Strain Injury Research Articles

Comparing the immediate effects of different neural mobilization exercises on hamstring flexibility in recreational soccer players.

Hamstring strain injuries remain a challenge for both athletes and clinicians given the high incidence rate, slow healing, and persistent symptoms. Increased tension in the neural structures is a known causative factor for hamstring tightness for which neural mobilization has emerged as a significant adjunct to routine stretching techniques. To compare the short-term effects of neural sliding and neural tensioning on hamstring length in male recreational soccer players with hamstring tightness. Sixty-two participants between ages 18 and 30 years were randomly assigned to one of the two groups viz. neural sliding or neural tensioning. Participants in either group performed the given stretching protocol in three sets. The Active Knee Extension Test (AKET) and Sit and Reach Test (SRT) were recorded before intervention, immediately after intervention, and after 60 min. between- and within group-analysis was done using analysis of variance. Between-group analysis showed that neural tensioning was more effective than neural sliding in improving hamstring length on both measures, however this difference was negligible. Within-group analysis demonstrated that the mean post-test scores on the AKET test and SRT were significantly greater than the pre-test scores in both groups (). A reduction in the post-test scores was observed after 60 min, irrespective of the type of stretching (). There was no difference in short-term effects of neural sliding or neural tensioning on hamstring flexibility in male recreational soccer players. Both groups showed improved flexibility immediately after the intervention with reduction in the effect after 60 min.

Biomechanical Parameters Assessed During Running Among Running-Related Athletes with Recurrent Hamstring Strain Injury: A Scoping Review

Biomechanical Parameters Assessed During Running Among Running-Related Athletes with Recurrent Hamstring Strain Injury: A Scoping Review

Do athletes with hamstring strain injury have shorter muscle fascicles in the injured limb?

IntroductionPrevious studies have suggested that a reduced length of the biceps femoris long head (BFlh) fascicles may increase the risk of hamstring strain injury (HSI). However, it remains unclear whether the BFlh fascicles of the injured limb are shorter than those of the contralateral limb in athletes with an acute HSI. ObjectiveTo investigate the between-limb asymmetry of BFlh fascicle length in amateur athletes with an acute HSI. MethodsMale amateur athletes were evaluated using ultrasound scans within five days following an HSI. The BFlh fascicle length was estimated using a validated equation. ResultsEighteen injured athletes participated in this study. There was no significant difference (p = 0.27) in the length of BFlh fascicles between the injured limb (9.53 ± 2.55 cm; 95%CI 8.26 to 10.80 cm) and the uninjured limb (10.54 ± 2.87 cm; 95%CI 9.11 to 11.97 cm). Individual analysis revealed high heterogeneity, with between-limb asymmetries (percentage difference of the injured limb compared to the uninjured limb) ranging from −42% to 25%. Nine out of the 18 athletes had a fascicle length that was more than 10% shorter in the injured limb compared to the uninjured limb, five athletes had a difference of less than 10%, and four athletes had a fascicle length that was more than 10% longer in the injured limb compared to the uninjured limb. ConclusionThe architecture characteristics of injured and uninjured muscles is not consistent among athletes with HSI. Therefore, rehabilitation programs focused on fascicle lengthening should be evaluated on a case-by-case basis.

Diffusion tensor imaging of hamstring muscles after acute strain injury and throughout recovery in collegiate athletes.

To identify the region of interest (ROI) to represent injury and observe between-limb diffusion tensor imaging (DTI) microstructural differences in muscle following hamstring strain injury. Participants who sustained a hamstring strain injury prospectively underwent 3T-MRI of bilateral thighs using T1, T2, and diffusion-weighted imaging at time of injury (TOI), return to sport (RTS), and 12 weeks after RTS (12wks). ROIs were using the hyperintense region on a T2-weighted sequence: edema, focused edema, and primary muscle injured excluding edema (no edema). Linear mixed-effects models were used to compare diffusion parameters between ROIs and timepoints and limbs and timepoints. Twenty-four participants (29 injuries) were included. A significant ROI-by-timepoint interaction was detected for all diffusivity measures. The edema and focused edema ROIs demonstrated increased diffusion at TOI compared to RTS for all diffusivity measures (p-values < 0.006), except λ1 (p-values = 0.058-0.12), and compared to 12wks (p-values < 0.02). In the no edema ROI, differences in diffusivity measures were not observed (p-values > 0.82). At TOI, no edema ROI diffusivity measures were lower than the edema ROI (p-values < 0.001) but not at RTS or 12wks (p-values > 0.69). A significant limb-by-timepoint interaction was detected for all diffusivity measures with increased diffusion in the involved limb at TOI (p-values < 0.001) but not at RTS or 12wks (p-values > 0.42). Significant differences in fractional anisotropy over time or between limbs were not detected. Hyperintensity on T2-weighted imaging used to define the injured region holds promise in describing muscle microstructure following hamstring strain injury by demonstrating between-limb differences at TOI but not at follow-up timepoints.

Platelet-rich plasma does not accelerate the healing of damaged muscle following muscle strain.

Although platelet-rich plasma (PRP)has been widely used regardless of the severity of muscle strain, there have been very few basic studies in which its effects on muscle injury were examined by using models that accurately mimic the clinical muscle strain injury process. Therefore, the aim of this study was to confirm by physiological and structural analyses whether PRP purified by a general preparation method has a muscle healing effect on muscle damage caused by eccentric contraction (ECC).Male Wistar rats were subjected to muscle injury induced by ECC in bilateral plantar flexor muscles using electrical stimulation and an automatically dorsiflexing footplate. The rats were randomly assigned to three groups by type of injection: phosphate-buffered saline (PBS),leukocyte-poor PRP (LP-PRP),or leukocyte-rich PRP (LR-PRP)injection into gastrocnemius muscles three times at weekly intervals. The platelet concentrations of the LP-PRPand LR-PRPwere three to five times higher than that of whole blood. The recovery process of torque strength in the plantar flexor muscle, signal changes in MRI images, and histological evaluation 3 weeks after injury showed no obvious differences among the three groups, and every muscle recovered well from the injury without marked fibrosis. The results that neither LP-PRPnor LR-PRPwas found to accelerate healing of muscle injuries suggested that conventional preparation and use of PRP for simple muscle injuries caused by muscle strain should be carefully considered, and further basic research using models that accurately mimic clinical practice should be carried out to determine the optimal use of PRP.

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

ObjectivesThe 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).MethodsThis 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.ResultsSWS 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).ConclusionsThe 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 statementHamstring 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

Hamstrings mechanical properties profiling in football players of different competitive levels and positions after a repeated sprint protocol.

Purpose: This study compares the average speed, knee flexor peak torque and shear modulus of the hamstrings after a repeated sprint task, in football players of different competitive levels and playing positions. Methods: Fifty-four football field players without hamstring strain injury history participated, 15 being categorized as professional (2nd league) and 39 as semi-professional (17 in 3rd and 22 in 4th league). Muscle shear modulus was assessed using ultrasound-based shear wave elastography at rest and at 20% of maximal voluntary isometric effort before and immediately after the repeated sprint protocol. Results: No significant differences were seen in average sprint speed between competitive levels (p = 0.07; η2p = 0.28) and positions (p = 0.052; η2p = 0.29). Moreover, the sprint fatigue index showed no significant differences between competitive levels (p = 0.14; η2p = 0.08) and playing positions (p = 0.89; η2p = 0.05). No significant differences were observed in hamstring shear modulus changes between competitive levels (p = 0.94; η2p = 0.03) and positions (p = 0.92; η2p = 0.03). Peak torque changes also showed non-significant association with competitive levels (p = 0.46; η2p = 0.03) and positions (p = 0.60; η2p = 0.02). Conclusion: The results of this study suggest that the average sprint speed performance parameter and mechanical parameters are not able to distinguish football players of different competitive levels and positions.

MECHANICAL STIFFNESS OR RESOLVED INFLAMMATION: WHAT IS MORE IMPORTANT FOR TENDON REHABILITATION?

As high incidences of tendinopathies are observed particularly in those who intensively use their tendons, we assume that pathological changes are caused, at least partially, by mechanical overload. This has led to the so-called overload hypothesis, explaining the development of tendinopathies by structural failure resulting from excessive load. At the same time, tendon loading is an important part in tendon rehabilitation. Currently, exercise treatment approaches such as eccentric training or heavy load resistance training are widely applied in tendinopathy rehabilitation, with good clinical results such as an improvement in function and a reduction in pain. Particularly those rehabilitative approaches which impose high strains on the tendon may induce an adaptation of the tendon's mechanical properties such as increased tendon stiffness. An increased tendon stiffness is often interpreted as desirable, as it may protect the tendon from overloading and thus prevent future strain injuries. However, the tendinopathic tendon is not necessarily less stiff than the tendon in the contralateral leg and an improvement in tendon stiffness is not necessarily accompanied by an improvement in tendon pain or function. In addition, metabolic factors, resulting e.g. in low-level systemic inflammation, may contribute to pathological tendon tissue changes and are not necessarily affected by an exercise program, while nutritional interventions or dietary supplements may potentially affect tendon cell metabolism. Indeed, dietary supplements have been introduced as an additional therapeutic approach in the treatment of tendinopathies in recent years, and their positive curative effects have been reported for both the general population and athletes. In the management of tendinopathies, it may thus be advisable if therapeutic approaches aim to address both tendon mechanics and tendon metabolism for better treatment effectiveness and a sustainable improvement in pain and function.

Fatigue effects on the knee flexors neuromuscular parameters during repeated sprinting.

To identify at which point fatigue on neuromuscular parameters occurs in the knee flexors during a repeated sprint protocol. Physical active males without previous hamstring strain injury were recruited. Neuromuscular parameters such as peak torque (PT) and rate of torque development (RTD) were assessed after every two sprints in a 5 × (2 x 30m) repeated sprint protocol. Twenty physical active males participated in the study. A significant effect of sprint number was found (p < 0.001; η2p = 0.643) with a decreased sprint speed by 6.9% from fastest to slowest sprint. No significant differences were observed in the time between finishing the sprint and performing the first MVIC (46.3 ± 4.7s; p = 0.423), nor in the time between finishing a set and starting the next set (121.2 ± 7.6s; p = 0.503). Regarding neuromuscular parameters, the only significant difference found was in PT between before and after two sprints (117.95 ± 5.61N⋅m vs. 110.64 ± 5.71N⋅m; p = 0.048, d = 0.289) and on RTD 0-50ms before and after ten sprints (465.78 ± 223.76N⋅m/s vs. 382.30 ± 189.56N⋅m/s; p = 0.008; η2p = 0.149). A recovery time of 46s between sprints and testing neuromuscular parameters (due to experimental design) seems sufficient to restore the neuromuscular system. Therefore, it can be suggested that time recovery is the principal factor in detecting fatigue on neuromuscular parameters.

Reverse Nordic Curl Does Not Generate Superior Eccentric Activation of the Quadriceps Muscle Than Bodyweight Squat-Based Exercises.

The quadriceps femoris is consistently ranked among the muscles most prone to sustain strain injuries in sports involving kicking and sprinting actions. Given the documented preventive effect of Nordic hamstring curl programs against hamstring strain injuries, incorporating exercises that induce eccentric overload on the quadriceps could potentially help mitigate strain injuries within this muscle group. The Reverse Nordic Curl (RNC) has emerged as a viable field-based exercise for eccentrically working the quadriceps. This study aimed to compare quadriceps muscle eccentric activation during the RNC with 3 bodyweight squat-based exercises: single-leg squat (SLS), Bulgarian squat, and forward lunge. Cross-sectional study. Twenty-three healthy volunteers (15 men) were monitored for rectus femoris, vastus lateralis, and vastus medialis electromyographic signal, as well as knee range of motion, while performing 10 repetitions of each exercise. Electromyography data acquired during eccentric phases were normalized by maximum voluntary isometric contraction of the knee extensors. The exercises were compared based on the electromyography and knee range of motion values. RNC generated a similar rectus femoris and vastus medialis eccentric activation compared with the squat-based exercises (P > .05 for all), and a lower vastus lateralis activation than SLS (P < .001). Among the bodyweight squat-based exercises, SLS generated greater eccentric activation than forward lunge and Bulgarian squat for the 3 muscles (P < .05 for all). RNC was performed with lower knee-flexion range of motion than bodyweight squat-based exercises (P < .001). RNC did not produce superior eccentric quadriceps activation compared to bodyweight squat-based exercises, even proving to be less demanding for the vastus lateralis compared to the SLS. These findings may assist practitioners in selecting exercises to elicit quadriceps eccentric stimulus, with a focus on preventing strain injuries.

Return to Sport, Reinjury Rate, and Tissue Changes after Muscle Strain Injury: A Narrative Review.

A major challenge in sports medicine is to facilitate the fastest possible recovery from injury without increasing the risk of subsequent reruptures, and thus effective rehabilitation programs should balance between these two factors. The present review focuses on examining the role of different resistance training interventions in rehabilitation of acute muscle strain in the time frame from injury until return to sport (RTS), the rate of reinjuries, and tissue changes after injury. Randomized, controlled trials dealing with a component of resistance training in their rehabilitation protocols, as well as observational studies on tissue morphology and tissue changes as a result to muscle strain injuries, were included. The mean time for RTS varied from 15 to 86 days between studies (n = 8), and the mean rate of reinjury spanned from 0 to 70%. Eccentric resistance training at long muscle length and rapid introduction to rehabilitation postinjury led to significant improvement regarding RTS, and core-stabilizing exercises as well as implementing an individualized algorithm for rehabilitation seem to reduce the risk of reinjury in studies with a high rerupture rate. Independent of the rehabilitation program, structural changes appear to persist for a long time, if not permanently, after a strain injury.

Optimizing the Peripheral Venous Duplex Ultrasound Protocol to Minimize Repetitive Strain Injuries among Sonographers

Background and Objective: Peripheral venous duplex ultrasonography is the standard imaging test to assess patients with known or suspected deep vein thrombosis. The conventional protocol for the lower extremity exam may be time-consuming and ergonomically challenging, increasing the risk for repetitive strain injuries (RSIs) among sonographers. Recognizing the high demand for these ultrasounds and the impact of RSIs on sonographers, we aimed to optimize the lower extremity peripheral venous ultrasound protocol at our institution by addressing exam components that increased exam difficulty or length. Methods: To evaluate where the protocol could be appropriately shortened, we performed (1) a review of current literature, (2) a survey of sonographers, and (3) engagement with a group of radiologists. Results: It was determined that eliminating or minimizing requirements for routine augmentations and assessment of respiratory variation would have limited clinical impact while reducing exam duration and mitigating ergonomic risks associated with peripheral venous exams. Conclusion: Evaluating conventional protocols to optimize practice will help reduce burden on staff, improve efficiency, and ultimately support more effective diagnostic care.

Prevalence of current smoking and associated factors in older adults in Brazil.

The aim of this study was to estimate the prevalence of current smoking and its associated factors in adults aged 50 years and older in Brazil. This cross-sectional study utilized data from the ELSI-Brazil study, encompassing 9,412 adults aged 50 years or over. A multivariate model using Poisson regression with a robust estimator was employed, estimating prevalence ratios and their 95% confidence intervals. The prevalence of current smoking was 17.04%. It was positively and independently associated with male gender, age up to 62 years, living without a partner, illiteracy, chronic obstructive pulmonary disease, depression, poor or very poor sleep quality, and alcohol intake more than once a month. Conversely, systemic arterial hypertension, hypercholesterolemia, diabetes mellitus, and repetitive strain injuries showed an inverse and independent association with current smoking. The prevalence of current smoking among adults over 50 years old in Brazil was approximately 17%, with associations found with certain sociodemographic conditions and self-reported comorbidities.

Comparative Study of Blood Flow Restriction Therapy and Weight Training on the Knee Flexors Strength among Recreational Cricket Players: A Randomised Controlled Trial

Introduction: Cricket was once regarded as a “moderate injury risk” sport, However, there has been a continual increase in injury rates in cricket, with Hamstring Strain Injuries (HSIs) being the most prominent. More recent research suggests that the injury rate in cricket is rising, with HSIs one of the most common and severe injuries. Aim: To investigate the impact of Blood Flow Restriction Therapy (BFRT) and traditional resistance training on knee flexor strength and squat test among cricket players. Materials and Methods: This was a single-blinded, randomised controlled trial on 39 cricket players conducted in the Department of Physiotherapy, Galgotias University (GU), Greater Noida, Uttar Pradesh, India. Subjects aged between 18-25 years were randomly divided in a 1:1 ratio. Group A underwent BFRT combined with low-resistance training, and Group B underwent traditional resistance training. A four-week intervention, comprising two sessions weekly was administered. Results: For within-group comparisons, the paired t-test was used and for between-group comparisons, the independent t-test was used using Statistical Package for the Social Sciences (SPSS), version 25.0. Group A demonstrated a statistically significant increase in squat test scores from pre- to post-intervention compared to Group B after 4 weeks. No significant difference in muscle strength was observed among the two groups. Conclusion: Combining BFRT with low-resistance training significantly enhances knee flexor endurance, as evidenced by superior performance in the squat test compared to traditional resistance training alone. These findings suggest the potential of BFRT as a valuable adjunct to rehabilitation and performance enhancement strategies for lower limb injuries in athletes.

Relationship Between Nordic Hamstring Strength and Single Leg Bridge Test in University Soccer Players.

Nordic hamstring strength (NH strength) and single leg bridge test (SLBT) scores are used to predict the risk of hamstring strain injury. Although NH strength and SLBT scores may be related, the relationship between NH strength and SLBT score remains unknown. This study investigated the relationship between NH strength and SLBT scores in university soccer players. Cross-sectional study. Research laboratory. 38 male university soccer players. NH strength and SLBT scores. A participant was instructed to lean forward gradually at the slowest possible speed from a kneeling posture with the knee joint flexed 90° for the NH strength measurement. Participants in the SLBT crossed their arms over their chests, pushed down from their heels, and lifted their hips off the ground as many times as they could until they failed. We investigated the relationship between NH strength and SLBT scores in the left and right sides using Spearman rank correlation coefficient. Additionally, we calculated the percentage of left-right asymmetry in NH strength and SLBT scores and investigated the relationship between these variables using Pearson correlation coefficient. There were no significant correlations between NH strength and SLBT scores in the right (rs = .239, P = .16) and left (rs = .311, P = .065) legs. Furthermore, there was no significant relationship between NH strength and SLBT between-limb asymmetry (r = .073, P = .671). NH strength and SLBT scores could be different indexes, indicating either maximal muscle strength or muscle endurance. Thus, the findings suggested that when assessing risk factors for hamstring strain injury, both NH strength and SLBT scores should be measured.

Association of quantitative diffusion tensor imaging measures with time to return to sport and reinjury incidence following acute hamstring strain injury

Hamstring strain injuries (HSI) are a common occurrence in athletics and complicated by limited prognostic indicators and high rates of reinjury. Assessment of injury characteristics at the time of injury (TOI) may be used to manage athlete expectations for time to return to sport (RTS) and mitigate reinjury risk. Magnetic resonance imaging (MRI) is routinely used in soft tissue injury management, but its prognostic value for HSI is widely debated. Recent advancements in musculoskeletal MRI, such as diffusion tensor imaging (DTI), have allowed for quantitative measures of muscle microstructure assessment. The purpose of this study was to determine the association of TOI MRI-based measures, including the British Athletic Muscle Injury Classification (BAMIC) system, edema volume, and DTI metrics, with time to RTS and reinjury incidence. Negative binomial regressions and generalized estimating equations were used to determine relationships between imaging measures and time to RTS and reinjury, respectively. Twenty-six index injuries were observed, with five recorded reinjuries. A significant association was not detected between BAMIC score and edema volume at TOI with days to RTS (p-values ≥ 0.15) or reinjury (p-values ≥ 0.13). Similarly, a significant association between DTI metrics and days to RTS was not detected (p-values ≥ 0.11). Although diffusivity metrics are expected to increase following injury, decreased values were observed in those who reinjured (mean diffusivity, p = 0.016; radial diffusivity, p = 0.02; principal effective diffusivity eigenvalues, p-values = 0.007–0.057). Additional work to further understand the directional relationship observed between DTI metrics and reinjury status and the influence of external factors is warranted.

Psychological risk factors for a first hamstring strain injury in soccer: a qualitative study.

Hamstring strain injuries (HSIs) remain one of the most burdensome injuries in soccer. Current recommendations to prevent sports injuries suggest the importance for coaches and medical staff to consider psychological and contextual risk factors and to specify them according to the injury type and context. HSI risk factors in soccer have been widely investigated, mainly from physiological and biomechanical perspectives. However, psychological and health-related risk factors are still unexplored. Therefore, the objective of this study was to determine the psychological and health-related risk factors for a first HSI in male competitive soccer. Individual semi-structured interviews were conducted with ten male competitive soccer players, who had recently sustained a HSI. Based on multifactorial models of sports injury causation, soccer players' individual, contextual, and situational risk factors at the time of their first HSI were investigated. Interviews were analyzed using thematic analysis with deductive and inductive approaches. Individual psychological risk factors included common at-risk personality traits, obsessive passion for soccer with competitive motivational goals, strong athletic identity, and poor health literacy. The injured players were exposed to a controlling coaching style, with a fear of negative staff evaluations, and had recently experienced life stressors. They were injured during matches or overload periods and were highly engaged in the activity. Previously injured soccer players exhibit a lack of perspective concerning the repercussions of their actions on their health. From a preventive viewpoint, these results suggest enhancing the players' health literacy, supporting their autonomy, and moderating the controlling coaching style.

Economic impact of muscle injury rate and hamstring strain injuries in professional football clubs. Evidence from LaLiga.

The aims of this study were: 1) to describe the total muscular injuries, and specifically HSIs, and their corresponding missed matches; 2) to analyse their economic impact; and 3) to estimate the loss of incomes due to TV rights, in first division clubs from LaLigaTM depending on the expected and actual ranking position during the 2018/2019 season. To do that, a cross-sectional study for season 18/19 and for all players of the 20 Spanish professional football clubs was performed. The economic impact of injuries was estimated considering the missed matches and salary cost of all players and the audio-visual income loss was estimated considering the Spanish Royal Decree of Law (RDL 5/2015). The high number of muscular (270) and hamstring injuries (57) implies a high cost for professional first division football clubs, specifically € 365,811 per month for the former and € 47,388 per month for the latter. In addition, reaching a worse than expected position in LaLigaTM ranking involved a loss of 45,2 million € in TV rights incomes. The high cost of muscle injuries in first division teams justifies the need for multidisciplinary teams that are capable of reducing the number of injuries as well as recovery times.

Investigating musculoskeletal risks in manual mushroom harvesting: An ergonomic field study in canadian farms

Canada's annual production of 132,000 metric tonnes of mushrooms relies on manual harvesting, posing risks of work-related musculoskeletal disorders (WMSDs). This study employs ergonomic evaluation techniques, including Rapid Upper Limb Assessment (RULA) and Cumulative Trauma Disorder (CTD) index, along with a discomfort assessment questionnaire, to analyze workers' postural loads and self-reported discomfort. Results indicate that immediate alterations are needed in 85% of picking postures to reduce WMSD risks (RULA score: 6–7). The overall process shows a CTD index of 1.16, indicating potential repetitive strain injuries. Pickers report discomfort, particularly in the hand and shoulder. The study underscores the need for alternatives like redesigned growing beds to enhance worker safety in mushroom harvesting.

Hamstring Injuries, From the Clinic to the Field: A Narrative Review Discussing Exercise Transfer.

The optimal approach to hamstring training is heavily debated. Eccentric exercises reduce injury risk; however, it is argued that these exercises transfer poorly to improved hamstring function during sprinting. Some argue that other exercises, such as isometric exercises, result in better transfer to running gait and should be used when training to improve performance and reduce injury risk. Given the performance requirements of the hamstrings during the terminal swing phase, where they are exposed to high strain, exercises should aim to improve the torque production during this phase. This should improve the hamstrings' ability to resist overlengthening consequently, improving performance and limiting strain injury. Most hamstring training studies fail to assess running kinematics postintervention. Of the limited evidence available, only eccentric exercises demonstrate changes in swing-phase kinematics following training. Studies of other exercise modalities investigate effects on markers of performance and injury risk but do not investigate changes in running kinematics. Despite being inconsistent with principles of transfer, current evidence suggests that eccentric exercises result in transfer to swing-phase kinematics. Other exercise modalities may be effective, but the effect of these exercises on running kinematics is unknown.