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Original research
a
Musculoskeletal Research Unit, Central Queensland University, North Rockhampton, Qld., 4701 Australia
School of Health and Human Performance, Central Queensland University, North Rockhampton, Qld., 4701 Australia
Abstract
Objectives: Although previous research shows that the hamstring lengthtension relationship during eccentric contractions plays a role in
hamstring injury, training methods to promote beneficial adaptations are still unclear. The purpose of this pilot study was to determine
whether an eccentric hamstring specific training programme results in favourable adaptations.
Design: Eccentric training consisting of the Nordic hamstring exercise performed twice a week for four weeks. Pre- and post-training
concentric/concentric isokinetic testing of peak torque (PT) and position of peak torque (POS) was performed for both the quadriceps and
hamstrings of both legs at 608 sK1. Vertical jump height was also assessed.
Participants: Nine athletic, male subjects with no previous strength training experience.
Results: There was a significant increase in vertical jump height (preZ51.0G4.8 cm, postZ54.4G6.3 cm, pZ0.04), a significant reduction
in quadriceps PT (preZ204.6G21.9 N.m., postZ181.5G19.9 N.m., pZ0.01), a significant decrease in hamstring POS from full knee
extension (preZ32.5G7.48, postZ26.2G8.68, pZ0.01) and a significant hamstring POS difference between limbs (dominantZ33.8G9.58,
non-dominantZ24.9G6.58, pZ0.01).
Conclusion: Nordic hamstring exercise training may produce favourable neuromuscular adaptations for the possible prevention of hamstring
injuries while enhancing performance in athletic, untrained males.
q 2005 Elsevier Ltd. All rights reserved.
Keywords: Eccentric training; Hamstring injury; Prevention
1. Introduction
One of the most common injuries in nearly all forms of
team and individual sports involving the lower body is the
hamstring strain (Bennell & Cossley, 1996; Moseley, 1996;
Orchard, James, Alcott, Carter, & Farhart, 2002; Orchard,
Wood, Seward, & Broad, 1998). Analysis of epidemiological injury studies assessing these sports consistently ranks
hamstring strain injuries as one of the most prevalent factors
resulting in missed playing time by athletes (Orchard et al.,
1998; Seward, Orchard, Hazard, & Collinson, 1993).
* Corresponding author. Tel.: C61 07 49 309704; fax: C61 07 49
309871.
E-mail address: r.clark@cqu.edu.au (R. Clark).
1466-853X/$ - see front matter q 2005 Elsevier Ltd. All rights reserved.
doi:10.1016/j.ptsp.2005.02.003
68
2. Methodology
2.1. Overview
The testing protocol consisted of pre- and post-training
intervention isokinetic dynamometer testing of the
quadriceps and hamstrings at a velocity of 608 sK1. Peak
torque, position of peak torque and vertical jump were
assessed to determine lower body strength, effects on the
lengthtension relationship and dynamic power output.
69
Fig. 1. Starting position for the Nordic Hamstring Stretch exercise. The
athlete lowers their torso towards the ground using the hamstring muscles
as the primary brake against the force of gravity.
Fig. 2. Upper body ground contact during the Nordic Hamstring Stretch
exercise. The athlete performs a dynamic push-up jump and attempts to use
this momentum along with concentric contraction of the hamstrings to
return to the starting position.
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Table 1
Four week training protocol
Week
Sessions
per week
SetsReps
Technical notes
2/5
2
3
2
3
2/6
3/6
3/8
4. Discussion
The main purpose of this design was to determine whether
there were any significant differences in the dependant
variables as a consequence of test limb or test occasion. In
the event of a significant main effect or interaction following
ANOVA contrasts, post hoc comparisons of the means were
conducted using the least significant difference (LSD) test to
delineate differences amongst test limbs or test occasion.
Paired samples t-test were used to compare vertical jump
performance pre and post training. The level of significance
was set at p!0.05 for all tests. All analyses were performed
using SPSS version 12.
3. Results
The pre- and post-training intervention results for the
isokinetic testing including peak torque and position of peak
torque for the quadriceps and hamstrings of both limbs are
presented in Table 2. Statistical analysis revealed a
significant main effect of test occasion for quadriceps
peak torque with an 11.3% reduction in peak torque from
the pre to post tests when the data were pooled across test
limbs (see Fig. 3). Statistical analyses also revealed a
significant main effect of test limb for the position of
hamstring peak torque with a 36.4% increase in knee flexion
Table 2
Isokinetic performance measures assessed pre and post a 4 week eccentric hamstring training intervention
Isokinetic performance
measure
Quadriceps
PT
(N.m.)
Pos PT
(8)
Hamstrings
PT
(N.m.)
Pos PT
(8)
Pre
Post
P and F values
Dominant
Non-dominant
Dominant
Non-dominant
L!T
204.34
G20.1
69.32
G4.0
204.93
G23.8
62.82
G6.3
180.84
G19.8
66.84
G5.4
182.09
G20.0
65.11
G7.6
0.90
0.02
0.06
4.85
0.01*
9.77
0.95
0.00
0.95
0.00
0.07
4.34
98.61
G13.3
36.76
G10.8
99.00
G28.4
28.21
G4.0
97.30
G13.9
30.77
G8.2
103.64
G19.3
21.61
G9.0
0.49
0.53
0.01*
11.77
0.68
0.19
0.01*
10.3
0.36
0.93
0.91
0.01
L, effect for Limb (dominant and non-dominant); T, effect for test (pre- and post-intervention); L!T, interaction between limb and test; PT, peak torque; Pos
PT, position of peak torque. *Indicates significant difference (p!0.05).
250
Peak Torque (N.m.)
225
200
175
150
Pre
71
45
40
35
30
25
20
Pre
Post
Testing Day
62
45
60
40
35
30
25
20
Fig. 5. Hamstring joint angle position of peak torque from full knee
extension pre- and post-training intervention. *Indicates significant
difference between pre- and post-testing results (pZ0.01).
Non-dominant
Post
Testing Day
Dominant
Limb
Fig. 4. Hamstring joint angle position of peak torque from full knee
extension between the dominant and non-dominant limbs. *Indicates
significant difference between dominant and non-dominant limb results
(pZ0.01).
58
56
54
52
50
48
Pre
Post
Testing
72
Despite the beneficial adaptations in terms of the lengthtension relationship, there was no increase in hamstring
concentric peak torque as a result of the training
intervention. This replicates the findings of Mjlnes et al.
(2004) who found a limited effect of this method of training
on concentric hamstring strength.
Another interesting finding of this study was the
significant 11.3% reduction in peak torque produced by
the quadriceps after the training intervention. This may
be due to a number of factors, such as changes in the
viscoelastic properties of the muscular unit in response to
the training stimulus and/or increased antagonistic
activation of the hamstrings during the concentric
quadriceps phase of the testing protocol (Solomonow,
Baratta, & DAmbrosia, 1989). A change in the stiffness
properties of the hamstrings and/or increased antagonistic
activation may adversely affect the force output of the
quadriceps by applying internal opposition to the
quadriceps contraction in addition to the external
opposition supplied by the isokinetic dynamometer
(Solomonow et al., 1989).
Although a dramatic reduction in quadriceps peak
torque and only minor changes in hamstring peak torque
were observed in the open kinetic chain testing, a
significant 6.6% increase in vertical jump height was
reported. This revealed that the Nordic hamstring exercise
not only appears to have a beneficial effect on the length
tension relationship of the hamstrings, but results in
enhanced explosive power performance in untrained
athletes. Although there was a reduction in open-kinetic
chain quadriceps peak torque in the post-training results,
this may not carry over into closed kinetic chain jumping
movements. Furthermore, the minor changes in hamstring
peak torque may not be the reason for the improvement in
vertical jump. The change in hamstring position of peak
torque towards a more extended knee angle is likely to
have contributed to the increase in vertical jump height.
This may be due to increased joint stability of the knee
during the final takeoff phase of the jumping movement,
allowing for more efficient transfer of force through the
joint (Baratta, Solomonow, Zhou, Letson, Chuinard, &
DAmbrosia, 1988).
Previous studies have shown that the hamstrings play a key
role in preserving joint stiffness and stability during the
deceleration phase which occurs towards the terminal stage of
the knee extension movement (Baratta et al., 1988; Hagood,
Solomonow, Baratta, Zhou, & DAmbrosia, 1990). Therefore
it would be expected that to optimise force transfer through the
knee joint during dynamic movements it would be necessary
to maintain or increase hamstring coactivation during the
terminal phase of the movement. However, Baratta et al.
(1988) found that in untrained athletes who participated in
sports requiring repetitive jumping movements, this activation
of the antagonist hamstring muscles during the final phase of
the knee extension was markedly reduced. This suggests that
in non-weight trained athletes the hamstring muscles reduce
4.1. Limitations
Despite the limited number of subjects participating in
this study, a number of significant findings were observed.
However, further studies incorporating greater subject
numbers, the inclusion of a control group and multiple
trials for assessment of reliability would help to determine
the role of lower body eccentric training on performance
and injury risk factors. The results of this study suggest that
eccentric hamstring training may result in adaptations that
reduce the risk of hamstring strain injury, however further
studies are required before these benefits can be deemed
conclusive.
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