1
|
Kepir E, Demiral F, Akaras E, Paksoy AE, Sevindik Aktas B, Yilmaz Cankaya B, Oztop B, Yagiz G, Owen JA. Hamstring Muscle Stiffness in Athletes with and without Anterior Cruciate Ligament Reconstruction History: A Retrospective Study. J Clin Med 2024; 13:4370. [PMID: 39124637 PMCID: PMC11313014 DOI: 10.3390/jcm13154370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/13/2024] [Accepted: 07/16/2024] [Indexed: 08/12/2024] Open
Abstract
Introduction: Sports requiring sprinting, jumping, and kicking tasks frequently lead to hamstring strain injuries (HSI). One of the structural risk factors of HSI is the increased passive stiffness of the hamstrings. Anterior cruciate ligament (ACL) injury history is associated with a 70% increase in the incidence of HSI, according to a recent meta-analysis. The same report recommended that future research should concentrate on the relationships between the HSI risk factors. Hence, the present study aimed to retrospectively compare changes in the passive stiffness of the hamstrings in athletes with and without ACL reconstruction history. Methods: Using ultrasound-based shear-wave elastography, the mid-belly passive muscle stiffness values of the biceps femoris long head, semimembranosus, and semitendinosus muscles were assessed and compared amongst athletes with and without a history of ACL reconstruction. Results: There were no significant differences in the biceps femoris long head (injured leg (IL): 26.19 ± 5.28 KPa, uninjured contralateral (UL): 26.16 ± 7.41 KPa, control legs (CL): 27.64 ± 5.58 KPa; IL vs. UL: p = 1; IL vs. CL: p = 1; UL vs. CL: p = 1), semimembranosus (IL: 24.35 ± 5.58 KPa, UL: 24.65 ± 8.35 KPa, CL: 22.83 ± 5.67 KPa; IL vs. UL: p = 1; IL vs. CL: p = 1; UL vs. CL, p = 1), or semitendinosus (IL: 22.45 ± 7 KPa, UL: 25.52 ± 7 KPa, CL: 22.54 ± 4.4 KPa; IL vs. UL: p = 0.487; IL vs. CL: p = 1; UL vs. CL, p = 0.291) muscle stiffness values between groups. Conclusions: The passive mid-muscle belly stiffness values of the biceps femoris long head, semitendinosus, and semimembranosus muscles did not significantly differ between previously injured and uninjured athletes; therefore, further assessment for other muscle regions of hamstrings may be necessary. To collect more comprehensive data related to the structural changes that may occur following ACL reconstructions in athletes, a future study should examine the passive stiffness of wider muscle regions from origin to insertion.
Collapse
Affiliation(s)
- Ersagun Kepir
- Institute for Applied Human Physiology, School of Psychology and Sport Sciences, Bangor University, Bangor LL57 2DG, UK;
| | - Furkan Demiral
- Department of Radiology, Faculty of Medicine, Ataturk University, 25240 Erzurum, Türkiye
| | - Esedullah Akaras
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Erzurum Technical University, 25050 Erzurum, Türkiye
| | - Ahmet Emre Paksoy
- Department of Orthopaedic Surgery, Faculty of Medicine, Ataturk University, 25240 Erzurum, Türkiye
| | | | - Bahar Yilmaz Cankaya
- Department of Radiology, Faculty of Medicine, Ataturk University, 25240 Erzurum, Türkiye
| | - Bilgehan Oztop
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ataturk University, 25240 Erzurum, Türkiye
| | - Gokhan Yagiz
- Department of Kinesiology, College of Health and Human Performance, East Carolina University, Greenville, NC 27858, USA
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Amasya University, 05100 Amasya, Türkiye
- Department of Physical Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - Julian Andrew Owen
- Institute for Applied Human Physiology, School of Psychology and Sport Sciences, Bangor University, Bangor LL57 2DG, UK;
| |
Collapse
|
2
|
Yagiz G, Fredianto M, Ulfa M, Ariani I, Agustin AD, Shida N, Moore EWG, Kubis HP. A retrospective comparison of the biceps femoris long head muscle structure in athletes with and without hamstring strain injury history. PLoS One 2024; 19:e0298146. [PMID: 38408057 PMCID: PMC10896514 DOI: 10.1371/journal.pone.0298146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/17/2024] [Indexed: 02/28/2024] Open
Abstract
INTRODUCTION Hamstring strain injuries (HSI) and re-injuries are endemic in high-speed running sports. The biceps femoris long head (BFlh) is the most frequently injured muscle among the hamstrings. Structural parameters of the hamstring muscle are stated to be susceptible to strain injuries at this location. This retrospective study targeted comparing the BFlh's structural parameters between previously injured and uninjured athletes. METHODS Nineteen male athletes with previous BFlh strain injury history and nineteen athletes without former lower extremity injury history were included in this study. Fascicle length, mid-muscle belly and distal musculotendinous (MTJ) passive stiffnesses of the biceps femoris long head (BFlh) were examined via b-mode panoramic ultrasound scanning and ultrasound-based shear-wave elastography. Parameter comparisons of both legs within and between athletes with and without injury history were performed. RESULTS Comparison of the BFlh fascicle length between the injured leg of the injured group and the legs of the controls revealed a trend to shorter fascicle lengths in the injured leg (p = 0.067, d = -0.62). However, the mid-muscle belly passive stiffness of the BFlh was significantly higher in the injured legs (p = 0.009, d = 0.7) compared with the controls. Additionally, the distal MTJ stiffness was much higher in the previously injured legs compared with controls (p < 0.001, d = 1.6). CONCLUSIONS Outcomes support the importance of BFlh properties related to stiffness, and fascicle length for injury susceptibility in athletes. Future prospective studies should determine whether the higher stiffness in the injured athletes is a cause or consequence of the HSI. Physical therapy and rehabilitation programmes after HSI should focus on BFlh muscle properties i.e., elasticity and fascicle length for reducing re-injury and increasing sports performance.
Collapse
Affiliation(s)
- Gokhan Yagiz
- Department of Kinesiology, College of Health and Human Performance, East Carolina University, Greenville, NC, United States of America
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Amasya University, Amasya, Republic of Türkiye
| | - Meiky Fredianto
- Faculty of Medicine and Health Sciences, Orthopaedics and Traumatology Division, Surgery Department, School of Medicine, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
- Department of Orthopaedic Surgery, Siloam Hospitals Yogyakarta, Yogyakarta, Indonesia
| | - Maria Ulfa
- Faculty of Medicine and Health Sciences, School of Medicine, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
- Master of Hospital Administration, Postgraduate Program, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Indira Ariani
- Department of Radiology, Siloam Hospitals Yogyakarta, Yogyakarta, Indonesia
| | | | - Nami Shida
- Faculty of Health Sciences, Department of Physical Therapy, Tokyo Metropolitan University, Tokyo, Japan
| | - E. Whitney G. Moore
- Department of Kinesiology, College of Health and Human Performance, East Carolina University, Greenville, NC, United States of America
| | - Hans-Peter Kubis
- Institute for Applied Human Physiology, School of Human and Behavioural Sciences, Bangor University, Bangor, Wales, United Kingdom
| |
Collapse
|
3
|
Yagiz G, Shida N, Kuruma H, Furuta M, Morimoto K, Yamada M, Uchiyama T, Kubis HP, Owen JA. Rugby Players Exhibit Stiffer Biceps Femoris, Lower Biceps Femoris Fascicle Length to Knee Extensors, and Knee Flexors to Extensors Muscle Volume Ratios Than Active Controls. Int J Sports Physiol Perform 2023; 18:1030-1037. [PMID: 37495222 DOI: 10.1123/ijspp.2023-0077] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/02/2023] [Accepted: 06/10/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE This study aimed to determine if hamstring-strain-injury risk factors related to muscle structure and morphology differed between rugby union players and controls. METHODS The biceps femoris long head (BFlh) fascicle length and passive muscle stiffness and relative and absolute muscle volume of knee flexors (KF) and extensors (KE) were measured in 21 male subelite rugby players and 21 male physically active nonathletes. RESULTS BFlh fascicle length was significantly longer (mean difference [MD] = 1.6 [1.7] cm) and BFlh passive muscle stiffness was significantly higher in rugby players (MD = 7.8 [14.8] kPa). The absolute BFlh (MD = 71.9 [73.3] cm3), KF (MD = 332.3 [337.2] cm3), and KE (MD = 956.3 [557.4] cm3) muscle volumes were also significantly higher in rugby players. There were no significant differences in the relative BFlh and KF muscle volumes. The relative KE muscle volumes were significantly higher in rugby players (MD = 2.3 [3.7] cm3/kg). However, the percentage BFlh fascicle length:KE (MD = -0.1% [0.1%]), BFlh/KE (MD = -0.9% [1.9%]), and KF:KE (MD = -4.9% [5.9%]) muscle volume ratios were significantly lower in the rugby players. BFlh muscle volume significantly correlated with BFlh fascicle length (r = .59, r2 = .35) and passive muscle stiffness (r = .46, r2 = .21). CONCLUSION Future prospective studies should examine whether there are threshold values in BFlh passive muscle stiffness and BFlh fascicle length:KE, BFlh:KE, and KF:KE muscle volume ratios for predicting hamstring strain injuries.
Collapse
Affiliation(s)
- Gokhan Yagiz
- Institute for Applied Human Physiology, School of Human and Behavioural Sciences, College of Human Sciences, Bangor University, Bangor,United Kingdom
| | - Nami Shida
- Department of Physical Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Tokyo,Japan
| | - Hironobu Kuruma
- Department of Physical Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Tokyo,Japan
| | - Masahiro Furuta
- Department of Physical Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Tokyo,Japan
| | - Koji Morimoto
- Department of Physical Therapy, Faculty of Rehabilitation, Tokyo Professional University of Health Sciences, Tokyo,Japan
| | - Mutsuo Yamada
- Faculty of Health and Sport Sciences, Ryutsu Keizai University, Ryugasaki,Japan
| | | | - Hans-Peter Kubis
- Institute for Applied Human Physiology, School of Human and Behavioural Sciences, College of Human Sciences, Bangor University, Bangor,United Kingdom
| | - Julian A Owen
- Institute for Applied Human Physiology, School of Human and Behavioural Sciences, College of Human Sciences, Bangor University, Bangor,United Kingdom
| |
Collapse
|