Damage and recovery of the intrinsic and extrinsic foot muscles from running a full marathon.

PURPOSE: To investigate the effects of full marathon running on intrinsic and extrinsic foot muscle damage and to determine the relationship with the height change of the longitudinal foot arch following full marathon completion. METHODS: Magnetic resonance imaging-measured transverse relaxation time (T2 ) of the abductor hallucis (ABH), flexor digitorum brevis (FDB) and quadratus plantae (QP), flexor digitorum longus (FDL), tibialis posterior (TP), and flexor hallucis longus (FHL) from 22 collegiate runners were assessed before and 1, 3, and 8 days after full marathon running. The three-dimensional foot posture of 10 of the 22 runners was further obtained using a foot scanner system before and 1, 3, and 8 days after the marathon. RESULTS: Marathon-induced increases in T2 were observed in the QP, FDL, TP, and FHL 1 day after the marathon (+7.5%, +4.7%, +6.7%, and +5.9%, respectively), with the increased T2 of TP persisting until 3 days after the marathon (+4.6%). T2 changes of FDL and FHL from pre-marathon to DAY 1 showed direct correlations with the corresponding change in the arch height ratio (r = 0.823, p = 0.003, and r = 0.658, p = 0.038). CONCLUSION: The damage and recovery response from a full marathon differed among muscles; QP, FDL, TP, and FHL increased T2 after the marathon, whereas ABH and FDB did not. In addition, T2 changes in FDL and FHL and the arch height ratio change were correlated. Our results suggest that the extrinsic foot muscles could be more susceptible to damage than the intrinsic during marathon running.

Differences in the recruitment properties of the corticospinal pathway between the biceps femoris and rectus femoris muscles.

The neuromuscular activity in the hamstring and quadriceps muscles is vital for rapid force control during athletic movements. This study aimed to investigate the recruitment properties of the corticospinal pathway of the biceps femoris long head (BFlh) and rectus femoris (RF) muscles. Thirty-two male subjects were participated in this study. Corticospinal excitability was investigated for BFlh and RF during the isometric knee flexion and extension tasks, respectively, using transcranial magnetic stimulation. A sigmoidal relationship was observed between the stimulus intensity and amplitude of motor-evoked potentials and characterized by a plateau value, maximum slope, and threshold. Compared with RF, BFlh had a significantly lower plateau value (P < 0.001, d = 1.17), maximum slope (P < 0.001, r = 0.79), and threshold (P = 0.003, d = 0.62). The results showed that the recruitment properties of the corticospinal pathway significantly differ between BFlh and RF. These results reveal that when a sudden large force is required during athletic movements, the RF can produce force through a rapid increase in the recruitment of motor units. The BFlh, on the other hand, requires larger or more synchronized motor commands for enabling the proper motor unit behavior to exert large forces. These differences in the neurophysiological factors between the hamstrings and quadriceps can have a substantial effect on the balance of force generation during athletic activities.

Neuromuscular responses of the hamstring and lumbopelvic muscles during unanticipated trunk perturbations.

Hamstring strain often occurs when an opponent unanticipatedly perturbs an athlete's movements. We examined the neuromuscular responses of hamstring and trunk muscles during unanticipated trunk perturbations in athletes with and without a history of hamstring strain injury. Male college athletes (11 with a history of a unilateral hamstring injury and 10 without prior injury) knelt while wearing a chest harness attached to a cable that was pulled backward. They were instructed to resist the force isometrically and maintain their position when the perturbations were applied. The pressure was released with or without a cue (CUE or NoCUE). We measured trunk acceleration, three-dimensional kinematic data, and surface electromyography (EMG) signals of the erector spinae, internal oblique, gluteus maximus, biceps femoris long head, and semitendinosus muscles. Maximum trunk acceleration and displacement were greater with NoCUE in both groups (p < 0.05). EMG amplitude did not differ after perturbation of any investigated muscle. The injured group demonstrated a delayed onset of the gluteus maximus and erector spinae muscles in NoCUE versus CUE stimuli (p < 0.05). Athletes with a history of hamstring strain injury exhibited a reduced neuromuscular coordination of the lumbopelvic muscles in response to unanticipated trunk movement.

Biceps Femoris Muscle is Activated by Performing Nordic Hamstring Exercise at a Shallow Knee Flexion Angle.

The semitendinosus (ST) muscle is primarily used during Nordic hamstring exercise (NHE), which is often prescribed for preventing hamstring injury, though the biceps femoris long head (BFlh) muscle that is more susceptible to injuries. Thus, this study aimed to identify the modulation of BFlh muscle activity with different knee flexion angles during NHE using an inclined platform. Fourteen male athletes performed NHE and maintained their position at maximum inclination (NH). Subjects also performed isometric NHE using a platform inclined to 50° (ICL) and 40° (ICH), and the knee flexion angle was controlled to 50° and 30°. The electromyography (EMG) activity of the BFlh, ST, semimembranosus, gluteus maximus, elector spinae, and rectus abdominus muscles was determined during each exercise. The EMG of the ST was higher than that of the BFlh during NHE and the highest of all muscles in all exercises (p < 0.05). Moreover, the activity of the BFlh tended to be higher than that of the ST for ICH than for ICL, regardless of the knee joint angle. The activity of the BFlh becomes equivalent to that of the ST during NHE at a knee flexion angle of less than 50°. These results indicate that performing NHE at a shallow knee flexion angle will enhance the activity of the BFlh muscle.

Increase in foot arch asymmetry after full marathon completion.

Long-distance running results in lowering of the foot medial longitudinal arch, but it is unknown whether the left and right arches decrease equally. This study aimed to determine whether foot arch asymmetry increases upon completion of a full marathon and to identify factors capable of explaining the degree of asymmetry of navicular height and navicular height displacement. The three-dimensional foot posture data of 74 collegiate runners were obtained using an optical foot scanner system before (PRE) and immediately after (POST) a full marathon. The navicular height and arch height ratio (normalised navicular height by foot length) of both feet significantly decreased from PRE to POST full marathon completion (44.3 ± 6.3 mm versus 40.8 ± 6.5 mm, 17.8 ± 2.5 versus 16.6 ± 2.7, respectively; p < 0.001, both). The asymmetry of the arch height ratio was significantly greater POST than PRE marathon. Multiple linear regression analysis indicated that the POST-race Asymmetry Index (AI) of navicular height was significantly predicted by the PRE-race AI of navicular height; navicular height displacement was predicted by PRE-race navicular height and the marathon time. Full marathon running induced increasing asymmetry and lowering of the medial longitudinal arch in runners.

Greater knee varus angle and pelvic internal rotation after landing are predictive factors of a non-contact lateral ankle sprain.

OBJECTIVES: This study aimed to clarify the kinematic, kinetic characteristics associated with lateral ankle sprain. DESIGN: A 16-month prospective cohort study. SETTING: Laboratory. PARTICIPANTS: A total of 179 college athletes. MAIN OUTCOME MEASURES: Joint kinematics, moment during single-leg landing tasks, and ankle laxity were measured. The attendance of each participating team, injury mechanism, existence of body contact, presence of orthosis, with or without medical diagnosis, and periods of absence were recorded. RESULTS: Twenty-nine participants incurred lateral ankle sprain during non-contact motion. The Cox regression analysis revealed that greater knee varus peak angle (hazard ratio: 1.16 [95% confidence interval: 1.10-1.22], p < 0.001) and greater pelvic internal rotation peak angle toward the support leg were associated with lateral ankle sprain (hazard ratio: 1.08 [95% confidence interval: 1.02-1.15], p = 0.009). The cut-off values for each predictive factor were -0.17° (area under the curve = 0.89, p < 0.001) and 6.63° (area under the curve = 0.74, p < 0.001), respectively. CONCLUSIONS: A greater knee varus peak angle and pelvic internal rotation peak angle after single-leg landing are predictive factors for lateral ankle sprain.

Regional differences in hamstring muscle damage after a marathon.

Previous studies suggest that marathon running induces lower extremity muscle damage. This study aimed to examine inter- and intramuscular differences in hamstring muscle damage after a marathon using transverse relaxation time (T2)-weighted magnetic resonance images (MRI). 20 healthy collegiate marathon runners (15 males) were recruited for this study. T2-MRI was performed before (PRE) and at 1 (D1), 3 (D3), and 8 days (D8) after marathon, and the T2 values of each hamstring muscle at the distal, middle, and proximal sites were calculated. Results indicated that no significant intermuscular differences in T2 changes were observed and that, regardless of muscle, the T2 values of the distal and middle sites increased significantly at D1 and D3 and recovered at D8, although those values of the proximal site remained constant. T2 significantly increased at distal and middle sites of the biceps femoris long head on D1 (p = 0.030 and p = 0.004, respectively) and D3 (p = 0.007 and p = 0.041, respectively), distal biceps femoris short head on D1 (p = 0.036), distal semitendinosus on D1 (p = 0.047) and D3 (p = 0.010), middle semitendinosus on D1 (p = 0.005), and distal and middle sites of the semimembranosus on D1 (p = 0.008 and p = 0.040, respectively) and D3 (p = 0.002 and p = 0.018, respectively). These results suggest that the distal and middle sites of the hamstring muscles are more susceptible to damage induced by running a full marathon. Conditioning that focuses on the distal and middle sites of the hamstring muscles may be more useful in improving recovery strategies after prolonged running.

Movements with greater trunk accelerations and their properties during badminton games.

This study aimed to elucidate the movements requiring greater trunk accelerations and its frequencies during badminton games, and compare the acceleration components among such movements. Trunk acceleration was measured using a triaxial accelerometer during badminton games. The moments that generated >4 G resultant acceleration were extracted, and movements consistent with the extracted moments were identified. We calculated the extracted movement ratio and frequency and compared the resultant, mediolateral, vertical and anteroposterior accelerations between the top five extracted movements. There were 1,342 movements that generated >4 G [mean, 7.72 (95% confidence interval, 7.31-8.14) cases/min]. The top five movements were lunging during underhand strokes with the dominant hand side leg, landing after overhand strokes on the dominant and non-dominant hand side leg, and cutting from a split step using the dominant and non-dominant hand side leg. Landing on the dominant hand side leg had a greater resultant acceleration than the other movements and had the greatest impact during the badminton game. Lunging during underhand strokes on the dominant hand side leg had greater mediolateral acceleration than the other movements. These results reflected the properties of badminton.

Hamstring muscles' function deficit during overground sprinting in track and field athletes with a history of strain injury.

In this study, we aimed to clarify the characteristics of neuromuscular function, kinetics, and kinematics of the lower extremity during sprinting in track and field athletes with a history of strain injury. Ten male college sprinters with a history of unilateral hamstring injury performed maximum effort sprint on an athletic track. The electromyographic (EMG) activity of the long head of the biceps femoris (BFlh) and gluteus maximus (Gmax) muscles and three-dimensional kinematic data were recorded. Bilateral comparisons were performed for the EMG activities, pelvic anterior tilt angle, hip and knee joint angles and torques, and the musculotendon length of BFlh. The activity of BFlh in the previously injured limb was significantly lower than that in the uninjured limb during the late-swing phase of sprinting (p < 0.05). However, the EMG activity of Gmax was not significantly different between the previously injured and uninjured limbs. Furthermore, during the late-swing phase, a significantly more flexed knee angle (p < 0.05) and a decrease in BFlh muscle length (p < 0.05) were noted in the injured limb. It was concluded that previously injured hamstring muscles demonstrate functional deficits during the late swing phase of sprinting in comparison with the uninjured contralateral muscles.

Japanese translation and modification of the Oslo Sports Trauma Research Centre overuse injury questionnaire to evaluate overuse injuries in female college swimmers.

The purpose of the present study was to translate and modify the Oslo Sports Trauma Research Centre (OSTRC) overuse injury questionnaire into Japanese and validate it among Japanese athletes through a longitudinal survey. A modified back-translation method was used to translate the questionnaire from English to Japanese. The longitudinal survey was performed in 29 female college swimmers who were followed up for more than 24 consecutive weeks. The response rate to the 24 weekly questionnaires was 88.8% (95% confidence interval [CI]: 85.2-92.3). Internal consistency was measured by using Cronbach's alpha (0.73 (0.69-0.77)). The anatomical areas most frequently affected by overuse injuries were the lower back (average weekly prevalence: 27.6%, 95% CI: 25.1-30.1), shoulder (16.0%, 95% CI: 13.7-18.2), knee (9.9%, 95% CI: 7.7-12.0), and ankle (9.0%, 7.6-10.5). The severity score showed that knee (22.5, range: 6-65), ankle (21.5, range: 6-67), and lower back (20.7, range: 6-80) injuries had the greatest impact. The Japanese version of the modified OSTRC overuse injury questionnaire demonstrated reliability and validity based on the results of internal consistency and trend of injury of the swimmers. The participants in the present study did not have substantial injuries or time-loss injuries and continued practicing and competing, despite these minor injuries. Although knee and ankle injuries do not occur as often as lower back and shoulder injuries, these injuries often had a greater impact on swimmers when they did occur.

Tracking of Time-Dependent Changes in Muscle Hardness After a Full Marathon.

Inami, T, Nakagawa, K, Yonezu, T, Fukano, M, Higashihara, A, Iizuka, S, Abe, T, and Narita, T. Tracking of time-dependent changes in muscle hardness after a full marathon. J Strength Cond Res 33(12): 3431-3437, 2019-We sought to identify changes in individual muscle hardness after a full marathon and to track time-dependent changes using ultrasound strain elastography (SE). Twenty-one collegiate marathon runners were recruited. Muscle hardness (i.e., strain ratio, SR) was measured using SE for the rectus femoris (RF), vastus lateralis (VL), biceps femoris (BF) long head, tibialis anterior (TA), gastrocnemius medial (GM) head, and soleus (SOL) muscles at the following time points: pre (PRE), immediately post (POST), day-1 (D1), day-3 (D3), and day-8 (D8), after a full marathon. We found that the SR decreased after the full marathon (i.e., the muscle became harder), and that the lowest SR across all measured muscles was observed on D1. Although there was no difference in the magnitude of change in SR between the muscles of the thigh, that of the MG and SOL were significantly larger than that of the TA. Muscle hardness in the vastus lateralis, biceps femoris, and SOL recovered at D8 (i.e., nonsignificant difference from PRE), whereas recovery of rectus femoris and gastrocnemius medial hardness at D8 was not observed. Thus, the degree of change in muscle hardness does not occur uniformly within the lower extremity muscles. In particular, changes in muscle hardness of the TA after a full marathon are small compared with other muscles and time-dependent changes in each muscle vary during recovery. The features of muscle hardness identified in this study will be useful for coaches when mentoring runners on proper forms and for training advisers and therapists who seek to address deficiencies in running.

Differences in hamstring activation characteristics between the acceleration and maximum-speed phases of sprinting.

This study aimed to investigate activation characteristics of the biceps femoris long head (BFlh) and semitendinosus (ST) muscles during the acceleration and maximum-speed phases of sprinting. Lower-extremity kinematics and electromyographic (EMG) activities of the BFlh and ST muscles were examined during the acceleration sprint and maximum-speed sprint in 13 male sprinters during an overground sprinting. Differences in hamstring activation during each divided phases and in the hip and knee joint angles and torques at each time point of the sprinting gait cycle were determined between two sprints. During the early stance of the acceleration sprint, the hip extension torque was significantly greater than during the maximum-speed sprint, and the relative EMG activation of the BFlh muscle was significantly higher than that of the ST muscle. During the late stance and terminal mid-swing of maximum-speed sprint, the knee was more extended and a higher knee flexion moment was observed compared to the acceleration sprint, and the ST muscle showed higher activation than that of the BFlh. These results indicate that the functional demands of the medial and lateral hamstring muscles differ between two different sprint performances.

Relationship between the peak time of hamstring stretch and activation during sprinting.

The purpose of this study was to investigate the time series relationships between the peak musculotendon length and electromyography (EMG) activation during overground sprinting to clarify the risk of muscle strain injury incidence in each hamstring muscle. Full-body kinematics and EMG of the right biceps femoris long head (BFlh) and semitendinosus (ST) muscles were recorded in 13 male sprinters during overground sprinting at maximum effort. The hamstring musculotendon lengths during sprinting were computed using a three-dimensional musculoskeletal model. The time of the peak musculotendon length, in terms of the percentage of the running gait cycle, was measured and compared with that of the peak EMG activity. The maximum length of the hamstring muscles was noted during the late swing phase of sprinting. The peak musculotendon length was synchronous with the peak EMG activation in the BFlh muscle, while the time of peak musculotendon length in the ST muscle occurred significantly later than the peak level of EMG activation (p < 0.05). These results suggest that the BFlh muscle is exposed to an instantaneous high tensile force during the late swing phase of sprinting, indicating a higher risk for muscle strain injury.

Differences in activation properties of the hamstring muscles during overground sprinting.

The purpose of this study was to quantify activation of the biceps femoris (BF) and medial hamstring (MH) during overground sprinting. Lower-extremity kinematics and electromyography (EMG) of the BF and MH were recorded in 13 male sprinters performing overground sprinting at maximum effort. Mean EMG activity was calculated in the early stance, late stance, mid-swing, and late-swing phases. Activation of the BF was significantly greater during the early stance phase than the late stance phase (p<0.01). Activation of the BF muscle was significantly lower during the first half of the mid-swing phase than the other phases (p<0.05). The MH had significantly greater EMG activation relative to its recorded maximum values compared to that for the BF during the late stance (p<0.05) and mid-swing (p<0.01) phases. These results indicate that the BF shows high activation before and after foot contact, while the MH shows high activation during the late stance and mid-swing phases. We concluded that the activation properties of the BF and MH muscles differ within the sprinting gait cycle.

Effects of forward trunk lean on hamstring muscle kinematics during sprinting.

This study aimed to investigate the effects of forward trunk lean on hamstring muscle kinematics during sprinting. Eight male sprinters performed maximal-effort sprints in two trunk positions: forward lean and upright. A three-dimensional musculoskeletal model was used to compute the musculotendon lengths and velocity of the biceps femoris long head, semitendinosus, and semimembranosus muscles during the sprinting gait cycle. The musculotendon lengths of all the three hamstring muscles at foot strike and toe-off were significantly greater during the forward trunk lean sprint than during the upright trunk sprint. In addition, a positive peak musculotendon lengthening velocity was observed in the biceps femoris long head and semimembranosus muscles during the late stance phase, and musculotendon lengths at that instant were significantly greater during the forward trunk lean sprint than during the upright trunk sprint. The present study provides significant evidence that a potential for hamstring muscle strain injury involving forward trunk lean sprinting would exist during the stance phase. The results also indicate that the biceps femoris long head and semimembranosus muscles are stretched during forward trunk lean sprinting while contracting eccentrically in the late stance phase; thus, the elongation load on these muscles could be increased.

Change in muscle thickness under contracting conditions following return to sports after a hamstring muscle strain injury-A pilot study.

The purpose of this study was to measure the change in hamstring muscle thickness between contracting and relaxing conditions following a return to sports after a hamstring muscle strain and thereby evaluate muscle function. Six male track and field sprinters participated in this study. All had experienced a prior hamstring strain injury that required a minimum of 2 weeks away from sport participation. Transverse plane scans were performed at the following four points on the affected and unaffected sides under contracting and relaxing conditions: proximal biceps femoris long head, proximal semitendinosus, middle biceps femoris long head, and middle semitendinosus. The results demonstrated an increase in the thickness of the middle biceps femoris long head and middle semitendinosus regions on the unaffected side with contraction, whereas the affected side did not show a significant increase. The proximal semitendinosus muscle thickness was increased with contraction on both the unaffected and the affected sides. By contrast, the proximal biceps femoris muscle thickness did not show a significant increase on both sides. The results of this study show that evaluation of muscle thickness during contraction may be useful for assessing the change in muscle function after a hamstring muscle strain injury.

Mechanics of the muscles crossing the hip joint during sprint running.

We aimed to demonstrate the changes over time in the lengths and forces of the muscles crossing the hip joint during overground sprinting and investigate the relationships between muscle lengths and muscle-tendon unit forces - particularly peak biceps femoris force. We obtained three-dimensional kinematics during 1 running cycle from 8 healthy sprinters sprinting at maximum speed. Muscle lengths and muscle-tendon unit forces were calculated for the iliacus, rectus femoris, gluteus maximus, and biceps femoris muscles of the target leg as well as the contralateral iliacus and rectus femoris. Our results showed that during sprinting, the muscles crossing the hip joint demonstrate a stretch-shortening cycle and 1 or 2 peak forces. The timing of peak biceps femoris force, expressed as a percentage of the running cycle (mean [SD], 80.5 [2.9]%), was synchronous with those of the maximum biceps femoris length (82.8 [1.9]%) and peak forces of the gluteus maximus (83.8 [9.1]%), iliacus (81.1 [5.2]%), and contralateral iliacus (78.5 [5.8]%) and also that of the peak pelvic anterior tilt. The force of the biceps femoris appeared to be influenced by the actions of the muscles crossing the hip joint as well as by the pelvic anterior tilt.

Hamstring functions during hip-extension exercise assessed with electromyography and magnetic resonance imaging.

The purpose of this study was to compare the recruitment patterns in hamstring muscles during hip extension exercise by electromyography (EMG) and muscle functional magnetic resonance imaging (mfMRI). Six male volunteers performed 5 sets of 10 repetitions of the hip extension exercise. Electromyography (EMG) activity during the exercise was recorded for the biceps femoris long head (BFlh), semitendinosus (ST), and semimembranosus (SM) muscles; mfMRI T2 values and cross-sectional areas (CSAs) of the same muscles were measured at rest, immediately after, 2 and 7 days after the exercise. The study found that EMG of the BFlh and SM were significantly higher than that of the ST. Immediately after the exercise, the T2 value and CSA changes in the SM showed a significant increase. It was concluded that the BFlh and SM were selectively recruited during the hip extension exercise.

Functional differences in the activity of the hamstring muscles with increasing running speed.

In this study, we examined hamstring muscle activation at different running speeds to help better understand the functional characteristics of each hamstring muscle. Eight healthy male track and field athletes (20.1 +/- 1.1 years) performed treadmill running at 50%, 75%, 85%, and 95% of their maximum velocity. Lower extremity kinematics of the hip and knee joint were calculated. The surface electromyographic activities of the biceps femoris and semitendinosus muscles were also recorded. Increasing the running speed from 85% to 95% significantly increased the activation of the hamstring muscles during the late swing phase, while lower extremity kinematics did not change significantly. During the middle swing phase, the activity of the semitendinosus muscle was significantly greater than that of the biceps femoris muscle at 75%, 85%, and 95% of running speed. Statistically significant differences in peak activation time were observed between the biceps femoris and semitendinosus during 95%max running (P < 0.05 for stance phase, P < 0.01 for late swing phase). Significant differences in the activation patterns between the biceps femoris and semitendinosus muscles were observed as running speed was increased, indicating that complex neuromuscular coordination patterns occurred during the running cycle at near maximum sprinting speeds.