Abstract
Isolated injury to the long head of biceps femoris is the most common type of acute hamstring strain injury (HSI). However, the precise hamstring injury mechanism (i.e., sprint-type) is still not well understood, and research is inconclusive as to which phase in the running cycle HSI risk is the greatest. Since detailed information relating to hamstring muscle function during sprint running cannot be obtained in vivo in humans, the findings of studies investigating HSI mechanisms are based on modeling that requires assumptions to be made based on extrapolations from anatomical and biomechanical investigations. As it is extremely difficult to account for all aspects of muscle-tendon tissues that influence function during high-intensity running actions, much of this complexity is not included in these models. Furthermore, the majority of analyses do not consider the influence of prior activity or muscular fatigue on kinematics, kinetics and muscle activation during sprinting. Yet, it has been shown that fatigue can lead to alterations in neuromuscular coordination patterns that could potentially increase injury risk. The present critical review will evaluate the current evidence on hamstring injury mechanism(s) during high-intensity running and discuss the interactions between fatigue and hamstring muscle activation and function.
Highlights
As running speed increased from 80% to 100%, biceps femoris (BF) activity during the terminal swing phase increased an average of 67%, while ST and SM only showed a 37% increase [39]
hamstring strain injury (HSI) is commonly thought to occur in the terminal swing phase, and taking into account that this assumption has been established without full consideration of the problems raised above, the possibility cannot be excluded that HSI can occur in the early stance phase, during which some studies report a second peak in hamstring muscle activity [49,52]
Soccer-specific fatigue has been associated with significant increases in peak eccentric isokinetic knee flexion torques [75,76], with decrements greatest at longer hamstring muscle lengths [76]. These findings suggest that the force absorption capacity might be reduced at the longest hamstring muscle lengths, which could increase vulnerability to hamstring muscle strain since force production in sprint running is highly dependent on the utilization of recoil energy from elastic tissues [77]
Summary
Hamstring strain injury (HSI) is the most common non-contact muscle injury in high-speed running sports such as Australian football [1,2,3,4,5], American football [6], rugby [7,8,9] and soccer [10,11,12,13]. Despite the increasing research focus in this area, the potential injury mechanisms are not well defined [20], and injury incidence seems to have either remained about the same [15] or even increased (e.g., soccer; [21]) in recent years This injury burden is a concern for clubs in terms of team performance from a key player availability perspective in senior professionals [22] and in the long-term development of younger players [23]. Peripheral fatigue corresponds to an alteration in muscle contraction capacity and can be induced by disturbances in the propagation of the muscle action potential, excitation-contraction coupling and contractile (force production) mechanisms [28] In sports such as soccer, mechanical demands, those related to decelerations and eccentric actions, can induce muscle damage. The objective of this critical review is to evaluate the current evidence and provide an overview of: (1) mechanisms of hamstring injury and (2) interactions between fatigue, hamstring muscle activation and function and potential interactions with risk
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