Hamstrings Muscle Morphology After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis

Sherman, David A.; Rush, Justin L.; Glaviano, Neal R.; Norte, Grant E.

doi:10.1007/s40279-021-01431-y

Cited by 22 publications

(12 citation statements)

References 50 publications

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“…37 Postoperative ST atrophy may shorten its fascicle length thereby reducing active operating range. 38 Reduction of physiological CSA will lower muscle force capacity and therefore impair ST generated posterior tibial drawer which supports the ACL. 39 The greatest deficits in ST peak CSA and volume were found This study had limitations that should be considered.…”

Section: Regional Differences In Muscle Morphologymentioning

confidence: 99%

Shape differences in the semitendinosus following tendon harvesting for anterior cruciate ligament reconstruction

Moulin

Bourne

Diamond

et al. 2022

Journal Orthopaedic Research

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Following hamstring autograft anterior cruciate ligament reconstruction (ACLR), muscle length, cross-sectional area, and volume are reduced. However, these discrete measures of morphology do not account for complex three-dimensional muscle shape. The primary aim of this study was to determine between-limb semitendinosus (ST) shape and regional morphology differences in young adults following tendon harvest for ACLR and to compare these differences with those in healthy controls. In this cross-sectional study, magnetic resonance imaging was performed on 18 individuals with unilateral ACLR and 18 healthy controls.Bilaterally, ST muscles were segmented, and shape differences assessed between limbs and compared between groups using Jaccard index (0-1) and Hausdorff distance (mm). Length (cm), peak cross-sectional area (cm 2 ), and volume (cm 3 ) were measured for the entire muscle and proximal, middle, and distal regions, and compared between limbs and groups. Compared to healthy controls, the ACLR group had significantly (p < 0.001, Cohen's d = −2.33) lower bilateral ST shape similarity and shape deviation was significantly (p < 0.001, d = 2.12) greater. Shape deviation was greatest within the distal region of the ACLR (Hausdorff: 23.1 ± 8.68 mm). Compared to both the uninjured contralateral limb and healthy controls, deficits in peak crosssectional area and volume in ACLR group were largest in proximal (p < 0.001, d = −2.52 to −1.28) and middle (p < 0.001, d = −1.81 to −1.04) regions of the ST.Overall, shape analysis provides unique insight into regional adaptations in ST morphology post-ACLR. Findings highlight morphological features in distal ST not identified by traditional discrete morphology measures. Clinical significance:Following ACLR, risk of a secondary knee or primary hamstring injury has been reported to be between 2-to-5 times greater compared to those without ACLR.Change in semitendinosus (ST) shape following ACLR may affect force transmission and distribution within the hamstrings and might contribute to persistent deficits in knee flexor and internal rotator strength.

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Section: Regional Differences In Muscle Morphologymentioning

confidence: 99%

Shape differences in the semitendinosus following tendon harvesting for anterior cruciate ligament reconstruction

Moulin

Bourne

Diamond

et al. 2022

Journal Orthopaedic Research

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“…This aspect seems to be more frequently investigated with reference to the post traumatic picture (Rush et al, 2020;Sherman et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

The Acute Effects of Small-Sided Games on Hamstring Strength in Young Soccer Players

Sannicandro

Cofano

Raiola

2022

Teor. metod. fiz. vihov.

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The study purpose.The Small-side games (SSG) are high intensity drills very popular in soccer training. The knowledge of the acute effects of the exercises that make up the training session is very relevant especially to reduce youth soccer injury risk. This study aim to assessment the acute effects of SSG on hamstring eccentric strength and to know the lower limb strength asymmetries (LLSA) in young soccer players. Materials and methods. The sample is composed of male young soccer players Under 17 (n = 24, 16.6 ± 0.5 years, 168.8 ± 4.6 cm, 58.2 ± 3.5 kg). Before and after SSG (4vs4, 3×4 min, 3min recovery, no goalkeepers) the hamstring eccentric strength and the lower limb eccentric strength asymmetry were evaluated used a specific dynamometer (N3 Easytech, Italy) and relative software. Every young soccer player performed a single repetition of the Nordic hamstring exercise with dynamometer; after about 2 minutes, instead, they performed 5 repetitions of the same exercise, without interruption. For both assessments, were detected the eccentric strength and the LLSA. Results. The hamstring eccentric strength assessment show substantial and statistically significant differences in the assessment in comparison pre-post values. A significant reduction was observed for eccentric strength peak (p < 0.018 and p < 0.014 for right/left limb), for eccentric average strength (p < 0.017 and p < 0.006 for right/left limb). The eccentric peak strength asymmetry value and the average strength asymmetry value revealed a significant increase (p < 0.0001). Conclusions. The reduction of strength after SSG requires careful consideration of the exercises order in the training session. The practitioners can plan training sessions and apply SSGs more effectively, with more attention to the effects on hamstrings.

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“…Muscle weakness, activation failure, and volume loss are hallmark characteristics consistently observed among individuals with a history of joint injury or pathology (eg, ACL tear, knee pain, chronic ankle instability, osteoarthritis [OA]). 9,[11][12][13][14][15][16][17][18][19][20][21] Clinically, these signs indicate a diminished ability to voluntarily contract skeletal muscle tissue following injury. However, to understand this phenomenon from a neurophysiological perspective, we must consider motor neuron behavior as muscle function is dependent on both the availability of motor neurons and the ability to voluntarily recruit them.…”

Section: Clinical Relevance Of Amimentioning

confidence: 99%

“…In cases like ACLR, where the antagonist (hamstrings) and agonist (quadriceps) are both weakened due to atrophy, this may be a beneficial intervention for improving agonist efficiency by reducing antagonist coactivation, particularly because individuals with ACLR present with an increase in hamstrings neural activity and higher hamstrings-toquadriceps coactivation, 162,163 despite the hamstrings being weaker and atrophied. 13,[164][165][166] Two studies 167,168 have formally investigated the immediate effects of antagonist fatigue to increase agonist neuromuscular function in individuals with ACLR. Both showed increases in quadriceps strength and voluntary quadriceps activation as well as reductions in hamstring-to-quadriceps coactivation.…”

Section: Clinical Bottom Linementioning

confidence: 99%

Arthrogenic Muscle Inhibition: Best Evidence, Mechanisms, and Theory for Treating the Unseen in Clinical Rehabilitation

Norte¹,

Rush²,

Sherman³

2022

Journal of Sport Rehabilitation

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Context: Arthrogenic muscle inhibition (AMI) impedes the recovery of muscle function following joint injury, and in a broader sense, acts as a limiting factor in rehabilitation if left untreated. Despite a call to treat the underlying pathophysiology of muscle dysfunction more than three decades ago, the continued widespread observations of post-traumatic muscular impairments are concerning, and suggest that interventions for AMI are not being successfully integrated into clinical practice. Objectives: To highlight the clinical relevance of AMI, provide updated evidence for the use of clinically accessible therapeutic adjuncts to treat AMI, and discuss the known or theoretical mechanisms for these interventions. Evidence Acquisition: PubMed and Web of Science electronic databases were searched for articles that investigated the effectiveness or efficacy of interventions to treat outcomes relevant to AMI. Evidence Synthesis: 122 articles that investigated an intervention used to treat AMI among individuals with pathology or simulated pathology were retrieved from 1986 to 2021. Additional articles among uninjured individuals were considered when discussing mechanisms of effect. Conclusion: AMI contributes to the characteristic muscular impairments observed in patients recovering from joint injuries. If left unresolved, AMI impedes short-term recovery and threatens patients’ long-term joint health and well-being. Growing evidence supports the use of neuromodulatory strategies to facilitate muscle recovery over the course of rehabilitation. Interventions should be individualized to meet the needs of the patient through shared clinician–patient decision-making. At a minimum, we propose to keep the treatment approach simple by attempting to resolve inflammation, pain, and effusion early following injury.

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Hamstrings Muscle Morphology After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis

Cited by 22 publications

References 50 publications

Shape differences in the semitendinosus following tendon harvesting for anterior cruciate ligament reconstruction

Shape differences in the semitendinosus following tendon harvesting for anterior cruciate ligament reconstruction

The Acute Effects of Small-Sided Games on Hamstring Strength in Young Soccer Players

Arthrogenic Muscle Inhibition: Best Evidence, Mechanisms, and Theory for Treating the Unseen in Clinical Rehabilitation

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