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Lunn DE, Nicholson G, Cooke M, Crespo R, Robinson T, Price RJ, Walker J. Discrete Hamstring: Quadriceps Strength Ratios Do Not Represent Angle-Specific Ratios in Premier League Soccer Players. J Strength Cond Res 2023; 37:2417-2422. [PMID: 37815243 DOI: 10.1519/jsc.0000000000004574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
ABSTRACT Lunn, DE, Nicholson, G, Cooke, M, Crespo, R, Robinson, T, Price, RJ, and Walker, J. Discrete hamstring: quadriceps strength ratios do not represent angle-specific ratios in Premier League soccer players. J Strength Cond Res 37(12): 2417-2422, 2023-This study compared angle-specific hamstring:quadriceps (H:Q) ratios with their discrete counterparts during strength testing in professional male soccer players. Twenty-seven professional English Premier League soccer players were recruited for this study (age: 22 ± 4 years; stature: 1.81 ± 0.08 m; body mass: 74.7 ± 6.5 kg). Isokinetic testing of the knee flexors and extensors was conducted concentrically at two angular velocities (60° and 240°·s -1 ) and eccentrically (for the knee flexors only) at 30°·s -1 . Conventional H:Q ratio was calculated as the ratio between peak joint moment in the flexors and extensors at 60°·s -1 . Functional H:Q ratio was calculated as the peak joint moment in the flexors during the eccentric condition and the extensors at 240°·s -1 . Discrete conventional and functional H:Q ratios were 0.56 ± 0.06 and 1.28 ± 0.22, respectively. The residual differences between discrete values and angle-specific residual values were 13.60 ± 6.56% when normalized to the magnitude of the discrete value. For the functional ratios, the normalized residual was 21.72 ± 5.61%. Therefore, neither discrete ratio was representative of angle-specific ratios, although the conventional ratio had lower error overall. Therefore, practitioners should consider H:Q ratio throughout the full isokinetic range of motion, not just the discrete ratio calculated from peak joint moments, when designing and implementing training programs or monitoring injury risk, recovery from injury, and readiness to return to play.
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Affiliation(s)
- David E Lunn
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom; and
| | - Gareth Nicholson
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom; and
| | - Mark Cooke
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom; and
| | - Rubén Crespo
- Leeds United Football Club, Leeds, United Kingdom
| | - Tom Robinson
- Leeds United Football Club, Leeds, United Kingdom
| | - Rob J Price
- Leeds United Football Club, Leeds, United Kingdom
| | - Josh Walker
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom; and
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Kellis E, Sahinis C, Baltzopoulos V. Is hamstrings-to-quadriceps torque ratio useful for predicting anterior cruciate ligament and hamstring injuries? A systematic and critical review. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:343-358. [PMID: 35065297 DOI: 10.1016/j.jshs.2022.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/11/2021] [Accepted: 12/08/2021] [Indexed: 05/17/2023]
Abstract
BACKGROUND For the past 30 years, the hamstring (H)-to-quadriceps (Q) (H:Q) torque ratio has been considered an important index of muscle strength imbalance around the knee joint. The purpose of this systematic review was to examine the value of H:Q torque ratio as an independent risk factor for hamstring and anterior cruciate ligament (ACL) injuries. METHODS Database searches were performed to identify all relevant articles in PubMed, MEDLINE, Cochrane Library, and Scopus. Prospective studies evaluating the conventional (concentric H:Q), functional (eccentric H: concentric Q), and mixed (eccentric H at 30°/s: concentric Q at 240°/s) H:Q ratios as risk factors for occurrence of hamstring muscle strain or ACL injury were considered. Risk of bias was assessed using the Quality In Prognosis Studies tool. RESULTS Eighteen included studies reported 585 hamstrings injuries in 2945 participants, and 5 studies documented 128 ACL injuries in 2772 participants. Best evidence synthesis analysis indicated that there is very limited evidence that H:Q strength ratio is an independent risk factor for hamstring and ACL injury, and this was not different between various ratio types. Methodological limitations and limited evidence for ACL injuries and some ratio types might have influenced these results. CONCLUSION The H:Q ratio has limited value for the prediction of ACL and hamstring injuries. Monitoring strength imbalances along with other modifiable factors during the entire competitive season may provide a better understanding of the association between H:Q ratio and injury.
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Affiliation(s)
- Eleftherios Kellis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres 62100, Greece.
| | - Chrysostomos Sahinis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres 62100, Greece
| | - Vasilios Baltzopoulos
- Research Institute for Sport and Exercise Sciences (RISES), Faculty of Science, Liverpool John Moores University, Liverpool L3 5UX, UK
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Veeck F, Ruas CV, Pinto MD, Grazioli R, Cardoso GP, Albuquerque T, Schipper L, Valente HG, Santos VH, Dornelles M, Rabaldo P, Rocha CS, Baroni BM, Cadore EL, Pinto RS. Low Pre-Season Hamstring-to-Quadriceps Strength Ratio Identified in Players Who Further Sustained In-Season Hamstring Strain Injuries: A Retrospective Study from a Brazilian Serie A Team. Sports (Basel) 2023; 11:sports11040089. [PMID: 37104163 PMCID: PMC10140913 DOI: 10.3390/sports11040089] [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: 03/10/2023] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 04/28/2023] Open
Abstract
A common pre-season injury prevention assessment conducted by professional football clubs is the hamstring-to-quadriceps (H:Q) strength ratio calculated by peak torque (PT). However, it is debatable whether players that present low pre-season H:Q ratios are more susceptible to further sustaining in-season hamstring strain injuries (HSI). Based upon retrospective data from a Brazilian Serie A football squad, a particular season came to our attention as ten out of seventeen (~59%) professional male football players sustained HSI. Therefore, we examined the pre-season H:Q ratios of these players. H:Q conventional (CR) and functional (FR) ratios, and the respective knee extensor/flexor PT from the limbs of players further sustaining in-season HSI (injured players, IP) were compared to the proportional number of dominant/non-dominant limbs from uninjured players (UP) in the squad. FR and CR were ~18-22% lower (p < 0.01), whereas quadriceps concentric PT was ~25% greater for IP than UP (p = 0.002). Low scores of FR and CR were correlated (p < 0.01) with high levels of quadriceps concentric PT (r = -0.66 to -0.77). In conclusion, players who sustained in-season HSI had lower pre-season FR and CR compared to UP, which appears to be associated with higher levels of quadriceps concentric torque than hamstring concentric or eccentric torque.
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Affiliation(s)
- Filipe Veeck
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre 90690-200, Brazil
| | - Cassio V Ruas
- Brazilian Institute of Neuroscience and Neurotechnology, Institute of Physics Gleb Wataghin, University of Campinas, São Paulo 13083-854, Brazil
- School of Medical and Health Sciences, Edith Cowan University, Joondalup 6027, Australia
| | - Matheus Daros Pinto
- School of Medical and Health Sciences, Edith Cowan University, Joondalup 6027, Australia
| | - Rafael Grazioli
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre 90690-200, Brazil
| | - Gustavo Pacheco Cardoso
- Medical and Technical Department, Grêmio Foot-Ball Porto Alegrense, Porto Alegre 90250-590, Brazil
| | - Thiago Albuquerque
- Medical and Technical Department, Grêmio Foot-Ball Porto Alegrense, Porto Alegre 90250-590, Brazil
| | - Lucas Schipper
- Medical and Technical Department, Grêmio Foot-Ball Porto Alegrense, Porto Alegre 90250-590, Brazil
- Physical Therapy Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
| | - Henrique Gonçalves Valente
- Medical and Technical Department, Grêmio Foot-Ball Porto Alegrense, Porto Alegre 90250-590, Brazil
- Physical Therapy Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
| | - Victor H Santos
- Medical and Technical Department, Grêmio Foot-Ball Porto Alegrense, Porto Alegre 90250-590, Brazil
| | - Márcio Dornelles
- Medical and Technical Department, Grêmio Foot-Ball Porto Alegrense, Porto Alegre 90250-590, Brazil
| | - Paulo Rabaldo
- Medical and Technical Department, Grêmio Foot-Ball Porto Alegrense, Porto Alegre 90250-590, Brazil
| | - Clarice S Rocha
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre 90690-200, Brazil
| | - Bruno Manfredini Baroni
- Physical Therapy Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
| | - Eduardo Lusa Cadore
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre 90690-200, Brazil
| | - Ronei Silveira Pinto
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre 90690-200, Brazil
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Follmer B, Ruas CV, Dellagrana RA, Pereira De Lima LA, Pinto RS, Diefenthaeler F. Brazilian Jiu-Jitsu fighters present greatest rapid and maximal strength imbalances at extreme elbow angles. J Bodyw Mov Ther 2020; 25:126-132. [PMID: 33714483 DOI: 10.1016/j.jbmt.2020.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 10/19/2020] [Accepted: 11/09/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The performance of Brazilian jiu-jitsu (BJJ) fighters is dependent on rapid and maximal elbow strength actions. Appropriate strength balance between elbow flexors (F) and extensors (E) across the full joint range of motion may be required to decrease risk of injuries. AIM To compare rapid and maximal elbow F/E strength balance through full range of motion in BJJ fighters. MATERIALS AND METHODS Twenty-three male BJJ fighters (27.9 ± 4.6 years, 82.9 ± 10.9 kg, 174.5 ± 6.8 cm, and 15.3 ± 6.8% body fat) with 8.2 ± 6.5 years of practice volunteered to participate. Participants were tested for rate of torque development (RTD) and peak torque (PT) of elbow F and E at six angles (45°, 60°, 75°, 90°, 105°, and 120°; 0° = full extension). Rapid (F RTD/E RTD) and maximal (F PT/E PT) angle-specific torque (AST) ratios were calculated. RESULTS Rapid AST ratio at 45° (0.66 ± 0.18) and maximal AST ratio at 45° (0.91 ± 0.16) and 120° (0.88 ± 0.20) were significantly less than all other AST ratios at mid-point angles of elbow range of motion (p < 0.05). Individual data demonstrates that both beginners and advanced BJJ fighters present overall similar rapid and maximal F/E AST imbalances. CONCLUSION BJJ fighters present greater rapid and maximal strength imbalances at extreme-compared to mid-point angles of range of motion. Results may benefit coaches to develop strength exercises focusing on these specific angles to potentially reduce the risk of elbow injury and improve performance of BJJ fighters.
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Affiliation(s)
- Bruno Follmer
- Biomechanics Laboratory, Center of Sports, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil; School of Exercise Science, Physical, and Health Education, University of Victoria, Victoria, BC, Canada; Rehabilitation Neuroscience Laboratory, University of Victoria, Victoria, BC, Canada.
| | - Cassio Victora Ruas
- Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
| | - Rodolfo Andre Dellagrana
- Biomechanics Laboratory, Center of Sports, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil.
| | - Luis Antonio Pereira De Lima
- Biomechanics Laboratory, Center of Sports, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil.
| | - Ronei Silveira Pinto
- Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Fernando Diefenthaeler
- Biomechanics Laboratory, Center of Sports, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil.
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Ruas CV, Pinto RS, Haff GG, Lima CD, Brown LE. Effects of Different Combinations of Concentric and Eccentric Resistance Training Programs on Traditional and Alternative Hamstrings-to-Quadriceps Ratios. Sports (Basel) 2019; 7:E221. [PMID: 31614760 PMCID: PMC6835643 DOI: 10.3390/sports7100221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/07/2019] [Accepted: 10/08/2019] [Indexed: 11/17/2022] Open
Abstract
Resistance training is often recommended for combined increases in traditional and alternative hamstrings-to-quadriceps (H:Q) ratios in order to reduce knee strength imbalance and associated hamstrings and knee ligament injury risk. The aim of this study was to investigate the effect of different concentric and eccentric resistance training programs on traditional and alternative H:Q ratios. Forty male volunteers were assigned to one of 4 groups: concentric quadriceps and concentric hamstrings (CON/CON, n = 10), eccentric quadriceps and eccentric hamstrings (ECC/ECC, n = 10), concentric quadriceps and eccentric hamstrings (CON/ECC, n = 10), or no training (control (CNTRL), n = 10). Traditional conventional (CR) and functional (FR), alternative rate of torque development (RTD), muscle size (MS), and muscle activation (MA) H:Q ratios were measured before and after six weeks of unilateral nondominant knee extension-flexion resistance training performed on an isokinetic dynamometer. The ECC/ECC training significantly increased FR (pre = 0.75 ± 0.11; post = 0.85 ± 0.15), whereas the lack of training (CNTRL) decreased the RTD H:Q ratio (pre = 1.10 ± 0.67; post = 0.73 ± 0.33). There were no differences between groups for the other traditional and alternative ratios following resistance training protocols. These findings suggest eccentric exercise for quadriceps and hamstrings as the most beneficial training program for inducing increases in the traditional FR. However, different resistance training strategies may be needed to also elicit increases in the alternative RTD, MS, and MA H:Q ratios for fully restoring muscle balance and reducing potential hamstrings and knee ligament injury risk.
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Affiliation(s)
- Cassio V Ruas
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup 6027, Australia.
- Exercise Research Laboratory, School of Physical Education, Physioteraphy and Dance, Universidade Federal do Rio Grande do Sul, Rua Felizardo 750, Porto Alegre 90690-200, Brazil.
| | - Ronei S Pinto
- Exercise Research Laboratory, School of Physical Education, Physioteraphy and Dance, Universidade Federal do Rio Grande do Sul, Rua Felizardo 750, Porto Alegre 90690-200, Brazil.
| | - Guy G Haff
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup 6027, Australia.
| | - Camila D Lima
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup 6027, Australia.
| | - Lee E Brown
- Center for Sport Performance and Human Performance Lab, Department of Kinesiology, California State University, Fullerton, 800 N State College Blvd, Fullerton, CA 92831, USA.
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Ruas CV, Pinto RS, Haff GG, Lima CD, Pinto MD, Brown LE. Alternative Methods of Determining Hamstrings-to-Quadriceps Ratios: a Comprehensive Review. SPORTS MEDICINE-OPEN 2019; 5:11. [PMID: 30911856 PMCID: PMC6434009 DOI: 10.1186/s40798-019-0185-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/12/2019] [Indexed: 11/16/2022]
Abstract
The hamstrings-to-quadriceps muscle strength ratio calculated by peak torque has been used as an important tool to detect muscle imbalance, monitor knee joint stability, describe muscle strength properties and functionality, and for lower extremity injury prevention and rehabilitation. However, this ratio does not consider other neuromuscular variables that can also influence the antagonist to agonist muscle relationship, such as torque produced at multiple angles of range of motion, explosive strength, muscle size, muscle fatigue, or muscle activation. The aim of this study was to comprehensively review alternative methods of determining the hamstrings-to-quadriceps ratio. These include ratios calculated by angle-specific torque, rate of torque development, muscle size, fatigue index, and muscle activation (measured by electromyography). Collectively, the literature demonstrates that utilizing alternative methods of determining the hamstrings-to-quadriceps ratio can be functionally relevant for a better understanding of the neuromuscular mechanisms underpinning the interaction of strength between hamstrings and quadriceps. However, there is insufficient evidence to recommend any of the alternative methods as sensitive clinical tools for predicting injury risk and monitoring knee joint integrity. Future longitudinal studies, along with injury incidence, are needed to further investigate all alternative methods of determining the hamstrings-to-quadriceps ratio. These have potential to offer insight into how athletes and the general population should be trained for performance enhancement and injury reduction, and may be used along with traditional methods for a thorough assessment of an individual’s H:Q muscle balance.
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Affiliation(s)
- Cassio V Ruas
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup, WA, Australia.
| | - Ronei S Pinto
- Exercise Research Laboratory, School of Physical Education, Physioteraphy and Dance, Universidade Federal do Rio Grande do Sul, Rua Felizardo 750, Porto Alegre, RS, Brazil
| | - G Gregory Haff
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup, WA, Australia
| | - Camila D Lima
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup, WA, Australia
| | - Matheus D Pinto
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup, WA, Australia
| | - Lee E Brown
- Center for Sport Performance and Human Performance Lab, Department of Kinesiology, California State University, 800 N State College Blvd, Fullerton, CA, USA
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Križaj J, Rauter S, Vodičar J, Hadžić V, Šimenko J. Predictors of vertical jumping capacity in soccer players. ISOKINET EXERC SCI 2019. [DOI: 10.3233/ies-182138] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Acute Effects of Proprioceptive Neuromuscular Facilitation on Peak Torque and Muscle Imbalance. J Funct Morphol Kinesiol 2018; 3:jfmk3040063. [PMID: 33466991 PMCID: PMC7739295 DOI: 10.3390/jfmk3040063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 11/25/2018] [Accepted: 12/03/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The effects of proprioceptive neuromuscular facilitation (PNF) stretching on muscle imbalance are not fully understood. The aim of this study was to examine the acute effects of PNF stretching on knee extension and flexion peak torque (PT), as well as the conventional and functional hamstrings to quadriceps (H:Q) ratios. METHODS Fifteen men (age = 22 ± 1 years; body mass = 76 ± 12 kg; height = 176 ± 7 cm) and fifteen women (age = 22 ± 2 years; body mass = 63 ± 8 kg; height = 161 ± 5 cm) performed concentric quadriceps and hamstrings, and eccentric hamstrings muscle actions at different angular velocities (60, 180, and 300°·s-1 concentric; 60 and 180°·s-1 eccentric) before and after a bout of PNF stretching, and a control condition. RESULTS Neither PNF or control conditions affected concentric PT or H:Q ratios (p > 0.05), apart from knee extension at 60°·s-1 in men (p = 0.001). However, there was a reduction in hamstrings eccentric PT in both control and PNF conditions for men and women (p = 0.003). CONCLUSIONS PNF stretching of the hamstrings may not adversely affect the H:Q ratios, and consequently not negatively affect injury risk associated with muscular strength imbalances.
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Pinto MD, Blazevich AJ, Andersen LL, Mil-Homens P, Pinto RS. Hamstring-to-quadriceps fatigue ratio offers new and different muscle function information than the conventional non-fatigued ratio. Scand J Med Sci Sports 2017; 28:282-293. [DOI: 10.1111/sms.12891] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2017] [Indexed: 01/13/2023]
Affiliation(s)
- M. D. Pinto
- Exercise Research Laboratory; Strength Training Research Group; Federal University of Rio Grande do Sul; Porto Alegre RS Brazil
- Centre for Exercise and Sports Science Research; School of Medical and Health Sciences; Edith Cowan University; Joondalup WA Australia
| | - A. J. Blazevich
- Centre for Exercise and Sports Science Research; School of Medical and Health Sciences; Edith Cowan University; Joondalup WA Australia
| | - L. L. Andersen
- National Research Centre for the Working Environment; Copenhagen Denmark
- Physical Activity and Human Performance group; SMI; Department of Health Science and Technology; Aalborg University; Aalborg Denmark
| | - P. Mil-Homens
- CIPER; Faculdade de Motricidade Humana; Universidade de Lisboa; Cruz Quebrada Portugal
| | - R. S. Pinto
- Exercise Research Laboratory; Strength Training Research Group; Federal University of Rio Grande do Sul; Porto Alegre RS Brazil
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