The Hamstrings: Anatomic and Physiologic Variations and Their Potential Relationships With Injury Risk

Afonso, José; Rocha-Rodrigues, Sílvia; Clemente, Filipe Manuel; Aquino, Michele; Nikolaidis, Pantelis T.; Sarmento, Hugo; Fílter, Alberto; Olivares-Jabalera, Jesús; Ramírez‐Campillo, Rodrigo

doi:10.3389/fphys.2021.694604

Cited by 25 publications

(11 citation statements)

References 169 publications

(279 reference statements)

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“…The development, implementation and evaluation of various strengthening exercises accounting for the specific demands of professional football and hamstring injury pattern are necessary 32. Furthermore, despite some of the hamstring injury risk factors elude experimental testing, hamstring muscle architecture, morphology and functional adaptations9 15 33 as modifiable and non-modifiable factors should be addressed as potential key determinants and their influence on force-generation capacity, innervation pattern as well as protecting factors to external loading demands for individualisation of preventive measures 34–36…”

Section: Discussionmentioning

confidence: 99%

Hamstring injury patterns in professional male football (soccer): a systematic video analysis of 52 cases

Gronwald

Klein²,

Hoenig

et al. 2021

Br J Sports Med

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ObjectiveTo closely describe the injury inciting events of acute hamstring injuries in professional male football (soccer) using systematic video analysis.MethodsVideo footage from four seasons (2014–2019) of the two highest divisions in German male football was searched for moderate and severe (ie, time loss of >7 days) acute non-contact and indirect contact match hamstring injuries. Two raters independently categorised inciting events using a standardised procedure to determine specific injury patterns and kinematics.Results52 cases of hamstring injuries were included for specific pattern analysis. The pattern analysis revealed 25 sprint-related (48%) and 27 stretch-related hamstring injuries (52%). All sprint-related hamstring injuries occured during linear acceleration or high-speed running. Stretch-related hamstring injuries were connected with closed chain movements like braking or stopping with a lunging or landing action and open chain movements like kicking. The kinematic analysis of stretch-related injuries revealed a change of movement involving knee flexion to knee extension and a knee angle of <45° at the assumed injury frame in all open and closed chain movements. Biceps femoris was the most affected muscle (79%) of all included cases.ConclusionDespite the variety of inciting events, rapid movements with high eccentric demands of the posterior thigh are likely the main hamstring injury mechanism. This study provides important data about how hamstring injuries occur in professional male football and supports the need for demand-specific multicomponent risk reduction programmes.

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Section: Discussionmentioning

confidence: 99%

Hamstring injury patterns in professional male football (soccer): a systematic video analysis of 52 cases

Gronwald

Klein²,

Hoenig

et al. 2021

Br J Sports Med

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“…sport-specific sprinting) in WSA compared to other modes of training-sports [55,56]. Moreover, PJT may improve flexibility [57][58][59] which is of paramount importance for athletes in general and WSA in particular [54,[60][61][62][63][64]. Although previous intervention studies have evidenced the effectiveness of PJT on PF and SSP in WSA, most published studies have included relatively small samples (i.e.…”

Section: Introductionmentioning

confidence: 99%

Effects of Plyometric Jump Training on Measures of Physical Fitness and Sport-Specific Performance of Water Sports Athletes: A Systematic Review with Meta-analysis

et al. 2022

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Background A growing body of literature is available regarding the effects of plyometric jump training (PJT) on measures of physical fitness (PF) and sport-specific performance (SSP) in-water sports athletes (WSA, i.e. those competing in sports that are practiced on [e.g. rowing] or in [e.g. swimming; water polo] water). Indeed, incoherent findings have been observed across individual studies making it difficult to provide the scientific community and coaches with consistent evidence. As such, a comprehensive systematic literature search should be conducted to clarify the existent evidence, identify the major gaps in the literature, and offer recommendations for future studies. Aim To examine the effects of PJT compared with active/specific-active controls on the PF (one-repetition maximum back squat strength, squat jump height, countermovement jump height, horizontal jump distance, body mass, fat mass, thigh girth) and SSP (in-water vertical jump, in-water agility, time trial) outcomes in WSA, through a systematic review with meta-analysis of randomized and non-randomized controlled studies. Methods The electronic databases PubMed, Scopus, and Web of Science were searched up to January 2022. According to the PICOS approach, the eligibility criteria were: (population) healthy WSA; (intervention) PJT interventions involving unilateral and/or bilateral jumps, and a minimal duration of ≥ 3 weeks; (comparator) active (i.e. standard sports training) or specific-active (i.e. alternative training intervention) control group(s); (outcome) at least one measure of PF (e.g. jump height) and/or SSP (e.g. time trial) before and after training; and (study design) multi-groups randomized and non-randomized controlled trials. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. The DerSimonian and Laird random-effects model was used to compute the meta-analyses, reporting effect sizes (ES, i.e. Hedges’ g) with 95% confidence intervals (95% CIs). Statistical significance was set at p ≤ 0.05. Certainty or confidence in the body of evidence for each outcome was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE), considering its five dimensions: risk of bias in studies, indirectness, inconsistency, imprecision, and risk of publication bias. Results A total of 11,028 studies were identified with 26 considered eligible for inclusion. The median PEDro score across the included studies was 5.5 (moderate-to-high methodological quality). The included studies involved a total of 618 WSA of both sexes (330 participants in the intervention groups [31 groups] and 288 participants in the control groups [26 groups]), aged between 10 and 26 years, and from different sports disciplines such as swimming, triathlon, rowing, artistic swimming, and water polo. The duration of the training programmes in the intervention and control groups ranged from 4 to 36 weeks. The results of the meta-analysis indicated no effects of PJT compared to control conditions (including specific-active controls) for in-water vertical jump or agility (ES = − 0.15 to 0.03; p = 0.477 to 0.899), or for body mass, fat mass, and thigh girth (ES = 0.06 to 0.15; p = 0.452 to 0.841). In terms of measures of PF, moderate-to-large effects were noted in favour of the PJT groups compared to the control groups (including specific-active control groups) for one-repetition maximum back squat strength, horizontal jump distance, squat jump height, and countermovement jump height (ES = 0.67 to 1.47; p = 0.041 to < 0.001), in addition to a small effect noted in favour of the PJT for SSP time-trial speed (ES = 0.42; p = 0.005). Certainty of evidence across the included studies varied from very low-to-moderate. Conclusions PJT is more effective to improve measures of PF and SSP in WSA compared to control conditions involving traditional sport-specific training as well as alternative training interventions (e.g. resistance training). It is worth noting that the present findings are derived from 26 studies of moderate-to-high methodological quality, low-to-moderate impact of heterogeneity, and very low-to-moderate certainty of evidence based on GRADE. Trial registration The protocol for this systematic review with meta-analysis was published in the Open Science platform (OSF) on January 23, 2022, under the registration doi https://doi.org/10.17605/OSF.IO/NWHS3 (internet archive link: https://archive.org/details/osf-registrations-nwhs3-v1).

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“…If the number of injuries to the calves is very low, instead those of the thigh are numerous: above all those in the posterior region, which in the EG, do not differ much from the CG. This data suggests that, appropriately, the literature indicates more complex exercises for hamstrings and that probably these exercises must be performed with external loads to be more effective (Afonso et al, 2021;Kipp et al, 2022).…”

Section: Discussionmentioning

confidence: 79%

The Preventive Warm up to Reduce No-Contact Injury Risk in Amateur Male Soccer Players

Sannicandro¹

2023

APE

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The study aims to describe the effects of preventive exercise introduced in a soccer traditional warm up on lower limb injury risk in amateur male soccer players. A total number of 76 no-contact injuries were recorded, 80.27% of them to the lower limbs, specifically in the: thigh (46.8%), calves (4.6%), adductor (15.1%), knee (12.9%) and ankle (20.6%). The number of injuries to the lower limbs was greater in the CG, comprising 72.1% compared to the 27.9% from the EG. Furthermore, when comparing the injuries in both groups depending on the muscle group or the joint, the same thing occurs: thigh (CG = 18 and EG = 13), calves (CG = 3 and EG = 1), adductor (CG = 8 and EG = 2), knee (CG = 10 and EG = 1) and ankle (CG = 10 and EG = 2). Thigh muscle injuries were identified as follows: in the CG, the 87.7% in the posterior region, the 12.3% in the anterior region; in the EG, the 88.6% in the posterior region and the 11.4% in the anterior region. Statistically significant differences (p < 0.01) were observed for the values of adductor, knee and ankle injury. The exercises that integrated the traditional warm-up were functional to reduce the risk of injury only for the adductor muscles; no statistically significant difference was observed for calves and thigh. For the hamstrings and the rectus femoris, there is a need to introduce exercises with external loads.

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The Hamstrings: Anatomic and Physiologic Variations and Their Potential Relationships With Injury Risk

Cited by 25 publications

References 169 publications

Hamstring injury patterns in professional male football (soccer): a systematic video analysis of 52 cases

Hamstring injury patterns in professional male football (soccer): a systematic video analysis of 52 cases

Effects of Plyometric Jump Training on Measures of Physical Fitness and Sport-Specific Performance of Water Sports Athletes: A Systematic Review with Meta-analysis

The Preventive Warm up to Reduce No-Contact Injury Risk in Amateur Male Soccer Players

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