Anthony Shield - does strength in the nhe predict hamstring injury
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Anthony Shield Senior lecturer, School of Exercise and Nutrition Science Institute of Health and Biomedical Innovation Queensland University of Technology, Brisbane, Australia. - Does strength in the Nordic hamstring exercise predict hamstring injury? (&th MuscleTech Network workshop) 14th October, Barcelona
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Anthony Shield - does strength in the nhe predict hamstring injury
- 1. Does strength in the Nordic hamstring exercise predict hamstring injury? David Opar (ACU) Morgan Williams (USW) Jack Hickey Ryan Timmins (ACU) Steven Duhig (QUT) Tony Shield (QUT)
- 2. 2 Patent Application Opar & Shield (2012) Funding
- 3. Is eccentric knee flexor strength a risk factor for hamstring injury?
- 4. Nordic interventions reduce injury! Petersen et al., 2011. AJSM. 39(11):2296-303. Established injury prevention effects Arnason et al 2008 Petersen et al 2011 Van der Horst et al 2014 No performance feedback!
- 6. Nordic testing in the ‘field’ Wireless load cells, data logged to lap-top, 100Hz
- 7. Nordic testing in the ‘field’ Wireless load cells, data logged to lap-top, 100Hz
- 9. 5 AFL teams recruited 210 players in total 186 in early pre-season testing A 6th team was withdrawn due to lack of compliance
- 10. Timeline for reporting Retrospective Prospective Hamstring strain Muscle Mechanism Severity Calf strain Quadriceps strain Groin injury Anterior cruciate rupture Hamstring strain Nordic test results
- 11. Strength testing schedule Pre-season In-season Nov Dec Jan Feb Mar - Sept 2012 2013
- 12. Hamstring strain injuries 28 ‘initial’ Hamstring strain injuries 79% 18% 4% BF SM ST 6 of these recurred
- 13. Pre-season strength Group Limb NHE Strength (N.kg-1) Subsequently… Early pre Late pre Injured players Injured Uninjured 3.04±0.97 3.37±1.10 n=27 3.51±0.95 3.60±0.87 n=17 Uninjured players Ave of both 3.81±1.06 n=159 4.18±0.92 n=157 Weaker than uninjured players
- 14. Strength & risk of injury Cut-off n % HSI RR p Early Pre 186 14.5 <3.16 N.kg-1 66 25.8 3.1 (1.5-6.4) 0.002 >3.16 N.kg-1 120 8.3 Late Pre 174 9.8 <3.45 N.kg-1 47 23.2 5.0 (1.9-12.6) 0.001 >3.45 N.kg-1 127 4.7 HSI = hamstring strain injury, RR = relative risk Cut-offs determined by ROC curve
- 15. Other factors not significant Factor RR p Prior hamstring strain 2.1 (1.0-4.3) 0.093 Prior ACL rupture 2.2 (0.9-5.1) 0.146 Prior Quad strain 1.9 (0.6-6.8) 0.601 Prior Groin pain 0.4 (0.1-2.7) 0.478 Limb imbalance >10% Early pre 1.3 (0.6-2.5) Late pre 2.0 (0.8-4.8) 0.677 0.185 Age > 25.5 1.5 (0.7-3.1) 0.339
- 16. Logistic regressions Multivariate regressions Univariate regressions Early pre: 0.937 (0.888-0.990), p=0.020 (6.3% in risk / 10N ) Late pre: 0.914 (0.845-0.989), p=0.026 (8.9% in risk / 10N ) OR’s per 10N increase in strength
- 17. Strength age & injury risk
- 18. Prior injury strength & injury risk Not significant!
- 19. Conclusions & discussion Players weaker at Nordics are more prone to hamstring strain injury Allows for targeted interventions? Provides strength guidelines AFL players are weak!!! Cricket players are stronger AFL: 330±73N, Cricket: 392±86N Is strength sufficiently prioritised?
- 20. Limitations / Next steps No exposure data New AFL study with GPS data 8 teams & ~300 players Applicability to other sports? Rugby & soccer studies have commenced