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Title: Hamstrings muscle anatomy and function, and implications for strain injury
Authors: Evangelidis, Pavlos
Keywords: Hamstrings
Muscle size
Muscle balance
Aponeurosis size
Muscle composition
Hamstrings-to-quadriceps ratio
Maximal strength
Explosive strength
Issue Date: 2015
Publisher: © P. E. Evangelidis
Abstract: The main aim of this thesis was to examine hamstrings anatomy and its influence on knee flexor muscle function in healthy young men. A secondary aim was to better understand the implications of hamstrings anatomy and function, and their variability, in relation to the risk of strain injury. The functional and conventional H:Q ratios (examined up to high angular velocities) as well as the knee joint angle-specific isometric H:Q ratio exhibited good test-retest reliability at joint positions that closely replicated the conditions of high injury risk. Football players did not exhibit any differences in angle-specific or peak torque H:Q ratios compared to recreationally active controls. Knee extensor and flexor strength, relative to body mass, of footballers and controls was similar for all velocities, except concentric knee flexor strength at 400° s-1 (footballers +40%; P < 0.01). Muscle volume explained 30-71% and 38-58% of the differences between individuals in knee extensors and flexors torque respectively across a range of velocities. A moderate correlation was also found between the volume of these antagonistic muscle groups (R2= 0.41). The relative volume of the knee extensors and flexors explained ~20% of the variance in the isometric H:Q ratio and ~31% in the high velocity functional H:Q ratio. Biceps femoris long head exhibited a balanced myosin heavy chain isoform distribution (47.1% type I and 52.9 % total type II) in young healthy men, while BFlh muscle composition was not related to any measure of knee flexor maximal or explosive strength. Biceps femoris long head proximal aponeurosis area varied considerably between participants (>4-fold) and was not related to biceps femoris long head maximal anatomical cross-sectional area (r= 0.04, P= 0.83). Consequently, the aponeurosis:muscle area ratio exhibited 6-fold variability (range, 0.53 to 3.09; CV= 32.5%). Aponeurosis size was not related to isometric or eccentric knee flexion strength. The findings of this thesis suggest that the main anatomical factor that contributes to knee flexors function in vivo is hamstrings muscle size, while muscle composition and aponeurosis size do not seem to have a significant influence. The high inter-individual variability of the biceps femoris long head proximal aponeurosis size suggests that a disproportionately small aponeurosis may be a risk factor for strain injury. In contrast, biceps femoris long head muscle composition does not seem to explain the high incidence of strain injuries in this muscle. Quadriceps and hamstrings muscle size imbalances contribute to functional imbalances that may predispose to strain injury and correction of any size imbalance may be a useful injury prevention tool. Finally, regular exposure to football training and match-play does not seem to influence the balance of muscle strength around the knee joint.
Description: A Doctoral Thesis. Submitted in partial fulfilment of the requirements for the award of Doctor of Philosophy of Loughborough University.
Sponsor: none
URI: https://dspace.lboro.ac.uk/2134/18033
Appears in Collections:PhD Theses (Sport, Exercise and Health Sciences)

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