As peak musculotendon force and strain for BF, 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.
Of all the major lower limb muscle groups, the hip extensor and knee flexor muscles during terminal swing demonstrated the most dramatic increase in biomechanical load when running speed progressed toward maximal sprinting.
The return to sport from injury is a difficult multifactorial decision, and risk of reinjury is an important component. Most protocols for ascertaining the return to play status involve assessment of the healing status of the original injury and functional tests which have little proven predictive ability. Little attention has been paid to ascertaining whether an athlete has completed sufficient training to be prepared for competition. Recently, we have completed a series of studies in cricket, rugby league and Australian rules football that have shown that when an athlete's training and playing load for a given week (acute load) spikes above what they have been doing on average over the past 4 weeks (chronic load), they are more likely to be injured. This spike in the acute:chronic workload ratio may be from an unusual week or an ebbing of the athlete's training load over a period of time as in recuperation from injury. Our findings demonstrate a strong predictive (R(2)=0.53) polynomial relationship between acute:chronic workload ratio and injury likelihood. In the elite team setting, it is possible to quantify the loads we are expecting athletes to endure when returning to sport, so assessment of the acute:chronic workload ratio should be included in the return to play decision-making process.
These findings demonstrate that large spikes in workload are associated with an increased injury risk using both models, although the EWMA model is more sensitive to detect increases in injury risk with higher ACWR.
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