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      Relationship between Nordic hamstring strength and maximal voluntary eccentric, concentric and isometric knee flexion torque

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          Abstract

          Nordic hamstring exercise is performed to prevent knee flexor muscle strain injuries and used to assess their injury risks. However, what exactly Nordic hamstring strength indicates is not clear. We investigated the relationship between Nordic hamstring strength and maximal voluntary contraction (MVC) torque of the knee flexors measured by an isokinetic dynamometer. Sixteen healthy young men who had not experienced hamstring strain injuries participated in the study. In Nordic hamstring, each participant was instructed to lean forward as far as possible in 3 s (approximately 30°/s), and force at the ankle joint of the dominant leg was measured during the movement. The force was multiplied by lower leg length and converted into torque. MVC torque of the knee flexors was measured isometrically at 30°, 45°, 60°, and 90° knee flexion joint angles, and concentrically and eccentrically at 30°/s and 60°/s in 10°–90° knee flexion for the dominant leg in a prone position. Correlations among the dependent variables were assessed using Pearson’s correlation coefficients. Peak Nordic hamstring torque ranged 96.8–163.5 Nm, and peak MVC eccentric torque ranged 50.7–109.4 Nm at 30°/s and 59.2–121.2 Nm at 60°/s. No significant correlations were evident between the peak Nordic hamstring torque and peak eccentric knee flexion torque (r = 0.24–0.3, p = 0.26–0.4). This was also the case for the Nordic hamstring torque and MVC torque of isometric (r = −0.03–0.1, p = 0.71–0.92) and concentric contractions (r = 0.28–0.49, p = 0.053–0.29). These results show that Nordic hamstring strength is not associated with the knee flexor torque measured by an isokinetic dynamometer. It may be that other factors than static and dynamic hamstring strengths affect Nordic hamstring strength.

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          Eta squared and partial eta squared as measures of effect size in educational research

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            Hamstring injuries have increased by 4% annually in men's professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study.

            There are limited data on hamstring injury rates over time in football.
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              Hamstring strain injuries: factors that lead to injury and re-injury.

              Hamstring strain injuries (HSIs) are common in a number of sports and incidence rates have not declined in recent times. Additionally, the high rate of recurrent injuries suggests that our current understanding of HSI and re-injury risk is incomplete. Whilst the multifactoral nature of HSIs is agreed upon by many, often individual risk factors and/or causes of injury are examined in isolation. This review aims to bring together the causes, risk factors and interventions associated with HSIs to better understand why HSIs are so prevalent. Running is often identified as the primary activity type for HSIs and given the high eccentric forces and moderate muscle strain placed on the hamstrings during running these factors are considered to be part of the aetiology of HSIs. However, the exact causes of HSIs remain unknown and whilst eccentric contraction and muscle strain purportedly play a role, accumulated muscle damage and/or a single injurious event may also contribute. Potentially, all of these factors interact to varying degrees depending on the injurious activity type (i.e. running, kicking). Furthermore, anatomical factors, such as the biarticular organization, the dual innervations of biceps femoris (BF), fibre type distribution, muscle architecture and the degree of anterior pelvic tilt, have all been implicated. Each of these variables impact upon HSI risk via a number of different mechanisms that include increasing hamstring muscle strain and altering the susceptibility of the hamstrings to muscle damage. Reported risk factors for HSIs include age, previous injury, ethnicity, strength imbalances, flexibility and fatigue. Of these, little is known, definitively, about why previous injury increases the risk of future HSIs. Nevertheless, interventions put in place to reduce the incidence of HSIs by addressing modifiable risk factors have focused primarily on increasing eccentric strength, correcting strength imbalances and improving flexibility. The response to these intervention programmes has been mixed with varied levels of success reported. A conceptual framework is presented suggesting that neuromuscular inhibition following HSIs may impede the rehabilitation process and subsequently lead to maladaptation of hamstring muscle structure and function, including preferentially eccentric weakness, atrophy of the previously injured muscles and alterations in the angle of peak knee flexor torque. This remains an area for future research and practitioners need to remain aware of the multifactoral nature of HSIs if injury rates are to decline.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SoftwareRole: Writing – original draft
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: ResourcesRole: SoftwareRole: SupervisionRole: Writing – review & editing
                Role: InvestigationRole: Methodology
                Role: InvestigationRole: Methodology
                Role: InvestigationRole: Methodology
                Role: InvestigationRole: Methodology
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                25 February 2022
                2022
                : 17
                : 2
                : e0264465
                Affiliations
                [1 ] Faculty of Sports and Health Science, Fukuoka University, Fukuoka, Japan
                [2 ] Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
                [3 ] Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
                [4 ] Center for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
                Federation University Australia, AUSTRALIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-2288-3399
                Article
                PONE-D-21-30942
                10.1371/journal.pone.0264465
                8880649
                35213652
                cd9b50e8-a29b-4554-b922-fe6a331d4e9e
                © 2022 Nishida et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 24 September 2021
                : 10 February 2022
                Page count
                Figures: 3, Tables: 2, Pages: 15
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100001691, Japan Society for the Promotion of Science;
                Award ID: JP19K24299
                Award Recipient :
                This work was supported by the JSPS KAKENHI (Grant Number JP19K24299), but the findings of the study are independent from the funding organisation. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Physical Sciences
                Physics
                Classical Mechanics
                Motion
                Torque
                Biology and Life Sciences
                Anatomy
                Musculoskeletal System
                Skeleton
                Skeletal Joints
                Knees
                Medicine and Health Sciences
                Anatomy
                Musculoskeletal System
                Skeleton
                Skeletal Joints
                Knees
                Biology and Life Sciences
                Anatomy
                Body Limbs
                Legs
                Knees
                Medicine and Health Sciences
                Anatomy
                Body Limbs
                Legs
                Knees
                Biology and Life Sciences
                Anatomy
                Musculoskeletal System
                Skeleton
                Skeletal Joints
                Knees
                Knee Joints
                Medicine and Health Sciences
                Anatomy
                Musculoskeletal System
                Skeleton
                Skeletal Joints
                Knees
                Knee Joints
                Biology and Life Sciences
                Anatomy
                Body Limbs
                Legs
                Knees
                Knee Joints
                Medicine and Health Sciences
                Anatomy
                Body Limbs
                Legs
                Knees
                Knee Joints
                Biology and Life Sciences
                Anatomy
                Musculoskeletal System
                Skeleton
                Pelvis
                Hip
                Medicine and Health Sciences
                Anatomy
                Musculoskeletal System
                Skeleton
                Pelvis
                Hip
                Medicine and Health Sciences
                Epidemiology
                Medical Risk Factors
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Physical Fitness
                Exercise
                Strength Training
                Medicine and Health Sciences
                Sports and Exercise Medicine
                Exercise
                Strength Training
                Biology and Life Sciences
                Sports Science
                Sports and Exercise Medicine
                Exercise
                Strength Training
                Medicine and Health Sciences
                Sports and Exercise Medicine
                Biology and Life Sciences
                Sports Science
                Sports and Exercise Medicine
                Medicine and Health Sciences
                Critical Care and Emergency Medicine
                Trauma Medicine
                Traumatic Injury
                Musculoskeletal Injury
                Custom metadata
                All relevant data are within the manuscript and its Supporting Information files.

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