base line, immediately after and 48 h post-race. Serum C reactive protein (sCRP), creatinine kinase (sCK) and lactate dehydrogenase (sLDH) were determined using an AU-5800 chemistry analyzer. L-BIA was obtained at 50 kHz with a Quantum V Segmental phase-sensitive bioimpedance analyzer. Results: Median sCRP increased (4-fold) after 48 h post-race. Median sCK and sLDH levels increased immediately post-race (3-fold, 2-fold) and 48h post-race (5-fold, 1-fold). Left, right and combined hamstring reactance (Xc) and phase angle (PhA) increased immediately post-race. Xc combined hamstring pre- and immediately post-race correlated with race-time and with sCK and sLDH median levels pre-race. Xc combined hamstring pre- and immediately post-race > 15.6 Ω and 15.8 Ω, respectively, predicted the race time of 3:00:00 h. Conclusion: L-BIA reactance (Xc) is an objective direct, real time, easy, noninvasive bioelectrical parameter that may predict muscle and marathon athlete performance.

Six Weeks of Unilateral Flywheel Hip-Extension and Leg-Curl Training Improves Flywheel Eccentric Peak Power but Does Not Enhance Hamstring Isokinetic or Isometric Strength

PURPOSE

This preregistered trial investigated how 6 weeks of unilateral flywheel leg-curl and hip-extension training impact isokinetic, isometric, and flywheel strength and power outcomes.

METHODS

The study involved 11 male university athletes (age 22 [2] y; body mass 77.2 [11.3] kg; height 1.74 [0.09] m) with one leg randomly allocated to flywheel training and one leg to control. Unilateral eccentric and isometric knee-flexion torque and flywheel unilateral leg-curl and hip-extension peak power were tested. Training intensity and volume (3-4 sets of 6 + 2 repetitions) were progressively increased.

RESULTS

The intervention enhanced hip-extension concentric (P < .01, d = 1.76, large) and eccentric (P < .01, d = 1.33, large) peak power more than the control (significant interaction effect). Similarly, eccentric (P = .023, d = 1.05, moderate) peak power was enhanced for the leg curl. No statistically significant differences between conditions were found for isokinetic eccentric (P = .086, d = 0.77, moderate) and isometric (P = .431, d = 0.36, small) knee-flexor strength or leg-curl concentric peak power (P = .339, d = 0.52, small). Statistical parametric mapping analysis of torque-angle curves also revealed no significant (P > .05) time-limb interaction effect at any joint angle.

CONCLUSION

Unilateral flywheel hamstring training improved knee-flexor eccentric peak power during unilateral flywheel exercise but not flywheel concentric, isokinetic eccentric, or isometric (long-lever) knee-flexor strength.

Resistance Training Practices of Brazilian Olympic Sprint and Jump Coaches: Toward a Deeper Understanding of Their Choices and Insights (Part III)

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.

Muscle dynamics analysis by clustered categories during jogging in patients with anterior cruciate ligament deficiency

BACKGROUND

Patients with anterior cruciate ligament (ACL) deficiency (ACLD) tend to have altered lower extremity dynamics. Little is known about the changes in dynamic function and activation during jogging in patients with ACLD.

METHODS

Twenty patients with an injured ACL before ACL reconstruction (ACLD group) and nine healthy male volunteers (control group) were recruited. Each volunteer repeated the jogging experiment five times. Based on the experimental data measured, a musculoskeletal multibody dynamics model was employed to simulate the tibiofemoral joint dynamics during jogging. Eighteen muscles were used for analysis. The obtained dynamics data were used for clustering and curve difference analysis.

RESULTS

The 18 muscles studied were divided into 3 categories. All the quadriceps, the soleus, the gastrocnemius, and the popliteus were classified as label 1. All the hamstrings were classified as label 2, and the sartorius muscles were classified as label 3. Among them, the classification of the short head of the biceps femoris was significantly different between the two groups (P < 0.001). The force curves of all 18 muscles and the between-group differences were studied according to clustered categories. Most muscle force in label 1 was approaching zero in the terminal stance phase, which was significantly lower than that in the control group (P < 0.05). The muscle force in label 2 had areas with significant differences in the stance phase. Muscle force in label 3 was significantly lower than that in the control group in the pre-swing phase.

CONCLUSIONS

This study showed that there are various changes of muscle function and activation in patients with ACLD. Through clustering and curve analysis, the joint reactions and changes of different muscle forces in the gait cycle between the ACLD and control groups could be further clarified.

Managing Lower Limb Muscle Reinjuries in Athletes: From Risk Factors to Return-to-Play Strategies

Muscle injuries and subsequent reinjuries significantly impact athletes, especially in football. These injuries lead to time loss, performance impairment, and long-term health concerns. This review aims to provide a comprehensive overview of the current understanding of muscle reinjuries, delving into their epidemiology, risk factors, clinical management, and prevention strategies. Despite advancements in rehabilitation programs and return-to-play criteria, reinjury rates remain alarmingly high. Age and previous muscle injuries are nonmodifiable risk factors contributing to a high reinjury rate. Clinical management, which involves accurate diagnosis, individualized rehabilitation plans, and the establishment of return-to-training and return-to-play criteria, plays a pivotal role during the sports season. Eccentric exercises, optimal loading, and training load monitoring are key elements in preventing reinjuries. The potential of artificial intelligence (AI) in predicting and preventing reinjuries offers a promising avenue, emphasizing the need for a multidisciplinary approach to managing these injuries. While current strategies offer some mitigation, there is a pressing need for innovative solutions, possibly leveraging AI, to reduce the incidence of muscle reinjuries in football players. Future research should focus on this direction, aiming to enhance athletes' well-being and performance.

Long-Term Neurophysiological Adaptations to Strength Training: A Systematic Review With Cross-Sectional Studies

ABSTRACT

Santos, PDG, Vaz, JR, Correia, J, Neto, T, and Pezarat-Correia, P. Long-term neurophysiological adaptations to strength training: a systematic review with cross-sectional studies. J Strength Cond Res 37(10): 2091-2105, 2023-Neuromuscular adaptations to strength training are an extensively studied topic in sports sciences. However, there is scarce information about how neural mechanisms during force production differ between trained and untrained individuals. The purpose of this systematic review is to better understand the differences between highly trained and untrained individuals to establish the long-term neural adaptations to strength training. Three databases were used for the article search (PubMed, Web of Science, and Scopus). Studies were included if they compared groups of resistance-trained with untrained people, aged 18-40 year, and acquired electromyography (EMG) signals during strength tasks. Twenty articles met the eligibility criteria. Generally, strength-trained individuals produced greater maximal voluntary activation, while reducing muscle activity in submaximal tasks, which may affect the acute response to strength training. These individuals also presented lower co-contraction of the antagonist muscles, although it depends on the specific training background. Global intermuscular coordination may be another important mechanism of adaptation in response to long-term strength training; however, further research is necessary to understand how it develops over time. Although these results should be carefully interpreted because of the great disparity of analyzed variables and methods of EMG processing, chronic neural adaptations seem to be decisive to greater force production. It is crucial to know the timings at which these adaptations stagnate and need to be stimulated with advanced training methods. Thus, training programs should be adapted to training status because the same stimulus in different training stages will lead to different responses.

Influence of resistance training on muscle architecture in older adults: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Resistance training (RT) consists of planned exercise programs to increase muscle strength capacity through neural and structural adaptations, such as changes in the geometric arrangement of muscle fibers. This study aimed to analyze the influence of RT on muscle architecture in older people.

METHODS

This PROSPERO-registered systematic review and meta-analysis (identification number CRD42022340477) followed the PRISMA guidelines. Four electronic databases were searched for eligible randomized controlled trials (RCTs) that observed older individuals submitted to RT programs that reported muscle architecture outcomes.

RESULTS

Seventeen RCTs met the eligibility criteria with a total of 488 participants. The main results of the meta-analysis showed that RT interventions had a significant effect on the thickness of the medial gastrocnemius (SMD = 0.12; 95% CI: - 0.07 to 0.17; p < 0.00001; I2 = 0%).

CONCLUSION

Based on available evidence, studies included in this review showed improvement in maximum isometric force, pennation angle, fascicle length, thickness, and muscle activation after RT interventions. In turn, the meta-analysis suggested a potential for improving the thickness of the medial gastrocnemius after the intervention. However, any clinical implications drawn from the analyses should be interpreted with caution, as these findings are substantially limited due to a low number of included studies and a potential heterogeneity between studies.

Effect of sit-to-stand-based training on muscle quality in sedentary adults: a randomized controlled trial

The aim of this study was to compare the effects of sit-to-stand (STS) training programs with 5 vs. 10 repetitions on muscle architecture and muscle function in sedentary adults. Sixty participants were randomly assigned into three groups: five-repetition STS (5STS), 10-repetition STS (10STS), or a control group (CG). Participants performed three sets of five or 10 repetitions of the STS exercise three times per week for 8 weeks. Before and after 8 weeks, all groups performed ultrasound measures to evaluate muscle thickness (MT), pennation angle (PA), and fascicle length (FL), and the five-repetition STS test to estimate the relative STS power and muscle quality index (MQI). After 8 weeks, both experimental groups improved MQI (40-45%), relative STS power (29-38%), and MT (8-9%) (all p < 0.001; no differences between the 5STS vs. 10STS groups). These improvements in both groups resulted in differences regarding the CG, which did not present any change. In addition, only the 5STS group improved PA (15%; p = 0.008) without differences to the 10STS and CG.This suggests that STS training is time-effective and low-cost for improving muscle function and generating adaptations in muscle architecture.

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

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 (NHE_ECC). 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 (NHE_SSC) compared to standard slow NHE_ECC on peak knee flexor force has not been investigated. The aim of the study was therefore to investigate fast NHE_SSC vs. standard slow NHE_ECC. Our hypothesis posited that peak knee flexor force would be greater for fast NHE_SSC compared with standard slow NHE_ECC. 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 NHE_ECC and fast NHE_SSC 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 NHE_SSC vs. standard slow NHE_ECC (822 vs. 726 N, p < 0.01, ES = 0.54). Participants achieved a 32% greater forward distance at the breakpoint stage during NHE_ECC compared to the coupling phase for NHE_SSC (54 vs. 41 cm, p < 0.001, ES = 1.37). Eccentric average velocity was more than three times higher for NHE_SSC compared with NHE_ECC (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 NHE_SSC compared to standard slow NHE_ECC. The fast NHE_SSC could therefore be an interesting alternative to the standard slow NHE_ECC execution, as it may offer potential advantages for sprint performance, as well as hamstring injury prevention and rehabilitation.

The effects of hip- vs. knee-dominant hamstring exercise on biceps femoris morphology, strength, and sprint performance: a randomized intervention trial protocol

BACKGROUND

The hamstrings are an important muscle group that contribute to horizontal force during sprint acceleration and are also the most injured muscle group in running-based sports. Given the significant time loss associated with hamstrings injury and impaired sprinting performance following return to sport, identifying exercises that drive adaptations that are both protective of strain injury and beneficial to sprint performance is important for the strength and conditioning professional. This paper describes the study protocol investigating the effects of a 6-week training program using either the hip-dominant Romanian deadlift (RDL) or the knee-dominant Nordic hamstring exercise (NHE) on hamstring strain injury risk factors and sprint performance.

METHODS

A permuted block randomized (1:1 allocation) intervention trial will be conducted involving young, physically-active men and women. A target sample size of 32 will be recruited and enrolled participants will undergo baseline testing involving extended-field-of-view ultrasound imaging and shear wave elastography of the biceps femoris long head muscle, maximal hamstrings strength testing in both the RDL and NHE, and on-field sprint performance and biomechanics. Participants will complete the 6-week training intervention using either the RDL or NHE, according to group allocation. Baseline testing will be repeated at the end of the 6-week intervention followed by 2 weeks of detraining and a final testing session. The primary outcome will be regional changes in fascicle length with secondary outcomes including pennation angle, muscle cross sectional area, hamstring strength, and maximal sprint performance and biomechanics. An exploratory aim will determine changes in shear wave velocity.

DISCUSSION

Despite extensive research showing the benefits of the NHE on reducing hamstring strain injury risk, alternative exercises, such as the RDL, may offer similar or potentially even greater benefits. The findings of this study will aim to inform future researchers and practitioners investigating alternatives to the NHE, such as the RDL, in terms of their effectiveness in reducing rates of hamstring strain injury in larger scale prospective intervention studies.

TRIAL REGISTRATION

The trial is prospectively registered on ClinicalTrials.gov (NCT05455346; July 15, 2022).

Effect of two eccentric hamstring exercises on muscle architectural characteristics assessed with diffusion tensor MRI

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.

London International Consensus and Delphi study on hamstring injuries part 3: rehabilitation, running and return to sport

Hamstring injuries (HSIs) are the most common athletic injury in running and pivoting sports, but despite large amounts of research, injury rates have not declined in the last 2 decades. HSI often recur and many areas are lacking evidence and guidance for optimal rehabilitation. This study aimed to develop an international expert consensus for the management of HSI. A modified Delphi methodology and consensus process was used with an international expert panel, involving two rounds of online questionnaires and an intermediate round involving a consensus meeting. The initial information gathering round questionnaire was sent to 46 international experts, which comprised open-ended questions covering decision-making domains in HSI. Thematic analysis of responses outlined key domains, which were evaluated by a smaller international subgroup (n=15), comprising clinical academic sports medicine physicians, physiotherapists and orthopaedic surgeons in a consensus meeting. After group discussion around each domain, a series of consensus statements were prepared, debated and refined. A round 2 questionnaire was sent to 112 international hamstring experts to vote on these statements and determine level of agreement. Consensus threshold was set a priori at 70%. Expert response rates were 35/46 (76%) (first round), 15/35 (attendees/invitees to meeting day) and 99/112 (88.2%) for final survey round. Statements on rehabilitation reaching consensus centred around: exercise selection and dosage (78.8%-96.3% agreement), impact of the kinetic chain (95%), criteria to progress exercise (73%-92.7%), running and sprinting (83%-100%) in rehabilitation and criteria for return to sport (RTS) (78.3%-98.3%). Benchmarks for flexibility (40%) and strength (66.1%) and adjuncts to rehabilitation (68.9%) did not reach agreement. This consensus panel recommends individualised rehabilitation based on the athlete, sporting demands, involved muscle(s) and injury type and severity (89.8%). Early-stage rehab should avoid high strain loads and rates. Loading is important but with less consensus on optimum progression and dosage. This panel recommends rehabilitation progress based on capacity and symptoms, with pain thresholds dependent on activity, except pain-free criteria supported for sprinting (85.5%). Experts focus on the demands and capacity required for match play when deciding the rehabilitation end goal and timing of RTS (89.8%). The expert panellists in this study followed evidence on aspects of rehabilitation after HSI, suggesting rehabilitation prescription should be individualised, but clarified areas where evidence was lacking. Additional research is required to determine the optimal load dose, timing and criteria for HSI rehabilitation and the monitoring and testing metrics to determine safe rapid progression in rehabilitation and safe RTS. Further research would benefit optimising: prescription of running and sprinting, the application of adjuncts in rehabilitation and treatment of kinetic chain HSI factors.

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

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.

Muscle Architecture, Morphology, and Mechanical and Functional Properties of Biceps Femoris Long Head in Professional Soccer Players with a Prior Healed Injured Hamstring

OBJECTIVE

The aim of the present study was to compare the fascicle length, pennation angle, muscle thickness and stiffness of the biceps femoris long head, and eccentric hamstring strength between injured dominant limbs, injured non-dominant limbs, uninjured dominant limbs and uninjured non-dominant legs in previously injured players, and between dominant and non-dominant legs in uninjured elite soccer players.

MATERIALS AND METHODS

Twenty elite soccer players participated in this study. Ultrasound imaging and MyotonPRO were used to determine the morphological and mechanical properties of the biceps femoris long head. Isokinetic and Nordic hamstring exercises were used to assess eccentric hamstring strength.

RESULTS

Previously injured players showed substantially lower fascicle length and muscle thickness, and significantly higher biceps femoris long head stiffness than uninjured players, without differences between limbs.

CONCLUSION

The morphological and mechanical properties of elite soccer players with hamstring injury history were different from those in uninjured players. The lack of differences between limbs showed that these values are characteristics of individual players that must be considered in the design of programs to prevent BFlh injury.

Effect of an Isometric or Eccentric Hip Extension Exercise Intervention on Hamstring Strength, Architecture, and Morphology

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.

Reliability and Comparison of Sonographic Methods for In Vivo Measurement of Human Biceps Femoris Long-Head Architecture

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.

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

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.

An investigation of movement dynamics and muscle activity during traditional and accentuated-eccentric squatting

Introduction

Accentuated-eccentric loading (AEL) takes advantage of the high force producing potential of eccentric muscle contractions, potentially maximising mechanical tension within the muscle. However, evidence is lacking on how AEL squatting may load the involved musculature, limiting scientifically justified programming recommendations. The purpose of this study was to investigate the effects of concentric and eccentric loads on joint loading and muscle activity of the lower limbs.

Methods

Resistance trained males performed traditional squatting (20–100% of concentric one-repetition maximum [1RM]) and AEL squatting with eccentric loads (110–150% of 1RM) provided by a novel motorised isotonic resistance machine (Kineo). Kinetics and kinematics of the hip, knee, and ankle joints were collected, with electromyography from the gluteus maximus, vastus lateralis, biceps femoris, and gastrocnemius medialis. A secondary cohort underwent a kinematic and electromyography analysis of squatting technique to compare Kineo and back and front barbell squatting.

Results

Knee joint peak eccentric moments occurred at 120% 1RM (P = 0.045), with no further increase thereafter. As eccentric load increased, the time course of moment development occurred earlier in the eccentric phase. This resulted in a 37% increase in eccentric knee extensor work from the 80% 1RM trial to the 120% 1RM trial (P<0.001). Neither hip nor ankle joints displayed further change in kinetics as eccentric load increased above 100% 1RM. Electromyographic activity during traditional squatting was ~15–30% lower in all eccentric trials than in concentric trials for all muscles. EMG plateaued between a load of 80–100% 1RM during the eccentric trials and did not increase with AEL. No significant differences in kinematics were found between Kineo and barbell squatting.

Conclusions

The knee extensors appear to be preferentially loaded during AEL squatting. The greater work performed during the eccentric phase of the squat as eccentric load increased suggests greater total mechanical tension could be the cause of adaptations from AEL. Our data suggest that AEL should be programmed with a load of 120% of 1RM. Further studies are needed to confirm the longer-term training effects of AEL.

A randomised controlled trial of 1- versus 2-day per week formats of Nordic hamstring training on explosive athletic tasks in prepubertal soccer players

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.

Biceps Femoris Fascicle Lengths Increase after Hamstring Injury Rehabilitation to a Greater Extent in the Injured Leg

Objectives

Document changes in fascicle length during rehabilitation from hamstring injury of the injured and uninjured legs and secondarily to describe any association between these changes and reinjury rate.

Design

Multicentre case series.

Methods

Fifty-two prospectively included hamstring injured athletes had their biceps femoris long head fascicle lengths measured at the start and end of rehabilitation using two-dimensional ultrasound. Absolute and relative changes in fascicle length were compared for each leg using linear mixed models. Participants were followed for six months after being cleared to return to sport for any reinjury. Fascicle lengths and rehabilitation duration were compared for those who reinjured and those who did not.

Results

Injured leg fascicle length was shorter at the start of rehabilitation (9.1 cm compared to 9.8 cm, p < 0.01 ) but underwent greater absolute and relative lengthening during rehabilitation to 11.1 cm (18% increase) compared to 10.2 cm (8% increase, p < 0.01 ) for the uninjured leg. There were no significant differences in any fascicle length parameter for the 5 participants who reinjured in the 6 months following their return to sport compared to those that did not reinjure.

Conclusions

While both injured and uninjured legs displayed increases in fascicle length during rehabilitation, the larger fascicle length increases in the injured leg suggest that either a different training stimulus was applied during rehabilitation to each leg or there was a different response to training and/or recovery from injury in the injured leg. Reinjury risk appears to be independent of fascicle length changes in this cohort, but the small number of reinjuries makes any conclusions speculative.

Eccentric exercise improves joint flexibility in adults: A systematic review update and meta-analysis

BACKGROUND

Eccentric exercise is thought to improve joint flexibility, but the size of the effect is not known. We aimed to quantify the overall effect of eccentric exercise on joint flexibility in adults.

DESIGN

Systematic review, meta-analysis.

DATA SOURCES

AMED, CINAHL, MEDLINE, EMBASE, SportDiscus.

PARTICIPANTS

Adults.

INTERVENTION

Eccentric exercise compared to no intervention or to a different intervention.

OUTCOME MEASURES

Joint range of motion or muscle fascicle length.

DATA EXTRACTION AND SYNTHESIS

Descriptive data of included trials and estimates of effect sizes were extracted. Standardised mean differences (SMD) of range of motion or fascicle length outcomes were meta-analysed using random effects models. Overall quality of evidence was assessed using the GRADE scale.

RESULTS

32 trials (1122 participants, 108 lost to follow-up) were included in the systematic review. The mean (SD) PEDro score was 5.2 (1.3). Four trials reported insufficient data for meta-analysis. Data from 27 trials (911 participants, 82 lost to follow-up) were meta-analysed. Eccentric exercise improved joint flexibility in adults (pooled random effects Hedges' g SMD = 0.54, 95% CI 0.34 to 0.74). The true effect size is different across studies and 50% of the variance in observed effects is estimated to reflect variance in true effects rather than sampling error (I² = 50%, Q = 67.6, d.f. = 34, p = 0.001). Overall quality of evidence ranged from 'low' to 'high'.

CONCLUSION

Eccentric exercise improves joint flexibility in adults. The overall standardised mean effect of eccentric exercise was moderately large, and the narrow width of the 95% confidence interval indicates the effect was estimated with good precision.

REGISTRATION

Open Science Foundation (https://osf.io/mkdqr); PROSPERO registration CRD42020151303.

Early introduction of high-intensity eccentric loading into hamstring strain injury rehabilitation

OBJECTIVES

This study aimed to investigate the number of days following hamstring strain injury (HSI) taken to introduce high-intensity eccentric loading (HIEL) into rehabilitation based on exercise-specific progression criteria, and whether pain resolution during isometric knee flexion strength testing occurred before or after this milestone.

DESIGN

Cohort study.

METHODS

We included 42 men (mean ± sd; age = 26 ± 5 years; height = 181 ± 8 cm; mass = 86 ± 12 kg) with HSIs, who performed fully supervised rehabilitation twice per week until they met return to play clearance criteria. Isometric knee flexion strength testing was completed before every rehabilitation session and HIEL was introduced via the Nordic hamstring exercise and unilateral slider once participants could perform a bilateral slider through full eccentric knee flexion range of motion. We reported the median (IQR) number of days following HSI taken to introduce HIEL, along with participant's pain rating during isometric knee flexion strength testing before that rehabilitation session. We also reported the median (IQR) number of days following HSI taken for participants to achieve pain resolution during isometric knee flexion.

RESULTS

HIEL was introduced 5 (2-8) days following HSI, despite 35/42 participants reporting pain during isometric knee flexion strength testing immediately prior to that rehabilitation session, which was rated as 3.5 (3-5) on a 0-10 numeric rating scale. Pain resolution during isometric knee flexion strength testing was achieved 11 (9-13) days following HSI.

CONCLUSION

HIEL can be safely introduced into early HSI rehabilitation based on exercise-specific progression criteria, without needing to wait for pain resolution during isometric knee flexion strength testing before doing so.

Effects of voluntary exercise on muscle structure and function in cerebral palsy

Skeletal muscles are required for functional movement and force production. While it is clear that cerebral palsy (CP) results in loss of muscle strength and bodily function, and that much of this loss is caused by injury to the central nervous system, muscle is a very plastic tissue that is also dramatically affected. In many studies, it is assumed that voluntary exercise will cause the muscle to respond in the same way that typically developing muscle does, but there are scarce data demonstrating that this is true. The purpose of this review is to briefly describe muscle architectural adaptation to various forms of exercise with specific reference to voluntary exercise performed in children with CP. Exercise itself is not generic but can vary by intensity, duration, and the exact nature of the muscle length change and velocity imposed during the exercise. Our goal is to stimulate discussion in this area by pointing out salient experimental variables and, ultimately, to improve activity and participation in children with CP.

The Effects of Eccentric Strength Training on Flexibility and Strength in Healthy Samples and Laboratory Settings: A Systematic Review

Background: The risk of future injury appears to be influenced by agonist fascicle length (FL), joint range of motion (ROM) and eccentric strength. Biomechanical observations of the torque-angle-relationship further reveal a strong dependence on these factors. In practice, a longer FL improves sprinting performance and lowers injury risk. Classical stretching is a popular and evidenced-based training for enhancing ROM but does not have any effects on FL and injury risk. However, recent studies show that eccentric-only training (ECC) improves both flexibility and strength, and effectively lowers risk of injury.

Objectives: To review the evidence on benefits of ECC for flexibility and strength.

Methods: COCHRANE, PUBMED, SCOPUS, SPOLIT, and SPONET were searched for laboratory trials that compare ECC to at least one comparison group. Studies were eligible if they examined both strength and flexibility metrics in a healthy sample (<65 years) and met criteria for controlled or randomized clinical trials (CCT, RCT). 18 studies have been included and successfully rated using the PEDro scale.

Results: 16 of 18 studies show strong evidence of strength and flexibility enhancements for the lower limb. While improvements between ECC and concentric training (CONC) were similar for eccentric (+19 ± 10% vs. +19 ± 11%) and isometric strength (+16 ± 10% vs. +13 ± 6%), CONC showed larger improvements for concentric strength (+9 ± 6% vs. +16 ± 7%). While for ROM ECC showed improvements (+9 ± 7%), no results could be found for CONC. The overall effectiveness of ECC seems to be higher than of CONC.

Conclusion: There is clear evidence that ECC is an effective method for changes in muscle architecture, leading to both flexibility and strength improvements for the lower limb. Due to limited data no shoulder study could be included. Further research is needed for the upper body joints with a focus on functional and structural adaptions.

Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021283248, identifier CRD42021283248

Evidence-Based Hamstring Injury Prevention and Risk Factor Management: A Systematic Review and Meta-analysis of Randomized Controlled Trials

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.

Effects of Plyometric Training on Lower Body Muscle Architecture, Tendon Structure, Stiffness and Physical Performance: A Systematic Review and Meta-analysis

BACKGROUND

Plyometric training (PT) has been widely studied in sport science. However, there is no review that determines the impact of PT on the structural variables and mechanical properties of the lower limbs and physical performance.

OBJECTIVE

The aim of this systematic review and meta-analysis was to determine the effects of PT on lower body muscle architecture, tendon structure, stiffness and physical performance.

METHODS

Five electronic databases were analysed. The inclusion criteria were: (1) Availability in English; (2) Experimental studies that included a PT of at least eight sessions; and (3) Healthy adults subjects. Four meta-analyses were performed using Review Manager software: (1) muscle architecture; (2) tendon structure; (3) muscle and tendon stiffness; (4) physical performance.

RESULTS

From 1008 search records, 32 studies were eligible for meta-analysis. Muscle architecture meta-analysis found a moderate effect of PT on muscle thickness (Standard Mean Difference (SMD): 0.59; [95% Confidence Interval (CI) 0.47, 0.71]) and fascicle length (SMD: 0.51; [95% CI 0.26, 0.76]), and a small effect of PT on pennation angle (SMD: 0.29; [95% CI 0.02, 0.57]). The meta-analysis found a moderate effect of PT on tendon stiffness (SMD: 0.55; [95% CI 0.28, 0.82]). The lower body physical performance meta-analysis found a moderate effect of PT on jumping (SMD: 0.61; [95% CI 0.47, 0.74]) and strength (SMD: 0.57; [95% CI 0.42, 0.73]).

CONCLUSION

PT increased the thickness, pennation angle and fascicle length of the evaluated muscles. In addition, plyometrics is an effective tool for increasing tendon stiffness and improving jump and strength performance of the lower body.

Daily protein-polyphenol ingestion increases daily myofibrillar protein synthesis rates and promotes early muscle functional gains during resistance training

Factors underpinning the time-course of resistance-type exercise training (RET) adaptations are not fully understood. This study hypothesized that consuming a twice-daily protein-polyphenol beverage (PPB; n = 15; age, 24 ± 1 yr; BMI, 22.3 ± 0.7 kg·m^-2) previously shown to accelerate recovery from muscle damage and increase daily myofibrillar protein synthesis (MyoPS) rates would accelerate early (10 sessions) improvements in muscle function and potentiate quadriceps volume and muscle fiber cross-sectional area (fCSA) following 30 unilateral RET sessions in healthy, recreationally active, adults. Versus isocaloric placebo (PLA; n = 14; age, 25 ± 2 yr; BMI, 23.9 ± 1.0 kg·m^-2), PPB increased 48 h MyoPS rates after the first RET session measured using deuterated water (2.01 ± 0.15 vs. 1.51 ± 0.16%·day^-1, respectively; P < 0.05). In addition, PPB increased isokinetic muscle function over 10 sessions of training relative to the untrained control leg (%U) from 99.9 ± 1.8 pretraining to 107.2 ± 2.4%U at session 10 (vs. 102.6 ± 3.9 to 100.8 ± 2.4%U at session 10 in PLA; interaction P < 0.05). Pre to posttraining, PPB increased type II fCSA (PLA: 120.8 ± 8.2 to 109.5 ± 8.6%U; PPB: 92.8 ± 6.2 to 108.4 ± 9.7%U; interaction P < 0.05), but the gain in quadriceps muscle volume was similar between groups. Similarly, PPB did not further increase peak isometric torque, muscle function, or MyoPS measured posttraining. This suggests that although PPB increases MyoPS and early adaptation, it may not influence longer term adaptations to unilateral RET.NEW & NOTEWORTHY Using a unilateral model of resistance training, we show for the first time that a protein-polyphenol beverage increases initial rates of myofibrillar protein synthesis and promotes early functional improvements. Following a prolonged period of training, this strategy also increases type II fiber hypertrophy and causes large individual variation in gains in quadricep muscle cross-sectional area.

The Dose-Response of the Nordic Hamstring Exercise on Biceps Femoris Architecture and Eccentric Knee Flexor Strength: A Randomized Interventional Trial

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.

Hamstring Strain Injury Rehabilitation

Hamstring strain injuries are common among athletes and often require rehabilitation to prepare players for a timely return to sport performance while also minimizing reinjury risk. Return to sport is typically achieved within weeks of the injury; however, subsequent athlete performance may be impaired, and reinjury rates are high. Improving these outcomes requires rehabilitation practitioners (eg, athletic trainers and physical therapists) to understand the causes and mechanisms of hamstring strain injury, know how to perform a thorough clinical examination, and progress loading to the site of injury safely and effectively. This narrative review discusses current clinical concepts related to these aspects of rehabilitation for hamstring strain injury, with the aim of helping practitioners improve athletes' outcomes. Collectively, this knowledge will inform the implementation of evidence-based rehabilitation interventions.

Screening Hamstring Injury Risk Factors Multiple Times in a Season Does Not Improve the Identification of Future Injury Risk

PURPOSE

To determine if eccentric knee flexor strength and biceps femoris long head (BFlh) fascicle length were associated with prospective hamstring strain injury (HSI) in professional Australian Football players, and if more frequent assessments of these variables altered the association with injury risk.

METHODS

Across two competitive seasons, 311 Australian Football players (455 player seasons) had their eccentric knee flexor strength during the Nordic hamstring exercise and BFlh architecture assessed at the start and end of preseason and in the middle of the competitive season. Player age and injury history were also collected in preseason. Prospective HSIs were recorded by team medical staff.

RESULTS

Seventy-four player seasons (16%) sustained an index HSI. Shorter BFlh fascicles (<10.42 cm) increased HSI risk when assessed at multiple time points only (relative risk [RR], 1.9; 95% confidence interval [CI], 1.2-3.0). Neither absolute (N) nor relative (N·kg-1) eccentric knee flexor strength was associated with HSI risk, regardless of measurement frequency (RR range, 1.0-1.1); however, between-limb imbalance (>9%), when measured at multiple time points, was (RR, 1.8; 95% CI, 1.1-3.1). Prior HSI had the strongest univariable association with prospective HSI (RR, 2.9; 95% CI, 1.9-4.3). Multivariable logistic regression models identified a combination of prior HSI, BFlh architectural variables and between-limb imbalance in eccentric knee flexor strength as optimal input variables; however, their predictive performance did not improve with increased measurement frequency (area under the curve, 0.681-0.726).

CONCLUSIONS

More frequent measures of eccentric knee flexor strength and BFlh architecture across a season did not improve the ability to identify which players would sustain an HSI.

Biceps femoris long head sarcomere and fascicle length adaptations after 3 weeks of eccentric exercise training

BACKGROUND

Eccentric exercise increases muscle fascicle lengths; however, the mechanisms behind this adaptation are still unknown. This study aimed to determine whether biceps femoris long head (BFlh) fascicle length increases in response to 3 weeks of eccentric exercise training are the result of an in-series addition of sarcomeres within the muscle fibers.

METHODS

Ten recreationally active participants (age = 27 ± 3 years; mass = 70 ± 14 kg; height = 174 ± 9 cm; mean ± SD) completed 3 weeks of Nordic hamstring exercise (NHE) training on a custom exercise device that was instrumented with load cells. We collected in vivo sarcomere and muscle fascicle images of the BFlh in 2 regions (central and distal) by using microendoscopy and 3 dimension ultrasonography. We then estimated sarcomere length, sarcomere number, and fascicle length before and after the training intervention.

RESULTS

Eccentric knee flexion strength increased after the training (15%; p < 0.001; η_p² = 0.75). Further, we found a significant increase in fascicle length (21%; p < 0.001; η_p² = 0.81) and sarcomere length (17%; p < 0.001; η_p² = 0.90) in the distal but not in the central portion of the muscle. The estimated number of sarcomeres in series did not change in either region.

CONCLUSION

Fascicle length adaptations appear to be heterogeneous in the BFlh in response to 3 weeks of NHE training. An increase in sarcomere length, rather than the addition of sarcomeres in series, appears to underlie increases in fascicle length in the distal region of the BFlh. The mechanism driving regional increases in fascicle and sarcomere length remains unknown, but we speculate that it may be driven by regional changes in the passive tension of muscle or connective tissue adaptations.

Stimuli for Adaptations in Muscle Length and the Length Range of Active Force Exertion-A Narrative Review

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.

No Correlation Between Plantar Flexor Muscle Volume and Sprint Performance in Sprinters

The plantar flexor torque plays an important role in achieving superior sprint performance in sprinters. Because of the close relationship between joint torque and muscle size, a simple assumption can be made that greater plantar flexor muscles (i.e., triceps surae muscles) are related to better sprint performance. However, previous studies have reported the absence of these relationships. Furthermore, to examine these relationships, only a few studies have calculated the muscle volume (MV) of the plantar flexors. In this study, we hypothesized that the plantar flexor MVs may not be important morphological factors for sprint performance. To test our hypothesis, we examined the relationships between plantar flexor MVs and sprint performance in sprinters. Fifty-two male sprinters and 26 body size-matched male non-sprinters participated in this study. On the basis of the personal best 100 m sprint times [range, 10.21–11.90 (mean ± SD, 11.13 ± 0.42) s] in sprinters, a K-means cluster analysis was applied to divide them into four sprint performance level groups (n = 8, 8, 19, and 17 for each group), which was the optimal number of clusters determined by the silhouette coefficient. The MVs of the gastrocnemius lateralis (GL), gastrocnemius medialis (GM), and soleus (SOL) in participants were measured using magnetic resonance imaging. In addition to absolute MVs, the relative MVs normalized to body mass were used for the analyses. The absolute and relative MVs of the total and individual plantar flexors were significantly greater in sprinters than in non-sprinters (all p < 0.01, d = 0.64–1.39). In contrast, all the plantar flexor MV variables did not differ significantly among the four groups of sprinters (all p > 0.05, η² = 0.02–0.07). Furthermore, all plantar flexor MV variables did not correlate significantly with personal best 100 m sprint time in sprinters (r = −0.253–0.002, all p > 0.05). These findings suggest that although the plantar flexor muscles are specifically developed in sprinters compared to untrained non-sprinters, the greater plantar flexor MVs in the sprinters may not be important morphological factors for their sprint performance.

The Effect of Hip Extension and Nordic Hamstring Exercise Protocols on Hamstring Strength: A Randomized Controlled Trial

ABSTRACT

Whyte, EF, Heneghan, B, Feely, K, Moran, KA, and O'Connor, S. The effect of hip extension and Nordic hamstring exercise protocols on hamstring strength: A randomized controlled trial. J Strength Cond Res 35(10): 2682-2689, 2021-Lower and between-limb asymmetrical eccentric hamstring isokinetic strength may be associated with hamstring injuries, which mainly affect the biceps femoris. The 45° hip extension exercise (HEE) strengthens the hamstrings in the lengthened position where the biceps femoris experiences greatest loading during high-speed running. However, the effect of an HEE program on eccentric hamstring isokinetic strength has not been investigated or compared with the Nordic Hamstring Exercise (NHE) program. Twenty-four male, varsity, Gaelic footballers (22.4 ± 2.7 years; 182.1 ± 6.0 cm; 84.4 ± 7.9 kg) were randomly allocated to an HEE or NHE 4-week program. Isokinetic (60°·s-1) eccentric peak torque, functional hamstring-to-quadriceps ratio, and between-limb eccentric strength (absolute and percentage) asymmetries were recorded before and after intervention. Muscle soreness scores were reported after exercise using a visual analogue scale. A mixed between-within analysis of variance investigated group (HEE vs. NHE) by time (pre vs. post) interaction effects, and any main effects. An independent-samples t-test compared muscle soreness scores between the NHE and HEE groups. No interaction or group main effects were found. Main effects for time were observed on dominant and nondominant limbs for eccentric peak torque (p < 0.001, η2 = 0.21, p = 0.01, η2 = 0.51, respectively) and functional hamstring quadriceps ratio (p = 0.03, η2 = 0.59, p < 0.0001, η2 = 0.26, respectively). There were no main effects for time between-limb eccentric peak torque or percentage asymmetries (p = 0.41, η2 = 0.03, p = 0.20, η2 = 0.07, respectively), or differences in muscle soreness scores (p > 0.05). A 4-week HEE program increases eccentric hamstring isokinetic strength similar to a NHE program, which may be useful as part of a hamstring injury prevention program.

Eccentric Hamstring Muscle Strength during Home Confinement Due to the COVID-19 Pandemic, and Football Competition Resumption in Professional Football Referees: A Prospective Observational Study

The COVID-19 pandemic has produced a major disruption for professional football leagues that has affected the physical preparation of both football players and referees. In Spain, health authorities decreed home confinement for eight weeks, supressing the normal training routines of professional referees. After home confinement, referees had four weeks to retrain as the national football league was set to resume matches to complete the 11 games remaining. The aim of the present investigation was to assess changes in eccentric hamstring muscle strength during football competition suspension/resumption due to the COVID-19 pandemic in 21 professional football referees (mean ± SD, age: 33.4 ± 5.1 years; height: 182.4 ± 5.0 cm; body mass: 75.1 ± 4.4 kg). Eccentric hamstring muscle strength was measured with the Nordic hamstring exercise at four time points. During home confinement, referees presented the lowest value of bilateral eccentric muscle strength (300 ± 14 N). Eccentric muscle strength increased by 13.2 ± 3.7% one week after the end of home confinement (339 ± 16 N; p = 0.001, effect size (ES) = 2.8) and remained stable before the first match (343 ± 17 N; p = 0.001, ES = 3.1) and after the end of the national league (328 ± 13 N; p = 0.001, ES = 2.0). In summary, home confinement produced detraining effects in professional football referees associated with hamstring muscle weakness. In this regard, strength-based activities with body loads may be insufficient to avoid muscle weakness and other means (e.g., weights) may be necessary to maintain muscle strength. However, the 4-weeks retraining period was sufficient to resolve hamstring muscle weakness induced by the restrictions of home confinement. This information may be helpful in the case of future sport competition suspension or home quarantine due to new waves of COVID-19 pandemic.

Impact of Askling L-PROTOCOL on Biceps Femoris Architecture, Hamstring Flexibility and Sprint Performance

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.

Autoregulation in Resistance Training for Lower Limb Tendinopathy: A Potential Method for Addressing Individual Factors, Intervention Issues, and Inadequate Outcomes

Musculoskeletal disorders, such as tendinopathy, are placing an increasing burden on society and health systems. Tendinopathy accounts for up to 30% of musculoskeletal disorders, with a high incidence in athletes and the general population. Although resistance training has shown short-term effectiveness in the treatment of lower limb tendinopathy, more comprehensive exercise protocols and progression methods are required due to poor long-term outcomes. The most common resistance training protocols are predetermined and standardized, which presents significant limitations. Current standardized protocols do not adhere to scientific resistance training principles, consider individual factors, or take the importance of individualized training into account. Resistance training programs in case of tendinopathy are currently not achieving the required intensity and dosage, leading to high recurrence rates. Therefore, better methods for individualizing and progressing resistance training are required to improve outcomes. One potential method is autoregulation, which allows individuals to progress training at their own rate, taking individual factors into account. Despite the finding of their effectiveness in increasing the strength of healthy athletes, autoregulation methods have not been investigated in case of tendinopathy. The purpose of this narrative review was 3-fold: firstly, to give an overview and a critical analysis of the individual factors involved in tendinopathy and current resistance training protocols and their limitations. Secondly, to give an overview of the history, methods, and application of autoregulation strategies both in sports performance and physiotherapy. Finally, a theoretical adaptation of a current tendinopathy resistance training protocol using autoregulation methods is presented, providing an example of how the method could be implemented in clinical practice or future research.

Relationships between Lower Limb Muscle Characteristics and Force-Velocity Profiles Derived during Sprinting and Jumping

PURPOSE

This study aimed to identify the relationships between lower limb muscle characteristics and mechanical variables derived from the vertical (jumping) and horizontal (sprinting) force-velocity-power (FVP) profiles.

METHODS

Nineteen subelite male rugby league players performed a series of squat jumps and linear 30-m sprints to derive the vertical and horizontal FVP profiles, respectively. The theoretical maximal force (F0), velocity (V0), and power (Pmax) were derived from both the vertical (i.e., vF0, vV0, and vPmax) and the horizontal (i.e., hF0, hV0, and hPmax) FVP profiles. Vastus lateralis (VL), biceps femoris long head, and gastrocnemius medialis (GM) and lateralis muscle fascicle length, pennation angle, and thickness were measured using B-mode ultrasonography. Magnetic resonance imaging was used to calculate volumes of major lower limb muscles, whereas proton magnetic resonance spectroscopy was used to quantify the carnosine content of the GM to estimate muscle fiber typology.

RESULTS

Variation in vPmax was best explained by GM muscle fiber typology (i.e., greater estimated proportion of Type II fibers) and VL volume (adjusted r2 = 0.440, P = 0.006), whereas adductor and vastus medialis volume and GM muscle fiber typology explained the most variation in hPmax (adjusted r2 = 0.634, P = 0.032). Rectus femoris and VL volume explained variation in vF0 (r2 = 0.430, P = 0.008), whereas adductor and vastus medialis volume explained variation in hF0 (r2 = 0.432, P = 0.007). Variations in vV0 and hV0 were best explained by GM muscle fiber typology (adjusted r2 = 0.580, P < 0.001) and GM muscle fiber typology and biceps femoris short head volume (adjusted r2 = 0.590, P < 0.001), respectively.

CONCLUSION

Muscle fiber typology and muscle volume are strong determinants of maximal muscle power in jumping and sprinting by influencing the velocity- and force-oriented mechanical variables.

Changes in Biceps Femoris Long Head Fascicle Length after 10-d Bed Rest Assessed with Different Ultrasound Methods

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.

Specificity of eccentric hamstring training and the lack of consistency between strength assessments using conventional test devices

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 (BF_lh) 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 BF_lh 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 BF_lh parameters.

Is Pre-season Eccentric Strength Testing During the Nordic Hamstring Exercise Associated with Future Hamstring Strain Injury? A Systematic Review and Meta-analysis

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.

Sprinting, Strength, and Architectural Adaptations Following Hamstring Training in Australian Footballers

The aim of this study was to determine the sprinting, strength, and architectural adaptations following a hip-dominant flywheel (FLY) or Nordic hamstring exercise (NHE) intervention in Australian footballers. Twenty-seven male athletes were randomized to FLY (n = 13) or NHE (n = 14) training across a 39-week period (inclusive of pre-season and in-season). Biceps femoris long head (BFlh) architecture was assessed throughout. Eccentric hamstring strength and 40 m sprint times (with force-velocity profiling) were assessed at baseline, end of pre-season, and following the intervention. After the intervention, BFlh fascicle length was longer in both groups compared to baseline (FLY: 1.16 cm, 95%CI: 0.66 to 1.66 cm, d = 1.99, p < 0.001; NHE: 1.08 cm, 95%CI: 95%CI 0.54 to 1.61 cm, d = 1.73, p < 0.001). Both groups also increased their eccentric strength (FLY: mean change 82 N, 95%CI 12 to 152 N, d = 1.34, p = 0.026; NHE: mean change 97 N, 95%CI 47 to 146 N, d = 1.77, p = 0.001). After pre-season, the NHE group improved their 5 m sprint time by 3.5% (±1.2%) and were 3.7% (±1.4%) and 2.0% (±0.5%) faster than the FLY group across 5 m and 10 m, respectively. At the end of pre-season, the FLY group improved maximal velocity by 3.4% (±1.4%) and improved horizontal force production by 9.7% in-season (±2.2%). Both a FLY and NHE intervention increase BFlh fascicle length and eccentric strength in Australian Footballers. An NHE intervention led to enhanced acceleration capacity. A FLY intervention was suggested to improve maximal sprint velocity and horizontal force production, without changes in sprint times. These findings have implications for hamstring injury prevention but also programs aimed at improving sprint performance.

Greater Hamstrings Muscle Hypertrophy but Similar Damage Protection after Training at Long versus Short Muscle Lengths

PURPOSE

We investigated the effects of seated versus prone leg curl training on hamstrings muscle hypertrophy and susceptibility to eccentric exercise-induced muscle damage.

METHODS

Part 1: Twenty healthy adults conducted seated leg curl training with one leg (Seated-Leg) and prone with the other (Prone-Leg), at 70% one-repetition maximum (1RM), 10 repetitions per set, 5 sets per session, 2 sessions per week for 12 wk. Magnetic resonance imaging (MRI)-measured muscle volume of the individual and whole hamstrings was assessed pre- and posttraining. Part 2: Nineteen participants from part 1 and another 12 untrained controls (Control-Leg) performed eccentric phase-only leg curl exercise at 90% 1RM, 10 repetitions per set, 3 sets for each of the seated/prone conditions with each leg. MRI-measured transverse relaxation time (T2) and 1RM of seated/prone leg curl were assessed before, 24, 48, and 72 h after exercise.

RESULTS

Part 1: Training-induced increases in muscle volume were greater in Seated-Leg versus Prone-Leg for the whole hamstrings (+14% vs +9%) and each biarticular (+8%-24% vs +4%-19%), but not monoarticular (+10% vs +9%), hamstring muscle. Part 2: After eccentric exercise, Control-Leg had greater increases in T2 in each hamstring muscle (e.g., semitendinosus at 72 h: +52%) than Seated-Leg (+4%) and Prone-Leg (+6%). Decreases in 1RM were also greater in Control-Leg (e.g., seated/prone 1RM at 24 h: -12%/-24%) than Seated-Leg (0%/-3%) and Prone-Leg (+2%/-5%). None of the changes significantly differed between Seated-Leg and Prone-Leg at any time points.

CONCLUSION

Hamstrings muscle size can be more effectively increased by seated than prone leg curl training, suggesting that training at long muscle lengths promotes muscle hypertrophy, but both are similarly effective in reducing susceptibility to muscle damage.

Progressive Workload Periodization Maximizes Effects of Nordic Hamstring Exercise on Muscle Injury Risk Factors

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.

Autoregulated and individualised resistance training versus predetermined and standardised resistance training in tendinopathy: A systematic review protocol

REVIEW OBJECTIVE

To synthesise the best available evidence on the effectiveness of interventions that have used autoregulated and individualised resistance training versus predetermined and standardised resistance training in treating any tendinopathy.

INTRODUCTION

Recent evidence suggests that individualised exercise may be more effective than standardised exercise for musculoskeletal disorders such as tendinopathy. However, no systematic reviews have been conducted on the topic and optimal treatment protocols and clinical recommendations are lacking.

INCLUSION CRITERIA

Randomised controlled trials assessing the effectiveness of autoregulated and individualised resistance training versus predetermined and standardised resistance training for tendinopathy in adults will be included.

METHODS

The authors will search for a wide range of sources to find both published and unpublished studies via EBSCOhost, including, but not limited to, MEDLINE, SPORTDiscus, CINAHL, Cochrane Central Register of Controlled Trials and Allied and Complementary Medicine Database. Studies published in a language other than English will only be considered if a translation is available. The Joanna Briggs Institute systematic review methodology will be followed when conducting the review. Data synthesis will be conducted using meta-analysis or narrative synthesis, where appropriate.