Individual distribution of muscle hypertrophy among hamstring muscle heads: Adding muscle volume where you need is not so simple.

PURPOSE: The aim of this study was to determine whether a 9-week resistance training program based on high load (HL) versus low load combined with blood flow restriction (LL-BFR) induced a similar (i) distribution of muscle hypertrophy among hamstring heads (semimembranosus, SM; semitendinosus, ST; and biceps femoris long head, BF) and (ii) magnitude of tendon hypertrophy of ST, using a parallel randomized controlled trial. METHODS: A total of 45 participants were randomly allocated to one of three groups: HL, LL-BFR, and control (CON). Both HL and LL-BFR performed a 9-week resistance training program composed of seated leg curl and stiff-leg deadlift exercises. Freehand 3D ultrasound was used to assess the changes in muscle and tendon volume. RESULTS: The increase in ST volume was greater in HL (26.5 ± 25.5%) compared to CON (p = 0.004). No difference was found between CON and LL-BFR for the ST muscle volume (p = 0.627). The change in SM muscle volume was greater for LL-BFR (21.6 ± 27.8%) compared to CON (p = 0.025). No difference was found between HL and CON for the SM muscle volume (p = 0.178).There was no change in BF muscle volume in LL-BFR (14.0 ± 16.5%; p = 0.436) compared to CON group. No difference was found between HL and CON for the BF muscle volume (p = 1.0). Regarding ST tendon volume, we did not report an effect of training regimens (p = 0.411). CONCLUSION: These results provide evidence that the HL program induced a selective hypertrophy of the ST while LL-BFR induced hypertrophy of SM. The magnitude of the selective hypertrophy observed within each group varied greatly between individuals. This finding suggests that it is very difficult to early determine the location of the hypertrophy among a muscle group.

Maximal shortening velocity during plantar flexion: Effects of pre-activity and initial stretching state.

We investigated the effects of the initial length of the muscle-tendon unit (MTU) and muscle pre-activation on muscle-tendon interactions during plantarflexion performed at maximal velocity. Ultrasound images of gastrocnemius medialis were obtained on 11 participants in three conditions: (a) active plantarflexion performed at maximal velocity from three increasingly stretched positions (10°, 20°, and 30° dorsiflexion), (b) passive plantarflexion induced by a quick release of the ankle joint from the same three positions, and (c) pre-activation, which consisted of a maximal isometric contraction of the plantarflexors at 10° of dorsiflexion followed by a quick release of ankle joint. During the active condition at maximal velocity, initial MTU stretch positively influenced ankle joint velocity (+15.3%) and tendinous tissues shortening velocity (+37.6%) but not the shortening velocity peak value reached by muscle fascicle. The muscle fascicle was shortened during the passive condition; however, its shortening velocity never exceeded peak velocity measured in the active condition. Muscle pre-activation resulted in a considerable increase in ankle joint (+114.7%) and tendinous tissues velocities (+239.1%), although we observed a decrease in muscle fascicle shortening velocity. During active plantarflexion at maximal velocity, initial MTU length positively influences ankle joint velocity by increasing the contribution of tendinous tissues. Although greater initial stretch of the plantarflexors (ie, 30° dorsiflexion) increased the passive velocity of the fascicle during initial movement, its peak velocity was not affected. As muscle pre-activation prevented reaching the maximal muscle fascicle shortening velocity, this condition should be used to characterize tendinous tissues rather than muscle contractile properties.

Cryotherapy induces an increase in muscle stiffness.

Although cold application (ie, cryotherapy) may be useful to treat sports injuries and to prevent muscle damage, it is unclear whether it has adverse effects on muscle mechanical properties. This study aimed to determine the effect of air-pulsed cryotherapy on muscle stiffness estimated using ultrasound shear wave elastography. Myoelectrical activity, ankle passive torque, shear modulus (an index of stiffness), and muscle temperature of the gastrocnemius medialis were measured before, during an air-pulsed cryotherapy (-30°C) treatment of four sets of 4 minutes with 1-minute recovery in between and during a 40 minutes postcryotherapy period. Muscle temperature significantly decreased after the second set of treatment (10 minutes: 32.3±2.5°C; P<.001), peaked at 29 minutes (27.9±2.2°C; P<.001) and remained below baseline values at 60 minutes (29.5±2.0°C; P<.001). Shear modulus increased by +11.5±11.8% after the second set (10 minutes; P=.011), peaked at 30 minutes (+34.7±42.6%; P<.001), and remained elevated until the end of the post-treatment period (+25.4±17.1%; P<.001). These findings provide evidence that cryotherapy induces an increase in muscle stiffness. This acute change in muscle mechanical properties may lower the amount of stretch that the muscle tissue is able to sustain without subsequent injury. This should be considered when using cryotherapy in athletic practice.

Achilles and patellar tendinopathy display opposite changes in elastic properties: A shear wave elastography study.

To compare tendon elastic and structural properties of healthy individuals with those with Achilles or patellar tendinopathy. Sixty-seven participants (22 Achilles tendinopathy, 17 patellar tendinopathy, and 28 healthy controls) were recruited between March 2015 and March 2016. Shear wave velocity (SWV), an index of tissue elastic modulus, and tendon thickness were measured bilaterally at mid-tendon and insertional regions of Achilles and patellar tendons by an examiner blinded to group. Analysis of covariance, adjusted for age, body mass index, and sex was used to compare differences in tendon thickness and SWV between the two tendinopathy groups (relative to controls) and regions. Tendon thickness was included as a covariate for analysis of SWV. Compared to controls, participants with Achilles tendinopathy had lower SWV at the distal insertion (Mean difference MD; 95% CI: -1.56; -2.49 to -0.62 m/s; P < .001) and greater thickness at the mid-tendon (MD 0.19; 0.05-0.33 cm; P = .007). Compared to controls, participants with patellar tendinopathy had higher SWV at both regions (MD 1.25; 0.40-2.10 m/s; P = .005) and greater thickness proximally (MD 0.17; 0.06-0.29 cm; P = .003). Compared to controls, participants with Achilles and patellar tendinopathy displayed lower Achilles tendon elastic modulus and higher patellar tendon elastic modulus, respectively. More research is needed to explore whether maturation, aging, or chronic load underlie these findings and whether current management programs for Achilles and patellar tendinopathy need to be tailored to the tendon.

Can chronic stretching change the muscle-tendon mechanical properties? A review.

It is recognized that stretching is an effective method to chronically increase the joint range of motion. However, the effects of stretching training on the muscle-tendon structural properties remain unclear. This systematic review with meta-analysis aimed to determine whether chronic stretching alter the muscle-tendon structural properties. Published papers regarding longitudinal stretching (static, dynamic and/or PNF) intervention (either randomized or not) in humans of any age and health status, with more than 2 weeks in duration and at least 2 sessions per week, were searched in PubMed, PEDro, ScienceDirect and ResearchGate databases. Structural or mechanical variables from joint (maximal tolerated passive torque or resistance to stretch) or muscle-tendon unit (muscle architecture, stiffness, extensibility, shear modulus, volume, thickness, cross-sectional area, and slack length) were extracted from those papers. A total of 26 studies were selected, with a duration ranging from 3 to 8 weeks, and an average total time under stretching of 1165 seconds per week. Small effects were seen for maximal tolerated passive torque, but trivial effects were seen for joint resistance to stretch, muscle architecture, muscle stiffness, and tendon stiffness. A large heterogeneity was seen for most of the variables. Stretching interventions with 3- to 8-week duration do not seem to change either the muscle or the tendon properties, although it increases the extensibility and tolerance to a greater tensile force. Adaptations to chronic stretching protocols shorter than 8 weeks seem to mostly occur at a sensory level.

Effects of hip and head position on ankle range of motion, ankle passive torque, and passive gastrocnemius tension.

Ankle joint range of motion (ROM) is notably influenced by the position of the hip joint. However, this result remains unexplained. Thus, the aim of this study was to test if the ankle passive torque and gastrocnemius muscle tension are affected by the hip and the head positions. The torque and the muscle shear elastic modulus (measured by elastography to estimate muscle tension) were collected in nine participants during passive ankle dorsiflexions performed in four conditions (by combining hip flexion at 90 or 150°, and head flexed or neutral). Ankle maximum dorsiflexion angle significantly decreased by flexing the hip from 150 to 90° (P < 0.001; mean difference 17.7 ± 2.5°), but no effect of the head position was observed (P > 0.05). Maximal passive torque and shear elastic modulus were higher with the hip flexed at 90° (P < 0.001). During submaximal ROM, no effects of the head and hip positioning (P > 0.05) were found for both torque and shear elastic modulus at a given common ankle angle among conditions. Shifts in maximal ankle angle due to hip angle manipulation are not related neither to changes in passive torque nor tension of the gastrocnemius. Further studies should be addressed to better understand the functional role of peripheral nerves and fasciae in the ankle ROM limits.

Validation of a scanning technique with minimal compression for measuring muscle volume with freehand 3D ultrasound.

Freehand 3D ultrasound (3D-US) is a promising technique for measuring muscle volume but it requires gel pads or water tanks to limit probe compression on the skin which makes it hard to use in clinical applications. Our objectives were to measure the effect of different compressions on muscle volume in order to assess the clinical applicability of a minimal compression method for lower limb muscles. 4 muscles of the lower limb on 15 healthy volunteers were scanned with a new commercial freehand 3D-US setup accessible to clinical experimentators. Each muscle was scanned with 3 levels of compression: standard compression, minimal compression and gel pad (method validated against MRI). Volume was calculated using software segmentation tools. Acquisitions and segmentations were done by the same examiner. There was a significant impact of standard compression on volume measurements, but no difference between minimal compression and gel pad. Standard compression underestimated volume with a mean bias of 16 mL. For minimal compression, 75 % of measured differences were below the predefined clinically acceptable limits of 10 mL. Mean bias for this method was 1.1 mL. In conclusion, standard compression in freehand 3D-US induces a systematic bias in volume calculations. But, with a trained examiner and the necessary precautions to minimize compression, this bias could be abolished and become acceptable in clinical applications. When a high accuracy is required, gel pads could still be important to consider.

Performance analysis in sport: contributions from a joint analysis of athletes' experience and biomechanical indicators.

The purpose of this study was to test the usefulness of combining two types of analysis to investigate sports performance with the aim of optimizing it. These two types of analysis correspond to two levels of athletes' activity: (a) their experiences during performance and (b) the biomechanical characteristics of their movements. Rowing served as an illustration, and the activity of one female crew member was studied during a race. Three types of data were collected: (a) audiovisual data recorded during the race; (b) verbalization data obtained in interviews conducted afterward; and (c) biomechanical data. The courses of experience of the two rowers during the race were reconstructed on the basis of the audiovisual and verbalization data. This paper presents a detailed analysis of a single phenomenon of the race experienced by one of the rowers. According to the coaches, it reflected a dysfunction in crew coordination. The aim of this analysis was to identify the biomechanical characteristics of the rowers' movements that might explain it. The results showed that the phenomenon could be explained principally by an amplitude differential between the two rowers' strokes. On this basis, the coaches defined new training objectives to remedy the dysfunction in crew coordination.

Thigh muscle activities in elite rowers during on-water rowing.

This study analysed the muscle activity levels and patterns of the major thigh muscle activation during training sections at different intensities of on-water rowing. 9 experienced rowers performed 2 imposed-pace sections (B1 and B2) and 2 maximal-speed sections (start, 500 m) of on-water rowing. The knee angle, power output, mean torque and stroke rate were measured using specific instrumentation and were synchronised with surface electromyography signals of 5 superficial quadriceps and hamstring muscles. B1 and B2 sections were not significantly different regarding mechanical parameters and EMG activities, while the start phase induced large differences. The EMG patterns for B1, B2 were similar (cross-correlation coefficients (CC) ranged between 0.972-0.984) and the moderate CC found between both B1 and start (0.605-0.720) and B2 and start (0.629-0.720). Our results suggest that the hamstring muscles have a motor action and contribute to the power production during the leg drive. During an all-out 500 m section, a decrease in power and stroke rate was found (up to 20%). However, EMG patterns were not time shifted for all muscles. During the leg drive, the muscle activity levels of the quadriceps muscles were unchanged, while the activity of the hamstring muscles decreased.

In vivo assessment of both active and passive parts of the plantarflexors series elastic component stiffness using the alpha method: a reliability study.

The aim of this study was to investigate the reliability of an in vivo adaptation of the short range stiffness experiment associated with the application of a mathematical model to determine the stiffness of both torque dependent and independent components of the plantarflexors series elastic component. Fourteen subjects participated in this study. The experimental protocol consisted of quickly moving the ankle joint in dorsiflexion during constant voluntary isometric plantarflexion at 7 submaximal torque levels. Relationships between joint stiffness and torque were established and the stiffness of both torque dependent and independent components were determined using the alpha method. The day-to-day reliability was assessed for joint stiffness and stiffness of both torque dependent and independent components (ICC higher than 0.88 and CVs lower than 6.0%). This method could then be used to better understand adaptive subjacent mechanisms to assess the effects of training protocols, and the rehabilitation of neuromuscular pathologies or traumatisms.

Effects of plyometric training on passive stiffness of gastrocnemii and the musculo-articular complex of the ankle joint.

This study aimed to determine simultaneously the effects of plyometric training on the passive stiffness of the ankle joint musculo-articular complex, the gastrocnemii muscle-tendon complex (MTC) and the Achilles tendon in order to assess possible local adaptations of elastic properties. Seventeen subjects were divided into a trained (TG) group and a control (CG) group. They were tested before and after 8 weeks of a plyometric training period. The ankle joint range of motion (RoM), the global musculo-articular passive stiffness of the ankle joint, the maximal passive stiffness of gastrocnemii and the stiffness of the Achilles tendon during isometric plantar flexion were determined. A significant increase in the jump performances of TG relative to CG was found (squat jumps: +17.6%, P=0.008; reactive jumps: +19.8%, P=0.001). No significant effect of plyometric training was observed in the ankle joint RoM, musculo-articular passive stiffness of the ankle joint or Achilles tendon stiffness (P>0.05). In contrast, the maximal passive stiffness of gastrocnemii of TG increased after plyometric training relative to CG (+33.3%, P=0.001). Thus, a specific adaptation of the gastrocnemii MTC occurred after plyometric training, without affecting the global passive musculo-articular stiffness of the ankle joint.

Shoulder rotators electro-mechanical properties change with intensive volleyball practice: a pilot study.

This pilot study was designed to assess the incidence of high-level volleyball practice on muscle strength production and muscle activation during internal and external shoulder rotations. Seven professional and seven French amateur league volleyball players performed maximal isometric at three forearm angles, concentric and eccentric isokinetic internal and external shoulder rotations. The torque production and muscle activation levels of PECTORALIS MAJOR and INFRASPINATUS were determined. Few significant differences were found for muscle activation and co-activation between amateur and professional volleyball players during both internal and external rotations. No significant difference in torque production was observed for shoulder internal rotation between professional and amateur volleyball players. Torque production was significantly higher during shoulder external rotation for amateur (46.58+/-2.62 N . m) compared to professional (35.35+/-1.17 N . m) volleyball players relative to isometric contractions, but it was not different during isokinetic efforts. The torque ratios for external/internal rotations were always significantly lower for professional (0.42+/-0.03 pooling isometric and concentric conditions) compared to amateur volleyball players (0.56+/-0.03 pooling isometric and concentric conditions). Those results emphasize that a high level of volleyball practice induces a strong external rotators deficit compared to sports such as swimming, baseball or tennis.

Characterization of muscle belly elastic properties during passive stretching using transient elastography.

Passive muscle stretching can be used in vivo to assess the viscoelastic properties of the entire musculo-articular complex, but does not allow the specific determination of the muscle or tendon viscoelasticity. In this respect, the local muscle hardness (LMH) of the gastrocnemius medialis (GM) belly was measured during a passive ankle stretching of 10 subjects using transient elastography. A Biodex isokinetic dynamometer was used to stretch ankle plantar flexors, to measure ankle angle, and the passive torque developed by the ankle joint in resistance to the stretch. Results show that the LMH increased during the stretching protocol, with an averaged ratio between maximal LMH and minimal LMH of 2.62+/-0.46. Furthermore, LMH-passive torque relationships were nicely fitted using a linear model with mean correlation coefficients (R(2)) of 0.828+/-0.099. A good reproducibility was found for the maximal passive torque (ICC=0.976, SEM=2.9Nm, CV=5.5%) and the y-intercept of the LMH-passive torque relationship (ICC=0.893, SEM=105Pa, CV=7.8%). However, the reproducibility was low for the slope of this relationship (ICC=0.631, SEM=10.35m(-2), CV=60.4%). The y-intercept of the LMH-passive torque relationship was not significantly changed after 10min of static stretching. This result confirms the finding of a previous study indicating that changes in passive torque following static stretching could be explained by an acute increase in muscle length without any changes in musculo-articular intrinsic mechanical properties.

Accuracy of Biodex system 3 pro computerized dynamometer in passive mode.

A specific experimental design has been developed to determine the accuracy of the Biodex system 3 pro dynamometer in passive mode. Five cyclic stretching repetitions were imposed to an elastic rubber band at different velocities using the dynamometer, and the torque produced was measured using both the dynamometer and external force and position sensors. Velocity patterns performed by the dynamometer were also characterized and our results show that these patterns were reliable (ICC=1.00). The torque measured with the dynamometer and the sensors were reliable (ICC=1.00), although significant differences were observed between both methods. However, the measured torque standard error was velocity independent and was lower than 0.33 Nm. Moreover, regressions between the two torque measurements were close to the axes-bisector (r=1.00, slope: 1.01+/-0.01, y-intercept: -0.36+/-0.22 Nm). Finally, our results showed decreases in torque during the five cycles, but these decreases were not due to the dynamometer. It can be concluded that the dynamometer performed valid torque measurements in passive mode, and was an accurate tool to determine passive mechanical properties of the musculo-articular system. However, some discrepancies between the programmed and the measured speed profiles have been observed when approaching the speed limit of the system.

Reaction time can be measured during voluntary contractions with electrode array.

Reaction time (RT) is classically divided into premotor time (PMT) and electromechanical delay (EMD). However, the determination of the onset of electromyographic activity (EMG) during voluntary contraction remains questionable. In addition, the reliability of RT, PMT and EMD needs to be determined. Twelve participants performed two sessions of RT trials, separated by 5 min. RT was evaluated during voluntary isometric contractions of the elbow flexors, i.e., time between a light signal (stimulus) and the onset of the mechanical response. To assess EMD, an electrode array (64 channels) was used to accurately detect the onset of EMG activity. PMT represented the major part of the RT (~88%). Coefficients of variation were reasonably satisfactory for all parameters (range: 11·9-13·4%). The use of electrode array appears to be a relevant method to measure EMD. Moreover, sessions based on two trials are reliable enough to detect changes in RT components.

Muscle force loss and soreness subsequent to maximal eccentric contractions depend on the amount of fascicle strain in vivo.

AIM: Defining the origins of muscle injury has important rehabilitation and exercise applications. However, current knowledge of muscle damage mechanics in human remains unclear in vivo. This study aimed to determine the relationships between muscle-tendon unit mechanics during maximal eccentric contractions and the extent of subsequent functional impairments induced by muscle damage. METHODS: The length of the muscle-tendon unit, fascicles and tendinous tissues was continuously measured on the gastrocnemius medialis using ultrasonography, in time with torque, during 10 sets of 30 maximal eccentric contractions of plantar flexors at 45°s(-1) , in seventeen participants. RESULTS: Muscle-tendon unit, fascicles and tendinous tissues were stretched up to 4.44 ± 0.33 cm, 2.31 ± 0.64 cm and 1.92 ± 0.61 cm respectively. Fascicle stretch length, lengthening amplitude and negative fascicle work beyond slack length were significantly correlated with the force decrease 48 h post-exercise (r = 0.51, 0.47 and 0.68, respectively; P < 0.05). CONCLUSIONS: This study demonstrates that the strain applied to human muscle fibres during eccentric contractions strongly influences the magnitude of muscle damage in vivo. Achilles tendon compliance decreases the amount of strain, while architectural gear ratio may moderately contribute to attenuating muscle fascicle lengthening and hence muscle damage. Further studies are necessary to explore the impact of various types of task to fully understand the contribution of muscle-tendon interactions during active lengthening to muscle damage.

In vivo quantification of the shear modulus of the human Achilles tendon during passive loading using shear wave dispersion analysis.

The shear wave velocity dispersion was analyzed in the Achilles tendon (AT) during passive dorsiflexion using a phase velocity method in order to obtain the tendon shear modulus (C 55). Based on this analysis, the aims of the present study were (i) to assess the reproducibility of the shear modulus for different ankle angles, (ii) to assess the effect of the probe locations, and (iii) to compare results with elasticity values obtained with the supersonic shear imaging (SSI) technique. The AT shear modulus (C 55) consistently increased with the ankle dorsiflexion (N = 10, p < 0.05). Furthermore, the technique showed a very good reproducibility (all standard error of the mean values <10.7 kPa and all coefficient of variation (CV) values ⩽ 0.05%). In addition, independently from the ankle dorsiflexion, the shear modulus was significantly higher in the proximal location compared to the more distal one. The shear modulus provided by SSI was always lower than C55 and the difference increased with the ankle dorsiflexion. However, shear modulus values provided by both methods were highly correlated (R = 0.84), indicating that the conventional shear wave elastography technique (SSI technique) can be used to compare tendon mechanical properties across populations. Future studies should determine the clinical relevance of the shear wave dispersion analysis, for instance in the case of tendinopathy or tendon tear.

Time-course effect of exercise-induced muscle damage on localized muscle mechanical properties assessed using elastography.

AIM: Changes in muscle stiffness after exercise-induced muscle damage have been classically inferred from passive torque-angle curves. Elastographic techniques can be used to estimate the shear modulus of a localized muscular area. This study aimed to quantify the changes in shear elastic modulus in different regions of the elbow flexors after eccentric exercise and their relation to muscle length. METHODS: Shear elastic modulus and transverse relaxation time (T2 ) were measured in the biceps brachii and brachialis muscles of sixteen participants, before, 1 h, 48 h and 21 days after three sets of ten maximal isokinetic eccentric contractions performed at 120° s(-1) . RESULTS: The shear elastic modulus of the elbow flexors significantly increased 1 h (+46%; P = 0.005), with no significant change at 48 h and 21D, post-exercise. In contrast, T2 was not modified at 1 h but significantly increased at 48 h (+15%; P < 0.05). The increase in shear elastic modulus was more pronounced at long muscle lengths and reached a similar extent in the different regions of the elbow flexors. The normalized hysteresis area of shear elastic modulus-length relationship for the biceps brachii increased 1 h post-exercise (31%) in comparison with the pre-exercise value (18%), but was not significantly altered after five stretching cycles (P = 0.63). CONCLUSION: Our results show homogeneous changes in muscle shear elastic modulus within and between elbow flexors. The greater increase in shear elastic modulus observed at long muscle lengths suggests the putative involvement of both cross-bridges number and titin in the modifications of muscle shear elastic modulus after damaging exercise.

Is tendon stiffness correlated to the dissipation coefficient?

The assessment of Achilles tendon mechanical properties in vivo has received much attention in the literature. Many studies investigated mechanical properties by assessing tendon stiffness. Despite tendon dissipative properties being representative of a storage-recoil process, its determination has received minimal attention in the literature. The aim of this study was to determine if Achilles tendon stiffness is associated with dissipative properties. The cross-sectional area, stiffness and dissipation coefficient of the Achilles tendon were measured in 35 subjects. No significant correlation was found between stiffness and the dissipation coefficient, irrespective of stiffness normalization with cross-sectional area (P > 0.05). Thus, it appears that both stiffness and dissipative properties must be assessed to determine the storage-recoil process capacities of the Achilles tendon in order to precisely characterize changes in the tendon mechanical properties after chronic interventions or rehabilitation programs.