Anatomy of proximal attachment, course, and innervation of hamstring muscles: a pictorial essay

Stępień, Karolina; Śmigıelski, Robert; Mouton, Caroline; Ciszek, Bogdan; Engelhardt, Martin; Seil, Romain

doi:10.1007/s00167-018-5265-z

Cited by 48 publications

(48 citation statements)

References 90 publications

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“…Our data indicate that the biceps femoris is the most-injured muscle of the hamstring complex, which is in agreement with previous research [25]. The anatomy of the biceps femoris (i.e., two different heads with dual innervation [39]) could explain its great injury incidence, since this dual innervation is important during the running cycle, requiring complex neuromuscular coordination patterns [40]. In addition, the complexity and close coherence in the synergistic muscle recruitment of the biceps femoris and the semitendinosus probably increase the injury risk [41].…”

Section: Discussionsupporting

confidence: 93%

A Longitudinal Investigation of Muscle Injuries in an Elite Spanish Male Academy Soccer Club: A Hamstring Injuries Approach

et al. 2020

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The aims of this study were to analyze the muscle injury incidence in an elite Spanish soccer academy during three consecutive seasons attending to different chronological age groups (i.e., U14, U16, U19 and senior) and to examine the hamstring injury incidence in this elite soccer academy. Elite male youth soccer players (227) participated in this study. A total of 207 time-loss injuries (i.e., injuries that involve at least one absence day) were observed during this study period. The overall incidence rate of muscle injury was 1.74 muscle injuries/1000 h. In addition, higher muscle injury incidence was observed during match play in comparison to training sessions (6.78 vs. 3.20 muscle injuries/1000 h, p < 0.05). The oldest age group presented the highest injury rate (2.73 muscle injuries/1000 h, p < 0.05), with the burden (i.e., number of absence days per 1000 h of exposure) peak values recorded in the U16 age group (26.45 absence days/1000 h). In addition, muscle tears accounted for the greatest percentage of muscle injuries (43.5%), and the most frequent anatomical site of injury was the hamstring (30.4%). Muscle tear was the most common type of hamstring injury (49.2%), with the biceps femoris the most commonly injured muscle of the hamstring complex (39.7%). Fullbacks (FB), wide midfielders (WM) and forwards (F) suffered a greater number of hamstring injuries. Hamstring injury incidence showed a seasonal variation, as indicated by peaks in August and October. Specifically, the highest injury incidence was observed in the final part of each period during match play. These results reinforce the necessity to implement individual preventive strategies according to each specific injury profile across the youth soccer development phase.

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Section: Discussionsupporting

confidence: 93%

A Longitudinal Investigation of Muscle Injuries in an Elite Spanish Male Academy Soccer Club: A Hamstring Injuries Approach

et al. 2020

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“…Clinically, it is sometimes difficult to precisely locate the lesion, and in these circumstances MRI plays a key role. Knowledge of some anatomical characteristics of the distribution of connective tissue and the orientation of fascicles/fibers in these muscle groups [13][14][15][16][17][18][19][20] is crucial for accurately interpreting the MRI findings in the diagnosis of muscle injuries of the lower limbs.…”

Section: Mechanisms Of Injury and Muscle Anatomical Featuresmentioning

confidence: 99%

“…The conjoined distal tendon of both heads attaches to the head of the fibula [13]. The distal myotendinous junction (DMTJ) of the biceps femoris has a complex multicomponent anatomy [15,16] that originates two zippers (superficial and deep) whose location is important ( Fig. 1d) given that it has been shown to have a different prognosis [15].…”

Section: Hamstring Complexmentioning

confidence: 99%

“…The distal myotendinous junction (DMTJ) of the biceps femoris has a complex multicomponent anatomy [15,16] that originates two zippers (superficial and deep) whose location is important ( Fig. 1d) given that it has been shown to have a different prognosis [15]. These lesions have a particularly high rate of recurrence, even with prolonged rehabilitation times.…”

Section: Hamstring Complexmentioning

confidence: 99%

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Sports-related lower limb muscle injuries: pattern recognition approach and MRI review

Isern-Kebschull

Mechó²,

Pruna

et al. 2020

Insights Imaging

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Muscle injuries of the lower limbs are currently the most common sport-related injuries, the impact of which is particularly significant in elite athletes. MRI is the imaging modality of choice in assessing acute muscle injuries and radiologists play a key role in the current scenario of multidisciplinary health care teams involved in the care of elite athletes with muscle injuries. Despite the frequency and clinical relevance of muscle injuries, there is still a lack of uniformity in the description, diagnosis, and classification of lesions. The characteristics of the connective tissues (distribution and thickness) differ among muscles, being of high variability in the lower limb. This variability is of great clinical importance in determining the prognosis of muscle injuries. Recently, three classification systems, the Munich consensus statement, the British Athletics Muscle Injury classification, and the FC Barcelona-Aspetar-Duke classification, have been proposed to assess the severity of muscle injuries. A protocolized approach to the evaluation of MRI findings is essential to accurately assess the severity of acute lesions and to evaluate the progression of reparative changes. Certain MRI findings which are seen during recovery may suggest muscle overload or adaptative changes and appear to be clinically useful for sport physicians and physiotherapists.

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“…Hamstring muscle complex consists of three main heads (biceps femoris long head [BF], semimembranosus [SM], and semitendinosus [ST]) acting on both hip and knee joint. 1,2 These bi-articular muscles are therefore significantly involved in numerous dynamic tasks (ie, jumping, landing, running, kicking). The substantial loading applied on large range of motions during such movements exposes hamstring muscles to a high risk of strain injury, particularly in high-velocity running during which they are actively stretched and withstand a maximum peak force at long muscle lengths.…”

Section: Introductionmentioning

confidence: 99%

Hamstring muscle elasticity differs in specialized high‐performance athletes

Avrillon

Lacourpaille

Hug

et al. 2019

Scandinavian Med Sci Sports

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The effect of training on hamstring flexibility has been widely assessed through the measurement of the maximal range of motion or passive torque. However, these global measures do not provide direct information on the passive muscle mechanical properties of individual muscle. This characterization is crucial to better understand the effect of interventions as selective adaptations may occur among synergist muscles. Taking advantage of shear wave elastography, we aimed to determine whether elite sport athletes exhibit different passive shear modulus of hamstring heads compared to controls.Passive shear modulus was measured on semitendinosus (ST), semimembranosus (SM), and biceps femoris (BF) using shear wave elastography with the knee flexed at 60° and 90°, and 90° of hip flexion. A total of 97 elite athletes from various sports including running sprint, figure skating, fencing, field hockey, taekwondo, basketball, and soccer and 12 controls were evaluated. The shear modulus measured at 60° of knee flexion was lower in SM for figure skating (P < .001; d = 1.8), taekwondo (P < .001; d = 2.1), fencing (P = .024; d = 1.0), and soccer (P = .011; d = 0.9) compared to controls, while no difference was found for athletic sprinters, field hockey, and basketball players. Shear modulus of the BF and ST muscle was not significantly different between controls and elite athletes, regardless of the sport specialization (all P values = 1). We provide evidence that the shear modulus of the SM is altered in athletes involved in elite sport practice performed over large range of motion and/or including substantial stretching program in training content (taekwondo, figure skating, fencing, and soccer). K E Y W O R D S elite athletes, shear wave elastography, stiffness 84 | AVRILLON et AL.

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Anatomy of proximal attachment, course, and innervation of hamstring muscles: a pictorial essay

Cited by 48 publications

References 90 publications

A Longitudinal Investigation of Muscle Injuries in an Elite Spanish Male Academy Soccer Club: A Hamstring Injuries Approach

A Longitudinal Investigation of Muscle Injuries in an Elite Spanish Male Academy Soccer Club: A Hamstring Injuries Approach

Sports-related lower limb muscle injuries: pattern recognition approach and MRI review

Hamstring muscle elasticity differs in specialized high‐performance athletes

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