Previous investigators have proposed that knee strength, hamstrings to quadriceps, and side-to-side asymmetries may vary according to soccer field positions. However, different results have been found in these variables, and a generalization of this topic could lead to data misinterpretation by coaches and soccer clubs. Thus, the aim of this study was to measure knee strength and asymmetry in soccer players across different field positions. One hundred and two male professional soccer players performed maximal concentric and eccentric isokinetic knee actions on the preferred and nonpreferred legs at a velocity of 60° · s. Players were divided into their field positions for analysis: goalkeepers, side backs, central backs, central defender midfielders, central attacking midfielders, and forwards. Results demonstrated that only goalkeepers (GK) differed from most other field positions on players' characteristics, and concentric peak torque across muscles. Although all players presented functional ratios of the preferred (0.79 ± 0.14) and nonpreferred (0.75 ± 0.13) legs below accepted normative values, there were no differences between positions for conventional or functional strength ratios or side-to-side asymmetry. The same comparisons were made only between field players, without inclusion of the GK, and no differences were found between positions. Therefore, the hamstrings to quadriceps and side-to-side asymmetries found here may reflect knee strength functional balance required for soccer skills performance and game demands across field positions. These results also suggest that isokinetic strength profiles should be considered differently in GK compared with other field positions due to their specific physiological and training characteristics.

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.

Commonly used injury risk prediction tests such as the hamstring-to-quadriceps (H:Q) strength ratio appear to be poor predictors of non-contact injury. However, these tests are typically performed in a non-fatigued state, despite accumulated fatigue being an important risk factor for both hamstring strain (HS) and anterior cruciate ligament (ACL) injuries in professional soccer players. After the effect of different H:Q calculation methods were compared and contrasted, the influence of neuromuscular fatigue on the H:Q strength ratio and the association between fatigued and non-fatigued ratio scores were examined. Thirty-five professional soccer players performed a 30-repetition isokinetic fatigue test protocol. Peak knee joint moments were computed for each repetition, and the H:Q conventional ratio (H:Q CR ) was calculated using several different, previously published, methods. Knee extensor and flexor moments were statistically decreased by the sixth repetition and continued to decrease until the end of the protocol. However, the H:Q ratio was statistically decreased at the end of the test due to a significant reduction in knee flexor moment K E Y W O R D Santerior cruciate ligament and hamstring strain injuries, fatigue test, hamstring-to-quadriceps ratio, isokinetic, neuromuscular fatigue, soccer, test interpretation

Match-induced fatigue of knee muscle strength and agonist-antagonist strength-ratios may affect both performance and risk of injury in soccer players. Once explosive tasks are imperative in soccer as well as hamstring strain injuries occur during highvelocity moments, rapid force capacity of this muscle group is especially important. This study evaluated the effect of matchinduced fatigue on knee muscle strength and strength-ratio parameters after a single professional soccer match. Male professional soccer players (n = 16; 24.2 ± 3.9 years) were tested before and after a soccer match (56.2 ± 22.6 min of playing) for knee flexors (hamstring) and extensors (quadriceps) isometric peak torque (MVC) and rate of torque development (RTD)as well as the hamstring-to-quadriceps ratio (H:Q)at 30°of knee flexion. Knee injuries often occur at this joint angle, which is common in sprinting, pivoting, sidecutting, and jumping. Match-induced fatigue caused a left shift in the knee extensors torque-time curve with no significant change in both early (i.e. 0-50 ms) and late (i.e. 0-200 ms) RTD, and a right shift in the knee flexors torque-time curve with a decrease in early RTD (∼16%, p = .029) and late RTD (∼11%, p = .011). Knee extensors and knee flexors peak torque remained unchanged (p > .05). Early RTD H:Q decreased by∼24% (p = .027), while late RTD H:Q and MVC H:Q remained unchanged (p > .05). In conclusion, matchinduced fatigue impaired the ability to rapidly produce force at an angle where injuries are most susceptible to occur. Important information is missed if only the traditional H:Q is considered.