An Evidence-Based Framework for Strengthening Exercises to Prevent Hamstring Injury
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REVIEW ARTICLE
An Evidence-Based Framework for Strengthening Exercises to Prevent Hamstring Injury Matthew N. Bourne1 • Ryan G. Timmins2 • David A. Opar2 • Tania Pizzari1 • Joshua D. Ruddy2 • Casey Sims3 • Morgan D. Williams4 • Anthony J. Shield3
Published online: 7 November 2017 Ó Springer International Publishing AG 2017
Abstract Strength training is a valuable component of hamstring strain injury prevention programmes; however, in recent years a significant body of work has emerged to suggest that the acute responses and chronic adaptations to training with different exercises are heterogeneous. Unfortunately, these research findings do not appear to have uniformly influenced clinical guidelines for exercise selection in hamstring injury prevention or rehabilitation programmes. The purpose of this review was to provide the practitioner with an evidence-base from which to prescribe strengthening exercises to mitigate the risk of hamstring
Electronic supplementary material The online version of this article (doi:10.1007/s40279-017-0796-x) contains supplementary material, which is available to authorized users. & Matthew N. Bourne [email protected] 1
Department of Rehabilitation, Nutrition and Sport, La Trobe Sport and Exercise Medicine Research Centre, Melbourne, VIC, Australia
2
School of Exercise Science, Australian Catholic University, Melbourne, VIC, Australia
3
School of Exercise and Nutrition Science, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
4
School of Health, Sport and Professional Practice, Faculty of Life Sciences and Education, University of South Wales, Wales, UK
injury. Several studies have established that eccentric knee flexor conditioning reduces the risk of hamstring strain injury when compliance is adequate. The benefits of this type of training are likely to be at least partly mediated by increases in biceps femoris long head fascicle length and improvements in eccentric knee flexor strength. Therefore, selecting exercises with a proven benefit on these variables should form the basis of effective injury prevention protocols. In addition, a growing body of work suggests that the patterns of hamstring muscle activation diverge significantly between different exercises. Typically, relatively higher levels of biceps femoris long head and semimembranosus activity have been observed during hip extensionoriented movements, whereas preferential semitendinosus and biceps femoris short head activation have been reported during knee flexion-oriented movements. These findings may have implications for targeting specific muscles in injury prevention programmes. An evidence-based approach to strength training for the prevention of hamstring strain injury should consider the impact of exercise selection on muscle activation, and the effect of training interventions on hamstring muscle architecture, morphology and function. Most importantly, practitioners should consider the effect of a strength training programme on known or proposed risk factors for h
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