Interventions for prevention and rehabilitation of hamstring injuriesReza Rahimi-Moghaddam
Hamstring strains are common injuries among athletes with a high re-injury rate. Most injuries occur during sprints and involve the biceps femoris muscle. There are many modifiable risk factors that prevention programs should address, such as a history of injury, preseason strength imbalances, and lack of eccentric hamstring exercises like the Nordic hamstring. Rehabilitation aims to return athletes to prior performance levels safely in the shortest time while avoiding reinjury, as the first month after return is highest risk. Multi-factorial programs are needed that consider injury severity, core stability, flexibility, and subjective readiness instead of just pain levels.
Nikos Malliaropoulos - Rehabilitation of hamstring injuries MuscleTech Network
Nikos Malliaropoulos
Director of the Athletics National Sports Medicine Centre Thessaloniki Greece. Consultant SEM Physician Barts and The London Clinical Senior Lecturer QMUL CSEM.
-
The rehabilitation of Hamstring injuries - Can we be more injury specific?
(6th MuscleTech Network Workshop)
14th October, Barcelona
Progression criteria during a muscle injury rehabilitation in footballFootball Medicine
This document outlines progression criteria for rehabilitation from a muscle injury in football (soccer). It discusses the biological healing process, defines muscle injuries and their risk factors and epidemiology. It then presents a 4-step, 3-week rehabilitation approach with specific progression criteria for each step, including achieving pain-free movement, increases in strength and range of motion, and return to functional training activities and team training. Imaging and clinical findings are also described for monitoring injury healing.
A criteria based progression rehabilitation protocol for hamstring strain injuries presented at the Sports Medicine Australia conference 2015 during the Hamstring symposium
Lluis Til. Sports Medicine & Orthopedics - FCBarcelona; Olympic Training Cent...MuscleTech Network
The document discusses hamstring injuries in athletes. It notes that hamstring injuries are among the most common and severe muscle injuries in sports. They often result in long recovery times and have a high risk of reinjury. The document then outlines approaches to treating hamstring injuries, including following classical rehabilitation approaches and applying the limited existing evidence. It also discusses developing injury prevention programs to prepare athletes' muscles for the stresses of their sport. Finally, it presents two case studies of hamstring injuries in athletes as examples of special cases.
Epidemiological studies have consistently shown hamstring
strain injuries (HSIs) to have a high prevalence rate in many
sports, such as sprinting (11%; Lysholm & Wiklander, 1987),
Australian Rules Football (16–23%; Orchard, 2001; Orchard,
Marsden, Lord, & Garlick, 1997) and football (12–14%:
Ekstrand, Hagglund, & Walden, 2011; Hawkins, Hulse,
Wilkinson, Hodson, & Gibson, 2001). The epidemiology and
aetiology of HSI in football has received extensive attention in
the scientific literature (Ekstrand et al., 2011; Woods et al., 2004),
given the economic burden associated with professional
players missing training and competitive fixtures (Woods,
Hawkins, Hulse, & Hodson, 2002). b
Flywheel training in football for injury prevention and performanceJari Puustinen
The document discusses using flywheel training for injury prevention and performance in football. It describes how flywheels can provide eccentric overload training through the entire range of motion compared to free weights. A 10-week training program for junior elite soccer players using flywheels twice per week reduced muscle injury rates and improved jumping and sprinting abilities. For in-season training, a weekly 25-minute high-intensity session incorporating flywheels improved change of direction ability in football players.
Delayed-Onset Muscle Soreness Alters the Response to Postural PerturbationsNosrat hedayatpour
The purpose of this study was to assess the EMG activity
of knee muscles during destabilizing perturbations performed
before, immediately after, and 24 and 48 h after eccentric
exercise.
Interventions for prevention and rehabilitation of hamstring injuriesReza Rahimi-Moghaddam
Hamstring strains are common injuries among athletes with a high re-injury rate. Most injuries occur during sprints and involve the biceps femoris muscle. There are many modifiable risk factors that prevention programs should address, such as a history of injury, preseason strength imbalances, and lack of eccentric hamstring exercises like the Nordic hamstring. Rehabilitation aims to return athletes to prior performance levels safely in the shortest time while avoiding reinjury, as the first month after return is highest risk. Multi-factorial programs are needed that consider injury severity, core stability, flexibility, and subjective readiness instead of just pain levels.
Nikos Malliaropoulos - Rehabilitation of hamstring injuries MuscleTech Network
Nikos Malliaropoulos
Director of the Athletics National Sports Medicine Centre Thessaloniki Greece. Consultant SEM Physician Barts and The London Clinical Senior Lecturer QMUL CSEM.
-
The rehabilitation of Hamstring injuries - Can we be more injury specific?
(6th MuscleTech Network Workshop)
14th October, Barcelona
Progression criteria during a muscle injury rehabilitation in footballFootball Medicine
This document outlines progression criteria for rehabilitation from a muscle injury in football (soccer). It discusses the biological healing process, defines muscle injuries and their risk factors and epidemiology. It then presents a 4-step, 3-week rehabilitation approach with specific progression criteria for each step, including achieving pain-free movement, increases in strength and range of motion, and return to functional training activities and team training. Imaging and clinical findings are also described for monitoring injury healing.
A criteria based progression rehabilitation protocol for hamstring strain injuries presented at the Sports Medicine Australia conference 2015 during the Hamstring symposium
Lluis Til. Sports Medicine & Orthopedics - FCBarcelona; Olympic Training Cent...MuscleTech Network
The document discusses hamstring injuries in athletes. It notes that hamstring injuries are among the most common and severe muscle injuries in sports. They often result in long recovery times and have a high risk of reinjury. The document then outlines approaches to treating hamstring injuries, including following classical rehabilitation approaches and applying the limited existing evidence. It also discusses developing injury prevention programs to prepare athletes' muscles for the stresses of their sport. Finally, it presents two case studies of hamstring injuries in athletes as examples of special cases.
Epidemiological studies have consistently shown hamstring
strain injuries (HSIs) to have a high prevalence rate in many
sports, such as sprinting (11%; Lysholm & Wiklander, 1987),
Australian Rules Football (16–23%; Orchard, 2001; Orchard,
Marsden, Lord, & Garlick, 1997) and football (12–14%:
Ekstrand, Hagglund, & Walden, 2011; Hawkins, Hulse,
Wilkinson, Hodson, & Gibson, 2001). The epidemiology and
aetiology of HSI in football has received extensive attention in
the scientific literature (Ekstrand et al., 2011; Woods et al., 2004),
given the economic burden associated with professional
players missing training and competitive fixtures (Woods,
Hawkins, Hulse, & Hodson, 2002). b
Flywheel training in football for injury prevention and performanceJari Puustinen
The document discusses using flywheel training for injury prevention and performance in football. It describes how flywheels can provide eccentric overload training through the entire range of motion compared to free weights. A 10-week training program for junior elite soccer players using flywheels twice per week reduced muscle injury rates and improved jumping and sprinting abilities. For in-season training, a weekly 25-minute high-intensity session incorporating flywheels improved change of direction ability in football players.
Delayed-Onset Muscle Soreness Alters the Response to Postural PerturbationsNosrat hedayatpour
The purpose of this study was to assess the EMG activity
of knee muscles during destabilizing perturbations performed
before, immediately after, and 24 and 48 h after eccentric
exercise.
Fabrizio Tencone
Isokinetic Medical Group, Torino, Italy – Head Juventus Football Club Medical Department, Italy.
-
From injury to return to sport: 25 years of experience in Italian football
(6th MuscleTech Network Workshop)
14th October, Barcelona
Bilateral and unilateral vertical ground reaction forcesFernando Farias
The purposes of this study were to assess unilateral and bilateral vertical jump performance
characteristics, and to compare the vertical ground reaction force characteristics of the impulse and landing
phase of a vertical jump between the dominant and non-dominant leg in soccer players.
Hamstring injuries are among the most com-
mon non-contact injuries in sports. The Nordic hamstring
(NH) exercise has been shown to decrease risk by
increasing eccentric hamstring strength.
Current concept in scientific and clinical rationale behind exercises for gh ...Satoshi Kajiyama
The article provides an overview of the biomechanical and clinical implications of rehabilitation exercises for the glenohumeral and scapulothoracic joints. It reviews the function and biomechanics of specific muscles, and examines common rehabilitation exercises through the lens of electromyography and biomechanics research. The goal is to help clinicians develop safe and effective exercise programs by understanding how exercises target specific muscles and how pathology may alter muscle firing patterns. Exercises that minimize deltoid activity relative to rotator cuff muscles, avoid positions linked to impingement risk, and recruit key muscles at various angles are discussed to optimize rehabilitation.
The effects of self-myofascial release using a foam roll or roller massager on joint range of motion, muscle recovery, and performance: a systematic review
Impact of the Nordic hamstring and hip extension exercises on hamstring archi...Fernando Farias
The architectural and morphological adaptations of the hamstrings in response to training
33 with different exercises have not been explored. PURPOSE: To evaluate changes in biceps
34 femoris long head (BFLH) fascicle length and hamstring muscle size following 10-weeks of
35 Nordic hamstring exercise (NHE) or hip extension (HE) training. METHODS: Thirty
36 recreationally active male athletes (age, 22.0 ± 3.6 years, height, 180.4 ± 7 cm, weight, 80.8 ±
37 11.1 kg) were allocated to one of three groups: 1) HE training (n=10), NHE training (n=10),
38 or no training (CON) (n=10). BFLH fascicle length was assessed before, during (Week 5) and
39 after the intervention with 2D-ultrasound. Hamstring muscle size was determined before and
40 after training via magnetic resonance imaging.
Effect of delayed-onset muscle soreness on muscle recovery after a fatiguing ...Nosrat hedayatpour
the aim of the study was to assess EMG MPF during
recovery following a fatiguing contraction at multiple
locations of the quadriceps femoris muscle injured
by eccentric exercise.
1) A study investigated the effects of 22 weeks of periodized soccer training focused on technical-tactical ability in young players.
2) The training reduced markers of muscle damage (CK and LDH levels) over time and improved high-intensity performance and tactical metrics in games.
3) Players who saw greater reductions in muscle damage markers also had larger increases in high-intensity actions during games.
The effect of instability training on knee joint proprioception and core stre...Fernando Farias
A general 10-week IT program utilizing Swiss balls and body mass as a resistance proved effective for improving knee proprioception as well as trunk flexion and extension strength in previously inactive individuals. The present study demonstrates that the use of body weight as a resis- tance under unstable conditions can provide significant improvements in knee proprioception (for as long as 9 months after training) and trunk strength for the untrained population that should contribute to general health and functionality.
Hamstring strain prevention in elite soccer playersFernando Farias
Hamstring strains are among the most
common injury in sport and are most
often observed in sports that involve
sprinting, turning, and jumping
(8,38,63). The prevalence of hamstring
strains has been measured between 11
and 16% in studies of soccer, Australian
rules football, and cricket (92). This can
result in an average of 6 players per squad
suffering a hamstring injury (defined as
“preventing player participation in
a match”) each season in professional
soccer and Australian rules football
Anthony Shield - is nmi a risk factor for hamstring strain injury MuscleTech Network
Anthony Shield
Senior lecturer, School of Exercise and Nutrition Science Institute of Health and Biomedical Innovation Queensland University of Technology, Brisbane, Australia.
-
Is neuromuscular inhibition a risk factor for hamstring strain?
Mechanics of the human hamstring muscles during sprintingFernando Farias
As peak musculotendon
force and strain for BF
LH
, ST, and SM occurred around the same time during terminal swing, it is suggested that this period in the
stride cycle may be when the biarticular hamstrings are at greatest injury risk. On this basis, hamstring injury prevention or rehabilitation
programs should preferentially target strengthening exercises that involve eccentric contractions performed with high loads at longer
musculotendon lengths.
Return to play in rectus femoris muscle injuries. Our experience with profess...MuscleTech Network
This document outlines a 4-step in-field return-to-play process for professional football players recovering from rectus femoris muscle injuries. The 4 steps progress from running circuits in dry sand, to circuits with a ball in dry sand, to uphill/downhill running, and finally specific football skills circuits. Each step aims to gradually increase difficulty, coordination, strength and sport-specific movements while monitoring pain and GPS data. The process is tailored to each player and aims to return them to full training and play in an optimal way according to their symptoms and injury severity.
Acute effect of different combined stretching methodsFernando Farias
The purpose of this study was to investigate the acute effect of different stretching methods, during a warm-up,
on the acceleration and speed of soccer players. The acceleration performance of 20 collegiate soccer players (body height:
177.25 ± 5.31 cm; body mass: 65.10 ± 5.62 kg; age: 16.85 ± 0.87 years; BMI: 20.70 ± 5.54; experience: 8.46 ± 1.49
years) was evaluated after different warm-up procedures, using 10 and 20 m tests. Subjects performed five types of a
warm-up: static, dynamic, combined static + dynamic, combined dynamic + static, and no-stretching. Subjects were
divided into five groups. Each group performed five different warm-up protocols in five non-consecutive days. The
warm-up protocol used for each group was randomly assigned. The protocols consisted of 4 min jogging, a 1 min
stretching program (except for the no-stretching protocol), and 2 min rest periods, followed by the 10 and 20 m sprint
test, on the same day. The current findings showed significant differences in the 10 and 20 m tests after dynamic
stretching compared with static, combined, and no-stretching protocols. There were also significant differences between
the combined stretching compared with static and no-stretching protocols. We concluded that soccer players performed
better with respect to acceleration and speed, after dynamic and combined stretching, as they were able to produce more
force for a faster execution.
Anterior Cruciate Ligament Injury: Identification of Risk Factors and Prevent...Fernando Farias
Injury to the anterior cruciate ligament (ACL) is common and affects
young individuals, particularly girls, who are active in sports that involve
jumping, pivoting, as well as change of direction. ACL injury is associ-
ated with potential long-term complications including reduction in ac-
tivity levels and osteoarthritis. Multiple intrinsic and extrinsic risk factors
have been identified, which include anatomic variations, neuromuscular
deficits, biomechanical abnormalities, playing environment, and hormonal
status. Multicomponent prevention programs have been shown to be ef-
fective in reducing the incidence of this injury in both girls and boys. Pro-
grams should include a combination of strengthening, stretching, aerobic
conditioning, plyometrics, proprioceptive and balance training, as well as
education and feedback regarding body mechanics and proper landing
pattern. Preventive programs should be implemented at least 6 wk prior to
competition, followed by a maintenance program during the season.
STRETCHING IS A COMMONLY
PRESCRIBED EXERCISE ACTIVITY
THAT HAS BEEN APPLIED TO
WARM-UP, INCREASING RANGE OF
MOTION (ROM), AND RECOVERY
FROM TRAINING. THE PRACTI-
TIONER SHOULD UNDERSTAND
THE EFFECTS OF STRETCHING
EXERCISE AND THE INHERENT DIF-
FERENCES BETWEEN TYPES OF
STRETCHING EXERCISES AND
ACTIVITIES DESIGNED TO
ENHANCE "LOOSENESS" AND
FREEDOM OF MOTION. STRETCH-
ING TO ENHANCE ROM MAY BE
CONTRAINDICATED WHEN
APPLIED TO RECOVERY ACTIVITIES.
STRETCHING FOR RECOVERY
SHOULD BE PAIN-FREE MOTION
WITHIN THE CONSTRAINTS OF
MAXIMUM ROM OF A JOINT.
Differences in strength and speed demands between 4v4 and 8v8 SSGFernando Farias
Small-sided games (SSGs) have been extensively used in training
footballers worldwide and have shown very good efficacy in
improving player performance (Hill-Haas, Dawson, Impellizzeri,
& Coutts, 2011). As an example, it has been shown that the
technical performance (Owen, Wong del, McKenna, & Dellal,
2011) and physical performance (Chaouachi et al., 2014; Dellal,
Varliette, Owen, Chirico, & Pialoux, 2012) of footballers can be
enhanced using SSG-based football training programmes.
In the last two decades, extensive research has been pub-
lished on physical and physiological response during SSGs in
football (for refs, see Halouani, Chtourou, Gabbett, Chaouachi,
& Chamari, 2014). It was found that the time-motion charac-
teristics of SSGs could vary greatly depending on certain
structural (e.g., pitch size, number of players, type and number
of goals) and rule (e.g., number of ball touches) constraints.
For example, it was observed that higher maximum speeds are
reached during SSGs played on bigger pitches (Casamichana &
Castellano, 2010). Furthermore, heart rate (HR) and lactate
concentrations were shown to be sensitive to structural and
rule changes in SSGs.
Sprint running acceleration is a key feature of physical performance in team sports, and recent
literature shows that the ability to generate large magnitudes of horizontal ground reaction force
and mechanical effectiveness of force application are paramount. We tested the hypothesis that
very-heavy loaded sled sprint training would induce an improvement in horizontal force
production, via an increased effectiveness of application. Training-induced changes in sprint
performance and mechanical outputs were computed using a field method based on velocity-
time data, before and after an 8-week protocol (16 sessions of 10x20-m sprints). 16 male
amateur soccer players were assigned to either a very-heavy sled (80% body-mass sled load)
or a control group (unresisted sprints). The main outcome of this pilot study is that very-heavy
sled resisted sprint training, using much greater loads than traditionally recommended, clearly
increased maximal horizontal force production compared to standard unloaded sprint training
(effect size of 0.80 vs 0.20 for controls, unclear between-group difference) and mechanical
effectiveness (i.e. more horizontally applied force; effect size of 0.95 vs -0.11, moderate
between-group difference)
Melhorar ou até mesmo manter o desempenho atlético em jogadores de esportes de equipe competitivos durante o longo período da temporada é um dos maiores desafios para qualquer treinador comprometido. Tempo muito limitado está disponível entre as partidas semanais para introduzir sessões intensivas de treinamento de força e poder, com uma freqüência normal de 1-2 unidades por semana. Este fato estimula a busca de métodos de treinamento mais eficientes capazes de melhorar uma ampla variedade de habilidades funcionais, evitando ao mesmo tempo os efeitos de fadiga.
This very short document appears to be about a student's activity called "PINTURA". However, there is no other information provided beyond the title. The inclusion of "Zzzz" seems to indicate the document is incomplete or empty.
Fabrizio Tencone
Isokinetic Medical Group, Torino, Italy – Head Juventus Football Club Medical Department, Italy.
-
From injury to return to sport: 25 years of experience in Italian football
(6th MuscleTech Network Workshop)
14th October, Barcelona
Bilateral and unilateral vertical ground reaction forcesFernando Farias
The purposes of this study were to assess unilateral and bilateral vertical jump performance
characteristics, and to compare the vertical ground reaction force characteristics of the impulse and landing
phase of a vertical jump between the dominant and non-dominant leg in soccer players.
Hamstring injuries are among the most com-
mon non-contact injuries in sports. The Nordic hamstring
(NH) exercise has been shown to decrease risk by
increasing eccentric hamstring strength.
Current concept in scientific and clinical rationale behind exercises for gh ...Satoshi Kajiyama
The article provides an overview of the biomechanical and clinical implications of rehabilitation exercises for the glenohumeral and scapulothoracic joints. It reviews the function and biomechanics of specific muscles, and examines common rehabilitation exercises through the lens of electromyography and biomechanics research. The goal is to help clinicians develop safe and effective exercise programs by understanding how exercises target specific muscles and how pathology may alter muscle firing patterns. Exercises that minimize deltoid activity relative to rotator cuff muscles, avoid positions linked to impingement risk, and recruit key muscles at various angles are discussed to optimize rehabilitation.
The effects of self-myofascial release using a foam roll or roller massager on joint range of motion, muscle recovery, and performance: a systematic review
Impact of the Nordic hamstring and hip extension exercises on hamstring archi...Fernando Farias
The architectural and morphological adaptations of the hamstrings in response to training
33 with different exercises have not been explored. PURPOSE: To evaluate changes in biceps
34 femoris long head (BFLH) fascicle length and hamstring muscle size following 10-weeks of
35 Nordic hamstring exercise (NHE) or hip extension (HE) training. METHODS: Thirty
36 recreationally active male athletes (age, 22.0 ± 3.6 years, height, 180.4 ± 7 cm, weight, 80.8 ±
37 11.1 kg) were allocated to one of three groups: 1) HE training (n=10), NHE training (n=10),
38 or no training (CON) (n=10). BFLH fascicle length was assessed before, during (Week 5) and
39 after the intervention with 2D-ultrasound. Hamstring muscle size was determined before and
40 after training via magnetic resonance imaging.
Effect of delayed-onset muscle soreness on muscle recovery after a fatiguing ...Nosrat hedayatpour
the aim of the study was to assess EMG MPF during
recovery following a fatiguing contraction at multiple
locations of the quadriceps femoris muscle injured
by eccentric exercise.
1) A study investigated the effects of 22 weeks of periodized soccer training focused on technical-tactical ability in young players.
2) The training reduced markers of muscle damage (CK and LDH levels) over time and improved high-intensity performance and tactical metrics in games.
3) Players who saw greater reductions in muscle damage markers also had larger increases in high-intensity actions during games.
The effect of instability training on knee joint proprioception and core stre...Fernando Farias
A general 10-week IT program utilizing Swiss balls and body mass as a resistance proved effective for improving knee proprioception as well as trunk flexion and extension strength in previously inactive individuals. The present study demonstrates that the use of body weight as a resis- tance under unstable conditions can provide significant improvements in knee proprioception (for as long as 9 months after training) and trunk strength for the untrained population that should contribute to general health and functionality.
Hamstring strain prevention in elite soccer playersFernando Farias
Hamstring strains are among the most
common injury in sport and are most
often observed in sports that involve
sprinting, turning, and jumping
(8,38,63). The prevalence of hamstring
strains has been measured between 11
and 16% in studies of soccer, Australian
rules football, and cricket (92). This can
result in an average of 6 players per squad
suffering a hamstring injury (defined as
“preventing player participation in
a match”) each season in professional
soccer and Australian rules football
Anthony Shield - is nmi a risk factor for hamstring strain injury MuscleTech Network
Anthony Shield
Senior lecturer, School of Exercise and Nutrition Science Institute of Health and Biomedical Innovation Queensland University of Technology, Brisbane, Australia.
-
Is neuromuscular inhibition a risk factor for hamstring strain?
Mechanics of the human hamstring muscles during sprintingFernando Farias
As peak musculotendon
force and strain for BF
LH
, ST, and SM occurred around the same time during terminal swing, it is suggested that this period in the
stride cycle may be when the biarticular hamstrings are at greatest injury risk. On this basis, hamstring injury prevention or rehabilitation
programs should preferentially target strengthening exercises that involve eccentric contractions performed with high loads at longer
musculotendon lengths.
Return to play in rectus femoris muscle injuries. Our experience with profess...MuscleTech Network
This document outlines a 4-step in-field return-to-play process for professional football players recovering from rectus femoris muscle injuries. The 4 steps progress from running circuits in dry sand, to circuits with a ball in dry sand, to uphill/downhill running, and finally specific football skills circuits. Each step aims to gradually increase difficulty, coordination, strength and sport-specific movements while monitoring pain and GPS data. The process is tailored to each player and aims to return them to full training and play in an optimal way according to their symptoms and injury severity.
Acute effect of different combined stretching methodsFernando Farias
The purpose of this study was to investigate the acute effect of different stretching methods, during a warm-up,
on the acceleration and speed of soccer players. The acceleration performance of 20 collegiate soccer players (body height:
177.25 ± 5.31 cm; body mass: 65.10 ± 5.62 kg; age: 16.85 ± 0.87 years; BMI: 20.70 ± 5.54; experience: 8.46 ± 1.49
years) was evaluated after different warm-up procedures, using 10 and 20 m tests. Subjects performed five types of a
warm-up: static, dynamic, combined static + dynamic, combined dynamic + static, and no-stretching. Subjects were
divided into five groups. Each group performed five different warm-up protocols in five non-consecutive days. The
warm-up protocol used for each group was randomly assigned. The protocols consisted of 4 min jogging, a 1 min
stretching program (except for the no-stretching protocol), and 2 min rest periods, followed by the 10 and 20 m sprint
test, on the same day. The current findings showed significant differences in the 10 and 20 m tests after dynamic
stretching compared with static, combined, and no-stretching protocols. There were also significant differences between
the combined stretching compared with static and no-stretching protocols. We concluded that soccer players performed
better with respect to acceleration and speed, after dynamic and combined stretching, as they were able to produce more
force for a faster execution.
Anterior Cruciate Ligament Injury: Identification of Risk Factors and Prevent...Fernando Farias
Injury to the anterior cruciate ligament (ACL) is common and affects
young individuals, particularly girls, who are active in sports that involve
jumping, pivoting, as well as change of direction. ACL injury is associ-
ated with potential long-term complications including reduction in ac-
tivity levels and osteoarthritis. Multiple intrinsic and extrinsic risk factors
have been identified, which include anatomic variations, neuromuscular
deficits, biomechanical abnormalities, playing environment, and hormonal
status. Multicomponent prevention programs have been shown to be ef-
fective in reducing the incidence of this injury in both girls and boys. Pro-
grams should include a combination of strengthening, stretching, aerobic
conditioning, plyometrics, proprioceptive and balance training, as well as
education and feedback regarding body mechanics and proper landing
pattern. Preventive programs should be implemented at least 6 wk prior to
competition, followed by a maintenance program during the season.
STRETCHING IS A COMMONLY
PRESCRIBED EXERCISE ACTIVITY
THAT HAS BEEN APPLIED TO
WARM-UP, INCREASING RANGE OF
MOTION (ROM), AND RECOVERY
FROM TRAINING. THE PRACTI-
TIONER SHOULD UNDERSTAND
THE EFFECTS OF STRETCHING
EXERCISE AND THE INHERENT DIF-
FERENCES BETWEEN TYPES OF
STRETCHING EXERCISES AND
ACTIVITIES DESIGNED TO
ENHANCE "LOOSENESS" AND
FREEDOM OF MOTION. STRETCH-
ING TO ENHANCE ROM MAY BE
CONTRAINDICATED WHEN
APPLIED TO RECOVERY ACTIVITIES.
STRETCHING FOR RECOVERY
SHOULD BE PAIN-FREE MOTION
WITHIN THE CONSTRAINTS OF
MAXIMUM ROM OF A JOINT.
Differences in strength and speed demands between 4v4 and 8v8 SSGFernando Farias
Small-sided games (SSGs) have been extensively used in training
footballers worldwide and have shown very good efficacy in
improving player performance (Hill-Haas, Dawson, Impellizzeri,
& Coutts, 2011). As an example, it has been shown that the
technical performance (Owen, Wong del, McKenna, & Dellal,
2011) and physical performance (Chaouachi et al., 2014; Dellal,
Varliette, Owen, Chirico, & Pialoux, 2012) of footballers can be
enhanced using SSG-based football training programmes.
In the last two decades, extensive research has been pub-
lished on physical and physiological response during SSGs in
football (for refs, see Halouani, Chtourou, Gabbett, Chaouachi,
& Chamari, 2014). It was found that the time-motion charac-
teristics of SSGs could vary greatly depending on certain
structural (e.g., pitch size, number of players, type and number
of goals) and rule (e.g., number of ball touches) constraints.
For example, it was observed that higher maximum speeds are
reached during SSGs played on bigger pitches (Casamichana &
Castellano, 2010). Furthermore, heart rate (HR) and lactate
concentrations were shown to be sensitive to structural and
rule changes in SSGs.
Sprint running acceleration is a key feature of physical performance in team sports, and recent
literature shows that the ability to generate large magnitudes of horizontal ground reaction force
and mechanical effectiveness of force application are paramount. We tested the hypothesis that
very-heavy loaded sled sprint training would induce an improvement in horizontal force
production, via an increased effectiveness of application. Training-induced changes in sprint
performance and mechanical outputs were computed using a field method based on velocity-
time data, before and after an 8-week protocol (16 sessions of 10x20-m sprints). 16 male
amateur soccer players were assigned to either a very-heavy sled (80% body-mass sled load)
or a control group (unresisted sprints). The main outcome of this pilot study is that very-heavy
sled resisted sprint training, using much greater loads than traditionally recommended, clearly
increased maximal horizontal force production compared to standard unloaded sprint training
(effect size of 0.80 vs 0.20 for controls, unclear between-group difference) and mechanical
effectiveness (i.e. more horizontally applied force; effect size of 0.95 vs -0.11, moderate
between-group difference)
Melhorar ou até mesmo manter o desempenho atlético em jogadores de esportes de equipe competitivos durante o longo período da temporada é um dos maiores desafios para qualquer treinador comprometido. Tempo muito limitado está disponível entre as partidas semanais para introduzir sessões intensivas de treinamento de força e poder, com uma freqüência normal de 1-2 unidades por semana. Este fato estimula a busca de métodos de treinamento mais eficientes capazes de melhorar uma ampla variedade de habilidades funcionais, evitando ao mesmo tempo os efeitos de fadiga.
This very short document appears to be about a student's activity called "PINTURA". However, there is no other information provided beyond the title. The inclusion of "Zzzz" seems to indicate the document is incomplete or empty.
Este documento es un diario que describe la rutina diaria de un grupo de maestros y maestras en una escuela primaria. Brevemente describe las actividades y estados de ánimo de cada maestro/a, como preparar clases, interactuar con los estudiantes, tomar descansos, y los eventos y celebraciones que han tenido lugar a lo largo del curso escolar como carnavales, olimpiadas deportivas, navidad y más.
O documento discute três esportes: basquete, handebol e futebol. Ele menciona a vitória do Pau-Orthez na Euroliga de basquete em Kaunas e o desempenho das jogadoras de handebol francesas em Malmö. No futebol, fala sobre Cissé voltando a jogar pelo Olympique de Marseille.
La pandemia de COVID-19 ha tenido un impacto significativo en la economía mundial. Muchos países experimentaron fuertes caídas en el PIB y aumentos en el desempleo debido a los cierres generalizados y las restricciones a los viajes. Aunque las vacunas han permitido la reapertura de muchas economías, los efectos a largo plazo de la pandemia en sectores como el turismo y los viajes aún no están claros.
O documento relata eventos ocorridos nos meses de Janeiro a Maio em Ipu e Pires Ferreira. Inclui posse de autoridades municipais, entrega de direção de instituição, apreensão de menores acusados de roubo, eventos comunitários, encontro de motoqueiros, assassinato em triângulo amoroso, e eleição de rainha em aniversário de Pires Ferreira.
1. The document discusses research on the effects of eccentric hamstring exercises for soccer players. It reviews 6 studies that provide evidence that eccentric hamstring strengthening can improve muscle strength and balance, increase peak torque, and reduce the risk of hamstring injury compared to concentric strengthening alone.
2. One key study found that performing eccentric hamstring exercises during the cool-down of soccer training sessions more effectively maintained strength compared to the warm-up. This has implications for reducing muscle fatigue.
3. The studies demonstrated increases in hamstring strength, peak torque, and hamstring to quadriceps ratios following eccentric training programs, as well as reductions in reported hamstring injuries among soccer players.
Muscular strength, functional performances and injury risk in professional an...Fernando Farias
Muscle strength and anaerobic power of the lower extre-
mities are neuromuscular variables that influence perfor-
mance in many sports activities, including soccer. Despite
frequent contradictions in the literature, it may be assumed
that muscle strength and balance play a key role in targeted
acute muscle injuries. The purpose of the present study was
to provide and compare pre-season muscular strength and
power profiles in professional and junior elite soccer players
throughout the developmental years of 15–21.
ISMST 2015 Abstract 2 - The influence of medical shockwaves on muscle activat...Kenneth Craig
This study investigated the effects of medical shockwave therapy on muscle activation patterns and performance in healthy athletes. Golfers and weightlifters underwent shockwave therapy targeting specific muscles. Post-treatment, golfers showed increased swing speed, ball distance, and faster muscle activation. Weightlifters showed faster muscle activation but lower energy output during squats, though they were able to lift more weight. The study suggests shockwave therapy may induce favorable biological responses in healthy muscles, reducing fatigue and potential for overuse injuries over time. Further research is warranted.
This study compared the effectiveness of two rehabilitation programs for acute hamstring strains. Twenty-four athletes with hamstring strains were randomly assigned to either a static stretching, isolated strengthening, and icing program (STST group) or a progressive agility, trunk stabilization, and icing program (PATS group). The PATS group had a significantly shorter average time to return to sports (22.2 days vs 37.4 days) and lower reinjury rates both within 2 weeks of returning (0% vs 54.5%) and within 1 year (7.7% vs 70%) compared to the STST group. A rehabilitation program including progressive agility and trunk stabilization exercises was found to be more effective for returning athletes to
Artigo - Acupuncture on oxygen consumptionRenato Almeida
1) Auricular acupuncture had a significant effect on improving the oxygen consumption and recovery ability of boxing athletes.
2) The study found that VO2max, a key indicator of cardiovascular endurance, was significantly higher after auricular acupuncture stimulation compared to a control group.
3) Auricular acupuncture stimulation may enhance athletic performance by improving aerobic ability as shown by increased VO2max and VEmax, and faster recovery of heart rate and body temperature after exercise.
This research article studied whether TRX suspension training could reduce injury rates in futsal athletes by improving Functional Movement Screening (FMS) scores. 24 futsal players were randomly assigned to a control or intervention group. The intervention group did TRX training 3 times a week for 6 weeks, while the control group did regular training. Both groups were tested with the FMS before and after. The intervention group significantly improved their deep squat, hurdle step, inline lunge, trunk rotary stability, and total FMS scores compared to the control group. The results suggest that TRX training can strengthen the core and improve motor control patterns to potentially reduce injuries in futsal players by increasing FMS scores.
This document discusses prosthetic trauma and the need for improved prosthetic devices that can restore stable and independent ambulation for persons with lower extremity amputations. It notes that over 500,000 people in the US live with lower limb loss and 130,000 lower limb amputations are performed annually. Current surgical procedures for amputation date back to the Civil War era and are not well suited for advanced prosthetics. State-of-the-art neural interfaces have been developed within this outdated surgical paradigm. True restoration of function requires an approach that considers the fundamental motor unit of agonist-antagonist muscle pairs for joint control.
1) The study investigated the role of sensory feedback from working muscles on central motor drive and the development of peripheral muscle fatigue during high-intensity cycling.
2) Eight competitive cyclists performed three 5 km cycling time trials under different conditions: control, placebo injection, and intrathecal fentanyl injection to impair sensory feedback.
3) Impairing sensory feedback with fentanyl increased central motor drive and power output early in exercise but led to greater peripheral muscle fatigue and poorer performance later in exercise, emphasizing the role of sensory feedback in regulating central motor drive and limiting fatigue development.
The document summarizes a study that examined the effects of endurance, resistance, and concurrent (endurance and resistance) training on cardiac structure in female students. The study found that 8 weeks of concurrent training significantly increased left ventricular end diastolic diameter compared to endurance or resistance training alone. Concurrent training also significantly increased left ventricular end systolic diameter, mass, and mass index. No other measured variables showed significant differences between groups. The results indicate that concurrent training may have a greater impact on cardiac adaptations than single-mode endurance or resistance training.
Effect of Deep Oscillation as a Recovery Method after Fatiguing Soccer TrainingMary Fickling
This study investigated the effects of deep oscillation (DO) as a recovery method after soccer training. In a randomized crossover study with 8 male soccer players, measurements were taken before and 48 hours after a fatiguing soccer training session. Half of the players performed DO self-treatment twice daily for 15 minutes, while the other half received no intervention. After 4 weeks, groups crossed over. The study found significant effects of DO on maximum leg flexion strength and perceived exertion rate. Other measures like maximum leg extension strength, creatine kinase levels, and delayed onset muscle soreness showed non-significant trends favoring the DO group over the control. Overall, the results suggest DO may help accelerate muscle recovery and should be further investigated
Effects of Eccentric Strength Training’s Time on Daily Plasma Testosterone Le...IOSR Journals
This study aims to evaluate the effects of the eccentric physical training’s time on daily plasma concentrations of testosterone among sedentary athletes. Sixty male athletes, with homogeneous age, size and weight were selected for the study during three months. They were subjects to a strength training of the extensor and flexor muscles of the knee. After they were divided in two groups of thirty subjects and then had physical training either in the morning between 6 and 7, or in the evening, between 16 and 17. The dosage of testosterone on each athlete was performed before and after submission to an eccentric physical program at the antecubital vein in a restful sitting. Our results have shown that eccentric physical training induces the increase of this steroid hormone in the two groups of athletes and the training in the evening promotes better its production. Our results also showed that the rate of this androgen drop significantly during the day in both groups of athletes trained in the morning or in the evening as well as their respective controls. However, the decline was even more pronounced for subjects trained in the morning
This document discusses prevention of sports injuries. It describes three types of injury prevention: primary, secondary, and tertiary. Primary prevention aims to promote health and prevent injury through measures like ankle braces. Secondary prevention focuses on early diagnosis and treatment to limit injury development through actions like RICE treatment. Tertiary prevention aims to rehabilitate and reduce existing disabilities through exercises after initial treatment. The document also discusses various injury prevention strategies and equipment like warm-ups, stretching, taping, bracing, protective gear, suitable shoes and surfaces.
The document discusses injuries that can occur in windmill style softball pitchers, including nerve injuries. It summarizes several studies that found a high percentage (over 70%) of softball players sustained injuries from pitching, most from overuse. Common injuries included strains, peripheral nerve injuries like neurapraxia, and injuries to the shoulder and elbow from the high torques involved in windmill pitching. Improper mechanics can increase risks, while proper mechanics and rest are important for prevention. Nerve injuries like ulnar nerve injuries and musculocutaneous nerve injuries have also been reported. NSAID use is also common among injured pitchers to mask pain. Overall the document emphasizes the importance of examining pitching mechanics and the entire kinetic
To Compare The Effect Of Core Stability Exercises And Muscle Energy Technique...IOSR Journals
Abstract: Low back pain is considered one of the commonest condition in the western and industrialized
countries. It is estimated that up to 50% of adults experience low back pain during their life span. People of all
age group can be effected by this menace irrespective to their gender and quality of life. It has become one of
the leading causes for the visit to physician thus also puts a heavy burden on the currency of the country.
Physiotherapy is the most widely used form of treatment adopted for gaining relief from low back pain. The
exercises include stretching, strengthening, range of motion exercises, McKenzie therapy and core stability
exercises other techniques like muscle energy technique etc. It has been concluded in various studies core
stability exercises and muscle energy technique are beneficial in low back pain patients but comparison of their
effect needs to be established to provide early and better relief from the disability. Therefore objective of the
study was to compare the effect of core stability exercises and muscle energy techniques on low back pain
patients. 60 subjects aged 18 – 45 years with low back pain were made part of the study based on inclusion and
exclusion criteria and were then divided into three groups named A, B and C. Group A received core stability
exercise and conventional physiotheraphy and group B received muscle energy techniques and conventional
physiotherapy. The exercise program was given on alternate days with a total of 24 sessions and progression of
the activity was made within the tolerance of the patient. Pre and post treatment readings were taken of pain,
ROM and quality of life scale. Results were analyzed using paired, unpaired t- test and ANOVA. Results showed
that there is significant effect on pain, ROM and quality of life scale in the three groups but group A was
clinically more significant than the other groups. The study concluded that patients with low back pain are
benefitted more by core stability exercises. So, core stability exercises should be practiced more.
Keywords: Low Back Pain, Core Stabilization Exercises, Muscle Energy Technique.
Good Vibrations by Jon Denoris for Kinetica Sportsdenoris
This presentation is a review I put together for www.Kinetica-Sports.com on the pro's and con's of whole body vibration training. I believe it's certainly an exciting area, albeit one which unfortunately is prone to the usual fitness "fads" and exaggerated claims especially regarding weight loss / body fat loss.
Good Vibrations by Jon Denoris for Kinetica Sportsdenoris
This presentation is a review of research on vibration training which I have compiled for Kinetica-sports.com. This is a potentially exciting area, albeit one which is prone to the usual "fitness fads" and exaggerated claims especially around it's usefulness for weight loss and body fat reduction.
This document summarizes a presentation on concussions and cervical injuries. It discusses how concussions are caused by rotational forces on the brain and shares similarities in symptoms with cervical injuries, which result from neck muscle strains. Tests are presented to differentiate between concussion and cervical injury. The risk of lower extremity injuries in the 6 months following a concussion is significantly higher than in non-concussed athletes, with the knee and ankle being most commonly injured. Ongoing balance and strength training is recommended for several months after concussion recovery to prevent future injuries.
This document discusses hamstring strain injuries, which are common in sports requiring sprinting. It notes that about one-third of hamstring injuries will recur within two weeks of returning to sport, suggesting rehabilitation programs may be inadequate. The injuries typically occur during the late swing phase of running when the hamstrings absorb energy. Rehabilitation aims to address weakness, inflexibility and movement impairments from the injury. Future research should develop more individualized rehabilitation based on injury location and measures of reinjury risk.
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Belgium vs Romania Injuries and Patience in Belgium’s Euro Cup Germany Squad....Eticketing.co
Belgium coach Domenico Tedesco will wait for several key players to recover from injury. Even if it means they miss the opening Euro Cup Germany stages of the European Championship in Germany this month. Veteran defender Jan Vertonghen, midfielder Youri Tielemans and defender Arthur. Theate are being given time to play in the tournament because they are considered vital to Belgium’s cause, Tedesco said on Tuesday.
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"Of course, you prefer to take players who are fully fit, but that's okay. We want to wait and be patient for some players even if they cannot play in those first matches," he told a press conference. The 37-year-old Vertonghen, Belgium’s Euro Cup 2024 most-capped international with 154 appearances, is struggling to shake off a groin injury.
"He will be there normally. This also applies to Youri Tielemans and Arthur Theate. The latter's position is very sensitive. We don't have many choices at left back. "It will only change if it turns out that they will only be available when, say, the final of the Euro 2024 Championship comes around. That's too long to wait. "However, I am confident that the injured boys are on track for the Euros.
Belgium vs Romania: Radu Dragusin Prepares for Crucial Role in Euro Cup Germany
Some of them have taken not one but two steps forward in their rehabilitation," he said. None of the injured players will feature in this week’s warm-up friendlies against Montenegro and Luxembourg. Romania centre-back Radu Dragusin found chances limited at Tottenham Hotspur in the second half of the 2023-24 season.
But is crucial to his country's cause at UEFA Euro 2024 where his aerial ability, physicality and hard graft make him a standout player. The 22-year-old moved to North London from Italian side Genoa in January but was kept on the sidelines by the form of another new arrival for the season, Mickey van de Ven, something Romania coach Edward Iordanescu admitted was a concern.
It will mean limited game-time going into the finals, but Dragusin, who cites Netherlands defender Virgil van Dijk as a role model, started every Euro Cup Germany qualifier as Romania went through the campaign unbeaten in their 10 games. He will be among their most important players in their first game in Germany against Ukraine in Munich on June 17, taking the right centre-back role in what is likely to be a back four.
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However, in 2023, they played one another twice, with France endearing both matches 4-0 and 2-1 individually. Against Poland and Austria, the Netherlands also have a stout record, winning just under half the matches. They faced Austria at Euro 2020, engaging 2-0, and they haven't lost to Poland since 1979.
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Hesan Soufi's Legacy: Inspiring the Next Generation
Prevención de lesiones
1. Scand J Med Sci Sports 2003: 13: 244±250 COPYRIGHT ß BLACKWELL MUNKSGAARD 2003Á ISSN 0905-7188
Printed in Denmark Á All rights reserved S C A N D I N A V I A N J O U R N A L O F
MEDICINE & SCIENCE
IN SPORTS
Hamstring injury occurrence in elite soccer players after preseason
strength training with eccentric overload
C. Askling1, J. Karlsson2, A. Thorstensson1
1
Department of Sport and Health Sciences, University College of Physical Education and Sports and Department of Neuroscience,
È
Karolinska Institutet, Stockholm, Sweden, 2Department of Orthopaedics, Sahlgrenska University Hospital/Ostra Goteborg, Sweden
È
Corresponding author: Carl Askling, Department of Sport and Health Sciences, University College of Physical Education and Sports,
Box 5626, SE-114 86 Stockholm, Sweden
Accepted for publication 12 December 2002
The primary purpose of this study was to evaluate whether a after the training period and all hamstring injuries were
preseason strength training programme for the hamstring registered during the total observational period of
muscle group ± emphasising eccentric overloading ± could 10 months. The results showed that the occurrence of ham-
affect the occurrence and severity of hamstring injuries string strain injuries was clearly lower in the training group
during the subsequent competition season in elite male (3/15) than in the control group (10/15). In addition, there
soccer players. Thirty players from two of the best were significant increases in strength and speed in the
premier-league division teams in Sweden were divided into training group. However, there were no obvious coupling
two groups; one group received additional specific hamstring between performance parameters and injury occurrence.
training, whereas the other did not. The extra training was These results indicate that addition of specific preseason
performed 1±2 times a week for 10 weeks by using a special strength training for the hamstrings ± including eccentric
device aiming at specific eccentric overloading of the overloading ± would be beneficial for elite soccer players,
hamstrings. Isokinetic hamstring strength and maximal both from an injury prevention and from performance
running speed were measured in both groups before and enhancement point of view.
Hamstring muscle strains are common injuries in strength training of the hamstrings has so far been
sports with high demands on speed and power, such performed.
as soccer (Ekstrand & Gillquist, 1983a; Inklaar, 1994a). Increasing amounts of evidence point to the advan-
Ekstrand & Gillquist (1983a) showed that 80% of all tages of including eccentric muscle actions in strength
muscle strains encountered by soccer players during training regimes to achieve optimal effects (Colliander
training and/or matches occurred in the lower extrem- & Tesch, 1990; Dudley et al., 1991). This has been
ity and that 47% of those were injuries to the ham- demonstrated both in studies of changes in maximal
strings. In a later study, Morgan & Oberlander (2001) strength performance (Hather et al., 1991) and in re-
reported that about 10% of Major League Soccer habilitation studies (Alfredson et al., 1998; Croisier
players encountered a hamstring injury during a et al., 2002). Eccentric training appears also to be mo-
season. tivated from a functional point of view as eccentric
Muscle strength deficiency has been proposed as one actions are an integral part of the functional repertoire
of several risk factors for hamstring injury (Yamamoto, of this muscle group (Nilsson et al., 1985; Mann et al.,
1993; Worrell, 1994), although earlier studies at- 1986). Furthermore, there are theories, which state that
tempting to establish relationships between muscle the strain injury would occur during eccentric ham-
strength parameters and occurrence of hamstring injur- string actions. Proved valid, this could be another in-
ies have shown diverging results (Orchard et al., 1997; centive for eccentric training as a preventive measure.
Bennell et al., 1998). The aim of this study was to evaluate whether a
Strength training has been advocated as a preventive preseason hamstring strength training programme ±
measure in order to avoid hamstring muscle injuries emphasising eccentric overloading ± could affect the
(Stanton & Purdam, 1989). This recommendation has occurrence and severity of hamstring injuries during
been based on experiments on animal muscle, where it the subsequent competition season in elite soccer
has been shown that a stronger muscle can absorb more players. Additional attention was paid to the effects of
energy prior to failure than a weaker muscle (Garrett, the training on strength and speed performance and
1990, 1996). To our knowledge, no prospective study their possible relationship with hamstring injury
concerning the possible preventive effect of specific prevention.
244
2. Hamstring training in soccer players
Materials and methods study period. After the training period, the training group
Subjects was interviewed concerning their subjective experience of the
specific hamstring training ± for example, discomfort, muscle
Thirty male soccer players from two of the best premier-league soreness, effects on performance and attitude towards this type
division teams in Sweden were recruited as subjects. All players of training.
remained in their respective team during the entire study period.
Fifteen players from each team participated; goalkeepers, injured
players and players with chronic hamstring problems were ex- Training programme
cluded. The participating players in each team (7 ‡ 8 and 8 ‡ 7, The training group performed a total of 16 sessions of specific
respectively) were randomly assigned to either a training group hamstring strength training, every fifth day for the first 4 weeks
(n ˆ 15) or a control group (n ˆ 15). A similar number of defend- and every fourth day during the last 6 weeks (total training period
ers and forwards were included in each group. All subjects gave 10 weeks, all players completed all sessions). The hamstring
their informed consent to participate. Before the study period training was performed in a non-fatigued state, after a standard-
started, there were no significant differences between the training ised warm-up period (15 min jogging/cycling). Four individually
and the control groups with respect to anthropometric measures supervised sessions over a 2-week period were allowed for famil-
(Table 1), muscle strength, maximal running speed, or hip flexi- iarisation before the start of the study. Thereafter each player was
bility (range of motion, ROM) (Table 2). responsible for his own training, including keeping track of times,
days, training intensity, muscle soreness and other symptoms in
Study design his training diary. Midway through the training period, one
training session for each player was again controlled by the
Before the start of the study, the players, coaches and medical project leader. Apart from the extra training, all players in both
personnel of the two teams were informed about the purpose and groups followed the ordinary training of each team. There was no
the design of the study. The coaches, physical therapists and further detailed registration of exposure.
physicians agreed to supervise the training and to register and The specific hamstring training consisted of both concentric
report all hamstring injuries. and eccentric actions and was performed on a YoYoÔ flywheel
The study was divided into two phases. Phase 1 ( preseason) ergometer (YoYo Technology AB, Stockholm, Sweden) (Berg &
was the first 10 weeks (January 7±March 15) and phase 2 (com- Tesch, 1994). The working principle of this device is based on
petition season) was the period between weeks 11 and 46 (March setting a flywheel into rotational motion via concentric muscle
16±November 15). Both the training and control groups followed action and then decelerating the motion via eccentric muscle
the same protocols, the only exception being that the training action. By performing the eccentric action over a smaller angular
group received additional specific hamstring training during displacement and hence with a greater muscle torque than the
phase 1. During the 8 days directly preceding and 3±12 days concentric one, an eccentric overload is accomplished.
following the training period, tests for hamstring strength and The subjects performed bilateral knee flexor actions in the
maximal running speed were performed in both groups. The prone position (fig. 1), accelerating the flywheel by concentric
incidence of hamstring injuries was registered over the whole hamstring action and subsequently decelerating it with eccentric
action of the same muscle group. The instruction was to apply
maximal effort from a straight knee position until full knee
Table 1. Background data, mean values and standard deviations (SD), flexion (130±1408), then start braking upon passing the 908 pos-
for the training group (n ˆ 15) and the control group (n ˆ 15). There ition on the way back and continue braking with maximal effort
were no significant differences between the two groups until the knees were straight. Once the flywheel had come to a
stop, the next cycle was initiated. The average angular velocity
Training group Control group
was approximately 608 sÀ1 (estimated with an electro-goniometer
in one subject) ± that is, the concentric and eccentric muscle
Age (years) 24 (2.6) 26 (3.6)
actions lasted about 2.2 and 1.5 s, respectively. Every training
Body mass (kg) 78 (5) 77 (6)
Body height (m) 1.82 (0.06) 1.81 (0.07) session consisted of four sets with eight repetitions; the first set
Body mass index (kg/m2) 23.5 (0.6) 23.3 (0.9) serving as specific warm-up. The rest period between sets was
approximately 1 min.
Table 2. Mean values and standard deviations (SD) in the training and control groups for concentric (con) and eccentric (ecc) strength (peak torque;
n ˆ 13 for both groups) and maximal running speed (time for 30-m-sprint; n ˆ 14 for both groups) before and after the preseason-training period.
Values for the range of motion (ROM; n ˆ 15 for both groups) for each leg in passive hip flexion measured before the training period are also
presented
Training group Control group
Before After After-Before Before After After-Before
Strength
Peak torque con (Nm) 131 (21) 151 (26) 20* (12) 130 (25) 133 (19) 2 (14)
Peak torque ecc (Nm) 148 (24) 176 (22) 28* (28) 158 (25) 156 (23) 0 (16)
Speed
Time 30 m (s) 3.36 (0.10) 3.28 (0.09) 0.074* (0.052) 3.38 (0.11) 3.38 (0.12) 0.002 (0.05)
ROM
Hip flexion dx (8) 70 (6) 75 (10)
Hip flexion sin (8) 71 (6) 74 (9)
*Significant difference After-Before (P < 0.05).
245
3. Askling et al.
Fig. 1. The set-up for specific hamstring training (for description, see Methods).
Isokinetic muscle strength isometric contraction and stretching. None of the injured players
had any diffuse lumbar region problems that could be related to
The isokinetic concentric and eccentric hamstring muscle the hamstring symptoms. The number of matches or practices
strength was measured, for each leg separately, in a seated pos- missed was decided, recorded and reported by the respective team
ition by using a Kinetic Communicator (KIN-COMÕ 500 H, physician. The medical personnel of each team were not part of
Chattecx Corp., Chattanooga, TN, USA) at an angular velocity the study, thus avoiding bias. The severity of the injuries was
of 608 sÀ1. A 10-min warm-up period on a cycle ergometer at classified into three categories, according to Ekstrand & Gillquist
50 W preceded the test. The subject was sitting with the thigh (1983a): (i) minor injuries (absence from practice/match less than
supported, hip flexed at 908, and arms folded; secured to the a week), (ii) moderate (absence more than 1 week to 1 month), or
apparatus with straps across the chest, pelvis, thigh and ankle. (iii) major (absence more than 1 month). Both groups were
The rotational axis of the knee was aligned with that of the treated identically and a finer gradation of the number of matches
dynamometer. The range of motion of the knee joint was 5±908 or practice sessions was not performed in any of the groups. Each
(08 ˆ straight knee). The test protocol consisted of two submax- injured player was interviewed in connection with the injury
imal repetitions followed by three maximal trials, first concentric- occasion according to a standardised questionnaire, including a
ally then eccentrically. About half a minute rest was allowed description of the injury situation and an attempt to analyse the
between the muscle actions. Gravity-corrected peak torque (PT) possible cause of the injury.
was registered and the trial giving the highest PT value was used
for statistical analysis.
Statistics
Running speed Differences between groups and between values before and after
the training period were tested for significance by using the two-
A test of maximal running speed, a so-called flying-30-m-test, was
tailed paired Student's t-tests. Statistical significance was
performed before and after the training period. The subjects were
accepted at the P < 0.05 level with Bonferroni adjustment for
allowed to accelerate over a distance of 20 m and the time for
multiple t-tests. In order to test for statistical significance between
running the next 30 m at full speed was measured using photocells
groups with respect to the occurrence of hamstring injuries,
(Time-it, Eleiko, Sweden, resolution 0.01 s). The fastest of three
Fisher's Exact test with a Yates correction was employed
trials was used for analysis. A standardised warm-up programme
(Agresti, 1992). The level of significance was set at P < 0.05.
preceded the tests and a 2-min recovery period was given between
runs. The tests were performed on an indoor all-weather-track
and conventional training shoes were used.
Results
Isokinetic muscle strength
Range of motion
The training group showed a significant increase
Range of motion was measured for passive hip flexion of each leg
on all 30 players during the week prior to the start of the training (P < 0.05) after the training period in both eccentric and
period. No warm-up exercises were performed and strength concentric knee flexor strength ( peak torque), whereas
training of the thigh muscles was prohibited during the 2 days there were no differences in the control group (Table 2).
preceding the test. The angular displacement during passive leg The increases in eccentric and concentric strength in the
raising with straight knee was measured with a flexometer
training group were of similar magnitude, 19 and 15%,
(Myrin, Follo A/S, Norway) according to Ekstrand et al. (1982).
respectively. Concentric strength constituted, on the
average, about 85% (82±89%) of the eccentric strength
Injury registration
in both groups, before and after the study period.
All hamstring injuries were registered during the entire study
period. An injury was included if it occurred during scheduled
matches or practices and caused the player to, at least, miss the Running speed
next game or practice session (Ekstrand & Gillquist, 1983a). All
injuries were diagnosed after a clinical examination and were The time for 30-m maximal speed running (flying-
defined as pain in connection with palpation as well as with 30-meters) was significantly (P < 0.05) shorter (2.4%)
246
4. Hamstring training in soccer players
in the after-test as compared to the before-test in the Interview
training group, whereas it remained unchanged in the
In the interview after the training period, 11 players in
control group (Table 2).
the training group stated that they had experienced
muscle soreness of varying intensity 1±3 days after the
Injury occurrence training sessions ± particularly, during the first half of
the training period. A majority of the players (11/15)
During the study period of 10 months, a total of 13
considered the extra hamstring training meaningful
(43%) hamstring injuries were reported among the 30
and were positive towards a continuation; five players
players, all occurring during the competition season
would prefer whole season extra training, whereas six
(March±October) (Table 3). A significantly (P < 0.05)
recommended that it be a part of the preseason sched-
lower number of injuries occurred in the training group
ule only.
(3/15) as compared to the control group (10/15). Seven
of the 10 injuries in the control group were classified as
Discussion
`minor'. Overall, eight of the injuries (62%) were classi-
fied as `minor', four (31%) as moderate and one (7%) as The main finding of the present study was that a
major. Six (46%) of the injuries happened during group of elite male soccer players performing extra
matches and seven (54%) during training sessions. preseason training specifically directed towards over-
Eight of the nine acute injuries were reported by the loading the hamstring muscles eccentrically had a
subjects as having occurred during sprint-like activities lower occurrence of hamstring strain injuries than a
and one (the only major injury) when performing a matched group performing ordinary training. The
glide-tackle. The number of traumatic injuries ± that training also had a positive effect on the concentric
is, injuries with a sudden onset ± was nine (69%), and eccentric maximal voluntary strength of the ham-
whereas the remaining four (31%, all minor injuries) strings, as well as on maximal running speed. The
were classified as overuse injuries, having an insidious players came from two of the highest ranked male
onset of symptoms. teams in the Swedish premier-league division, which
In a questionnaire completed by both groups before should be borne in mind when attempting to extrapo-
the study period, 10 players ± six in the training group late the findings. Although the teams may not represent
and four in the control group ± reported previous injur- the highest absolute level of soccer, the majority of
ies to the hamstrings during the preceding season. the players are full-time employees, undertaking fre-
Among the 13 players injured during the current quent training sessions and matches. Therefore, the
season, six (46%) had had a hamstring injury during significant effects of the extra training were even more
the previous season, five (all minor) in the same leg and remarkable.
one (the only major injury) in the contralateral leg. Of Previous studies have suggested that hamstring
the six re-injured players, two belonged to the training strain is one of the most common soft tissue injuries
group and four to the control group. in athletes (Garrett et al., 1984; Kujula et al., 1997;
In the first test before the training protocol started, Clanton & Coupe, 1998; De Smet & Best, 2000).
there were no differences in performance variables ± Earlier injury surveys in male elite soccer players
that is, isokinetic strength or running speed, or ROM in have, however, not been able to identify the hamstrings
passive hip flexion ± between the group of players Â
as a particularly injury-prone muscle group (Arnarson
(n ˆ 13) that were later to be injured and the group È
et al., 1996; Luthje et al., 1996). The prevalence of
that remained uninjured (n ˆ 17). Similarly, there were hamstring injuries in the present study was particularly
no significant differences in any of these variables high in the control group (67%), which is clearly higher
within the injured group ± that is, between the legs than in earlier studies (Ekstrand & Gillquist, 1983a;
that were to be injured and those that remained healthy. Morgan & Oberlander, 2001). It should be noted that
Table 3. Distribution of hamstring injuries (n ˆ 13), in relation to subject groups, severity (minor, moderate, major), occurrence, type and time
(month) of the year
Training group Control group
Minor Moderate Major Minor Moderate Major
Frequency 1 1 1 7 3 0
During match 1 1 2 2
During training 1 5 1
Acute injury 1 1 4 3
Insidious injury 1 3
Month (#) of the year 6 7 10 3, 4, 8, 8, 4, 7, 8
10, 10, 10
247
5. Askling et al.
the majority of these injuries were categorised as important factor to consider in such studies would be
`minor'. There are several possible explanations for the occurrence of previous hamstring injuries. In the
the apparent discrepancy between the current and control group that just received conventional soccer
earlier findings, although a conclusive explanation is training during the preseason, all four of those who
still lacking. One plausible explanation might be related reported that they had suffered a hamstring strain
È
to the method of data collection (Ostenberg & Roos, injury during the preceding season were re-injured
2000). This can be critical, particularly in studies using during the current season. Accordingly, several earlier
large subject numbers where the coach/player is to studies have clearly indicated that a previous injury
report the injury to the investigator. The size of the constitutes a severe risk for re-injury at the same loca-
present cohort was small enough to allow for a very tion (Inklaar, 1994b; Bennell et al., 1998; Orchard,
careful collection procedure, where the team physician 2001; Verrall et al., 2001).
made an acute clinical diagnosis and the main investi- In this study, none of the 13 players ± who were
gator followed up with an interview. Another explan- injured during the actual observational period ± did,
ation could be that the present study was focused on however, experience a second injury to the same leg
injuries to the hamstring muscles, whereas the previous during that particular period. This could possibly be
studies have attempted to survey the overall injury related to the special attention that each injury received
pattern. As mentioned, many of the present injuries from the investigators. Every injured player was care-
(62%) were `minor' ± that is, causing absence from fully followed up until the time of return to full activity.
practice/match for less than a week ± and they may Immediate treatment and a rehabilitation programme
have escaped attention in surveys of larger format. closely integrated with the healing process have been
Furthermore, the category of players studied is most emphasised as critical factors for minimising the risks
likely critical ± that is, the actual definition of a player's for re-injury (Taylor et al., 1993; Thorsson, 1996;
proficiency and thus the classification as `elite'. The È
Jarvinen et al., 2000; Kannus, 2000). This is essential
risk of injury may increase with the level of play as even if the first injury is characterised as `minor'
discussed by Heidt et al. (2000). (Ekstrand & Gillquist, 1983a).
In the training group, the number of hamstring in- The training group showed improvements both
juries was significantly lower as compared to the con- in isolated strength of the hamstrings and in a coordin-
trol group. At the same time, the performance in the ated activity ± that is, short-term maximal speed
strength and speed tests improved. However, no direct running. The ordinary training performed by the con-
coupling between the two was observed on an individ- trol group did not cause any such changes. The ham-
ual level. It was not within the scope of this study to string training was performed as a combination of
determine whether preseason strength and speed tests heavy concentric and eccentric overloading. Such a
were predictive of injury risk. This is in line with the combination of concentric and eccentric training has
general notion that hamstring strains are complex in- been shown to cause larger strength improvements than
juries with several potential predisposing factors ± for concentric training alone (Colliander & Tesch, 1990;
example, muscle weakness and imbalance, lack of flexi- Dudley et al., 1991; Hather et al., 1991). There are
bility, fatigue, etc. (Agre, 1985; Worrell, 1994). There studies demonstrating that eccentric training may
are studies showing that low muscle strength measured cause more pronounced strength gains than pure con-
isokinetically during the preseason can be related to a centric training (Hortobagyi et al., 1996b; Seger et al.,
higher risk of hamstring injuries during the ensuing 1998). However, in the present study it could not be
competition season (Orchard et al., 1997). Yet, other determined whether the preventive effect on hamstring
investigations were not able to show such a relationship injuries could be attributed to the extra eccentric over-
(Bennell et al., 1998). loading as such. It is worth noting that eccentric
The injured legs did not demonstrate any difference training is receiving increased recognition as a rehabili-
in flexibility before the observation period started. This tation tool, especially in connection with tendon injur-
is in accordance with a previous study, which showed ies (Alfredson et al., 1998).
no relationship between passive hip flexion measured The model used for eccentric overload in this study
during preseason and subsequent occurrence of ham- builds upon fundamental mechanics ± that is, the util-
string muscle injury (Ekstrand & Gillquist, 1983b). It isation of inertia ± and the training equipment was
may be noted in this context that excessive flexibility introduced by Berg & Tesch (1994). The apparatus
training per se may lead to hamstring strain injuries has a simple construction and is easy to use. It is
(Askling et al., 2000, 2002). important, however, that a careful introduction and
The low number of subjects is a limitation with familiarisation is given for the equipment to be used
the present study and there is a need for large-scale optimally. The extra training was applied relatively
multi-factorial prospective studies in order to clarify seldom in the present study, every fifth day for the
possible relationships between potential risk factors first 4 weeks and every fourth day during the remaining
and subsequent occurrence of hamstring injury. One 6 weeks. Still, muscle soreness was experienced by
248
6. Hamstring training in soccer players
most of the players. The number of players complain- other parts of the soccer game, such as jumping and
ing about soreness gradually decreased over the cutting.
training period (11/15 after the first session, 9/15 after
the eighth session, 7/15 after the last session).
Perspectives
Specific muscle training involves training of muscles
in isolated movements. The aim of this type of training Specific training of the hamstring muscle group is an
is to increase the performance of a muscle group to a integral part of the training protocol for many athletes
higher level than can be attained by soccer activity in individual sports, but is probably not common
alone and then to be able to use this enhanced capacity among team sports, such as soccer. The positive results
in an integrated movement. This appears to be the case from the present study should give an incentive for it to
here as maximal running speed increased after the spe- be utilised more systematically within elite soccer, both
cific hamstring training protocol. The hamstring from an injury prevention and from performance
muscles have a complex anatomy and the function of enhancement point of view. However, a larger scale
the four individual muscle portions, three of which study would be desirable as a basis for more definite
span both the knee and hip joints, is not fully under- recommendations.
stood. The activation pattern, documented primarily
with surface electromyography (Nilsson et al., 1985; Key words: eccentric overload; hamstring strain; range
Simonsen et al., 1985), shows two major periods of of motion; running speed; soccer players; strength
activation in fast running ± one at the end of swing, training.
the other during support. The hamstrings are involved
in braking and stabilisation of the hip and knee joints
and they contribute to propulsion primarily through Acknowledgement
hip extension (Mann et al., 1986). The hamstring Financial support was obtained from the Swedish Centre for
muscle group is likely to have an essential role also in Sport Research and the Swedish Olympic Committee.
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