Article

Hamstring strain injuries (HSIs) are the most prevalent injury in a number of
sports, and while anterior cruciate ligament (ACL) injuries are less common, they
are far more severe and have long-term implications, such as an increased risk of
developing osteoarthritis later in life. Given the high incidence and severity of
these injuries, they are key targets of injury preventive programs in elite
sport. Evidence has shown that a previous severe knee injury (including ACL
injury) increases the risk of HSI; however, whether the functional deficits that
occur after HSI result in an increased risk of ACL injury has yet to be
considered. In this clinical commentary, we present evidence that suggests that
the link between previous HSI and increased risk of ACL injury requires further
investigation by drawing parallels between deficits in hamstring function after
HSI and in women athletes, who are more prone to ACL injury than men athletes.
Comparisons between the neuromuscular function of the male and female hamstring
has shown that women display lower hamstring-to-quadriceps strength ratios during
isokinetic knee flexion and extension, increased activation of the quadriceps
compared with the hamstrings during a stop-jump landing task, a greater time
required to reach maximal isokinetic hamstring torque, and lower integrated
myoelectrical hamstring activity during a sidestep cutting maneuver. Somewhat
similarly, in athletes with a history of HSI, the previously injured limb,
compared with the uninjured limb, displays lower eccentric knee flexor strength,
a lower hamstrings-to-quadriceps strength ratio, lower voluntary myoelectrical
activity during maximal knee flexor eccentric contraction, a lower knee flexor
eccentric rate of torque development, and lower voluntary myoelectrical activity
during the initial portion of eccentric contraction. Given that the medial and
lateral hamstrings have different actions at the knee joint in the coronal plane,
which hamstring head is previously injured might also be expected to influence
the likelihood of future ACL. Whether the deficits in function after HSI, as seen
in laboratory-based studies, translate to deficits in hamstring function during
typical injurious tasks for ACL injury has yet to be determined but should be a
consideration for future work.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

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