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Background and Purpose Hamstring strength testing is crucial in assessing this important muscle group during rehabilitation and injury prevention. The purpose of this study was to evaluate the reliability and validity of measuring strength in a maximally lengthened position using a handheld dynamometer (HHD) compared to isokinetic testing. Methods Twenty healthy and active participants were recruited, and isometric strength testing was performed both on the Biodex machine and isometric end-range hamstring testing with the HHD on two occasions. Results Significant strong correlations (r= 0.87, p < 0.0001) were found between strength testing on the Biodex machine and the HHD for both the right and left sides. Bland-Altman plots demonstrated agreement between the two measurements. Excellent intra-rater reliability (ICC= 0.91-0.93) and moderate to good inter-rater reliability (ICC = 0.71-0.83) for the HHD test was demonstrated. Conclusions The HHD provides a reliable and valid alternative to isokinetic testing for assessing hamstring strength in a maximally lengthened position. This assessment can be valuable in monitoring rehabilitation progress and detecting deficits before and after returning to play. The HHD is an accessible and cost-effective option for assessing hamstring strength at long lengths in a clinical setting. Level of evidence 3 [ABSTRACT FROM AUTHOR]

* OBJECTIVE: To investigate the effect of progressive resistance exercise compared with low-intensity home-based exercises on knee-muscle strength and joint function in people with anterior cruciate ligament (ACL) reconstruction and persistent hamstring strength deficits at 12-24 months after surgery. * DESIGN: Randomized controlled superiority trial with parallel groups, balanced randomization (1:1), and blinded outcome assessment. * METHODS: People with ACL reconstruction (hamstring autograft) and persistent hamstring muscle strength asymmetry were recruited 1 to 2 years postsurgery and randomized to either 12 weeks of supervised progressive strength training (SNG), or 12 weeks of home-based, low-intensity exercises (CON). The primary outcome was between-group difference in change in maximal isometric knee flexor muscle strength at 12-week follow-up. * RESULTS: Fifty-one participants (45% women, 27 ± 6 years) were randomized to SNG (n = 25) or CON (n = 26), with 88% follow-up rate at 12 weeks. People in the SNG group improved their knee flexor muscle strength (0.18 N·m/kg, 95% confidence interval [CI]: 0.07, 0.29; P = .002) more than the CON group, from baseline to 12 weeks. The SNG group also had superior Knee Injury and Osteoarthritis Outcome Scores for Pain (4.6, 95% CI: 0.4, 8.7; P = .031) and daily living function (4.7, 95% CI: 1.2, 8.2; P = .010) compared to the CON group. * CONCLUSION: In people with persistent hamstring muscle strength deficits after ACL reconstruction, 12 weeks of supervised progressive strength training was superior to low-intensity home-based exercises for improving maximal knee flexor muscle strength and some patient- reported outcomes. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate muscle activity during hamstring rehabilitation exercises performed in training machine compared with elastic resistance. Design: Six women and 13 men aged 28-67 yrs participated in a crossover study. Electromyographic (EMG) activity was recorded in the biceps femoris and the semitendinosus during the concentric and the eccentric phase of hamstring curls performed with TheraBand elastic tubing and Technogym training machines and normalized to maximal voluntary isometric contraction-EMG (normalized EMG). Knee joint angle was measured using electronic inclinometers. Results: Training machines and elastic resistance showed similar high levels of muscle activity (biceps femoris and semitendinosus peak normalized EMG >80%). EMG during the concentric phase was higher than during the eccentric phase regardless of exercise and muscle. However, compared with machine exercise, slightly lower (P < 0.05) normalized EMG values were observed using elastic resistance at 30- to 50-degree knee joint angle for the semitendinosus and the biceps femoris during the concentric and the eccentric phase, respectively. Perceived loading (Borg CR10) was significantly higher (P < 0.001) during hamstring curl performed with elastic resistance (7.58 ± 0.08) compared with hamstring curl performed in a machine (5.92 ± 0.03). Conclusions: Hamstring rehabilitation exercise performed with elastic resistance induces similar peak hamstring muscle activity but slightly lower EMG values at more extended knee angles and with higher perceived loading as hamstring curls using training machines. [ABSTRACT FROM AUTHOR]

The article investigates the characteristic sonographic findings of acute hamstring injuries in soccer players from 50 teams participating in 1 of the top 5 Danish soccer divisions from January to December 2008. Results indicated that biceps femoris is the most commonly injured hamstring muscle detected by ultrasound, and more than half of the injuries are intramuscular. It also suggests that the prognosis of hamstring injuries should not be guided by the findings alone.

The article cites a Danish study which explored whether the revision rate after primary anterior cruciate ligament reconstruction (ACLR) is greater when using hamstring tendon grafts compared with patellar tendon grafts. The nationwide population-based cohort study found that the use of hamstring tendon grafts in ACLR was linked with an increased risk of revision compared with patellar tendon grafts. It also showed that both hamstring and patellar tendon grafts reveal good results after ACLR.

Background: The incidence of acute hamstring injuries is high in several sports, including the different forms of football.Purpose: The authors investigated the preventive effect of eccentric strengthening of the hamstring muscles using the Nordic hamstring exercise compared with no additional hamstring exercise on the rate of acute hamstring injuries in male soccer players.Study Design: Randomized controlled trial; Level of evidence, 1.Methods: Fifty Danish male professional and amateur soccer teams (942 players) were allocated to an intervention group (461 players) or a control group (481 players). Players in the intervention group conducted a 10-week progressive eccentric training program followed by a weekly seasonal program, whereas players in the control group followed their usual training program. The main outcome measures were numbers of overall, new, and recurrent acute hamstring injuries during 1 full soccer season.Results: Fifty-two acute hamstring injuries in the control group compared with 15 injuries in the intervention group were registered. Comparing intervention versus the control group, overall acute hamstring injury rates per 100 player seasons were 3.8 versus 13.1 (adjusted rate ratio [RR], 0.293; 95% confidence interval [CI], 0.150-0.572; P < .001). New injury rates per 100 player seasons were 3.1 versus 8.1 (RR, 0.410; 95% CI, 0.180-0.933; P = .034), whereas recurrent injury rates per 100 player seasons were 7.1 versus 45.8 (RR, 0.137; 95% CI, 0.037-0.509; P = .003). Number needed to treat [NNT] to prevent 1 acute hamstring injury (new or recurrent) is 13 (95% CI, 9-23) players. The NNT to prevent 1 new injury is 25 (95% CI, 15-72) players, and NNT to prevent 1 recurrent injury is 3 (95% CI, 2-6) players.Conclusion: In male professional and amateur soccer players, additional eccentric hamstring exercise decreased the rate of overall, new, and recurrent acute hamstring injuries. [ABSTRACT FROM PUBLISHER]