Hamstring strains in professional rugby players result in increased fascial stiffness without muscle quality changes as assessed using shear wave elastography

Kawai, Tomonori; Takahashi, M; Takamoto, Kouichi; Bito, Itsumu

doi:10.1016/j.jbmt.2021.03.009

Cited by 11 publications

(4 citation statements)

References 56 publications

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“…We speculate that the reason for this discrepancy might be related to the competitive level of soccer players between studies, and the method of injury diagnosis (ie, in the study of Freitas et al, 15 all the hamstring injuries were diagnosed through MRI, while in the present study they were based on athlete self-report). In terms of passive stiffness, our results are in accordance with those of Kawai et al, 23 who did not find stiffness differences between injured and noninjured limbs in athletes who suffered injury >6 weeks before testing. Therefore, in nonsevere situations, it is possible that passive stiffness of injured muscles is restored in <6 weeks.…”

Section: Discussionsupporting

confidence: 93%

Hamstring Stiffness and Strength Responses to Repeated Sprints in Healthy Nonathletes and Soccer Players With Versus Without Previous Injury

Freitas

Radaelli

Oliveira

et al. 2023

Sports Health: A Multidisciplinary Approach

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Background: The effect of 10 × 30 m repeated sprints on passive and active stiffness of semitendinosus (ST) and biceps femoris long head (BFlh), and knee flexor maximal voluntary isometric contraction (MVIC) and rate of force development (RFD), and whether athletes with previous hamstring injury have a different response, is unknown. Hypothesis: Repeated sprints would (1) increase BFlh stiffness and decrease ST stiffness and knee flexors MVIC and RFD in healthy participants; and (2) greater magnitude of response would be seen in athletes with previous hamstring injury. Study Design: Case series (experiment I) and case control (experiment II) study designs. Level of Evidence: Level 3. Methods: Healthy nonathletes attended 2 replicated sessions (experiment I, n = 18), while soccer players with (n = 38) and without (n = 67) previous hamstring injury attended 1 testing session (experiment II). Results: In both experiments, the knee flexors MVIC and RFD decreased after the sprints ( P < 0.05). In experiment I, the ST and BFlh passive stiffness reduced after the sprints ( P < 0.02), while a small BFlh active stiffness increase was noted ( P = 0.02); however, no correlation was observed between the 2 testing sessions for the postsprint muscle stiffness responses ( r = -0.07-0.44; P > 0.07). In experiment II, only an ST passive stiffness reduction was observed after the sprints ( P < 0.01). No differences were noted between injured and noninjured lower limbs for any variable ( P > 0.10). Conclusion: Repeated sprints are likely to decrease the knee flexor’s maximal and rapid strength, and to alter the hamstring stiffness in the nonathlete population. Previous hamstring injury does not apparently affect the footballer’s hamstring functional and mechanical responses to repeated sprints. Clinical Relevance: The responses of hamstring stiffness and knee flexor strength to repeated sprints are unlikely to be associated with hamstring injury.

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Section: Discussionsupporting

confidence: 93%

Hamstring Stiffness and Strength Responses to Repeated Sprints in Healthy Nonathletes and Soccer Players With Versus Without Previous Injury

Freitas

Radaelli

Oliveira

et al. 2023

Sports Health: A Multidisciplinary Approach

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“…Recovery is longer in older individuals [ 45 ], which may explain the persistent between-limb SWS difference observed previously [ 44 ]. Consistent with our observations, a recent study found no between-limb differences in muscle shear modulus (measured after the athletes had returned to sport) in professional rugby players [ 46 ]. Though the cross-sectional design of our study does not allow for longitudinal investigation of the healing process and the corresponding changes in between-limb SWS, we speculate that the muscle structure, specifically deposition of collagen and regeneration of the extracellular matrix and connective tissue, may resolve by RTS (~ 7–27 days), resulting in no between-limb differences in SWS at RTS and 12wks [ 47 , 48 ].…”

Section: Discussionsupporting

confidence: 92%

Ultrasound shear wave speeds reduced following hamstring strain injury but not after returning to sport

Crawford,

Wille,

Joachim

et al. 2024

Insights Imaging

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Objectives The purpose of the study was to investigate differences in ultrasound shear wave speed (SWS) between uninjured and injured limbs following hamstring strain injury (HSI) at time of injury (TOI), return to sport (RTS), and 12 weeks after RTS (12wks). Methods This observational, prospective, cross-sectional design included male and female collegiate athletes who sustained an HSI. SWS imaging was performed at TOI, RTS, and 12wks with magnetic resonance imaging. SWS maps were acquired by a musculoskeletal-trained sonographer at the injury location of the injured limb and location-matched on the contralateral limb. The average SWS from three 5 mm diameter Q-boxes on each limb were used for analysis. A linear mixed effects model was performed to determine differences in SWS between limbs across the study time points. Results SWS was lower in the injured limb compared to the contralateral limb at TOI (uninjured – injured limb difference: 0.23 [0.05, 0.41] m/s, p = 0.006). No between-limb differences in SWS were observed at RTS (0.15 [-0.05, 0.36] m/s, p = 0.23) or 12wks (-0.11 [-0.41, 0.18] m/s, p = 0.84). Conclusions The SWS in the injured limb of collegiate athletes after HSI was lower compared to the uninjured limb at TOI but not at RTS or 12 weeks after RTS. Critical relevance statement Hamstring strain injury with structural disruption can be detected by lower injured limb shear wave speed compared to the uninjured limb. Lack of between-limb differences at return to sport may demonstrate changes consistent with healing. Shear wave speed may complement traditional ultrasound or MRI for monitoring muscle injury. Key points • Ultrasound shear wave speed can non-invasively measure tissue elasticity in muscle injury locations. • Injured limb time of injury shear wave speeds were lower versus uninjured limb but not thereafter. • Null return to sport shear wave speed differences may correspond to structural changes associated with healing. • Shear wave speed may provide quantitative measures for monitoring muscle elasticity during recovery. Graphical Abstract

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“…Interestingly, by evaluating SWE, injured area of fascial tissue increased stiffness between injured leg and uninjured leg in 11 injured professional rugby players, mean average of shear wave modulus on injured side (17.34 ± 9.04 kPa) and maximum shear wave modulus on injured side (33.53 kPa) compared with mean average of shear wave modulus on uninjured side (12.7 ± 4.96 kPa) and maximum shear wave modulus on uninjured side (20.86 kPa) (Figures 5 and 6) [37].…”

Section: In Chronic Phase On Swementioning

confidence: 91%

Shear Wave Elastography for Chronic Musculoskeletal Problem

Kawai¹

2022

Elastography - Applications in Clinical Medicine

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Shear wave elastography is a new noninvasive tool for the analysis of the biomechanical properties of the muscles in healthy and pathological conditions. Shear wave elastography is currently considered as a promising real-time visualization tool for quantifying explicitly the mechanical properties of soft tissues in sports medicine including muscle strain injury (MSI). This chapter shows utilizing diagnostic tools of magnetic resonance imaging, B mode ultrasound (US), and shear wave elastography in both acute and chronic phases. Also, the proposal for this chapter is to indicate the possibility of utilizing shear wave elastography for musculoskeletal injury, not only properties of the muscle but also fascial tissues. It introduces the relationship between previous muscle strain injury and local soft tissue stiffness, and we assessed the mechanical properties of soft tissues from a clinical perspective.

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Hamstring strains in professional rugby players result in increased fascial stiffness without muscle quality changes as assessed using shear wave elastography

Cited by 11 publications

References 56 publications

Hamstring Stiffness and Strength Responses to Repeated Sprints in Healthy Nonathletes and Soccer Players With Versus Without Previous Injury

Hamstring Stiffness and Strength Responses to Repeated Sprints in Healthy Nonathletes and Soccer Players With Versus Without Previous Injury

Ultrasound shear wave speeds reduced following hamstring strain injury but not after returning to sport

Shear Wave Elastography for Chronic Musculoskeletal Problem

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