Correlation between strength and flexibility of knee flexors and extensors muscles in youth soccer players

Introduction: Soccer is the most played sport in the world and the one that causes more injuries. Imbalance between knee flexor and extensor is the main cause of muscle injuries in soccer players. Objective: The aim of this study was to verify the asymmetry and the correlation between the strength and flexibility of knee flexor and extensor as well as the difference of these variables between the right and left limbs in youth soccer players. Method: The sample consisted of 45 male youth soccer players for at least a year, aged between 13 and 16 years (14.7+0.86). The athletes underwent an assessment of flexibility of the posterior chain through the sit and reach test on Wells’ Bench and an assessment of flexibility of the quadriceps using the Ely’s test, with measurement of passive range of motion by goniometry. The peak of muscle strength was measured using a load cell (EMG  System, Brazil). Results: Data analysis showed difference between the values obtained in the Ely’s test of right and left leg (p=0,03), which did not happen for flexion strength (p=0.45), extension (p=0.41) and H:Q ratio (p = 0.40) when comparing the two members. It was observed a significant negative correlation between the H:Q ratio and the flexibility of the posterior chain test either for the right side (r=-0.40; p=0.006) or left side (r=-0.50; p=0.0004). Also a significant positive correlation was observed between quadriceps strength and flexibility of the posterior chain, both for the right (r=0.31; p=0.03) and the left side (r=0.32; p=0.02). Just for the left side a significant positive correlation was observed when compared the flexor muscle strength with the flexibility of the quadriceps (r=0.30; p=0.03). Conclusion: We conclude from this study that the flexibility of the posterior chain may be related to the strength of the antagonists, however, when the two physical qualities were compared in the same muscles, it showed no correlation.

Hamstring and Quadriceps Muscle Strength in Youth to Senior Elite Soccer: A Cross-Sectional Study Including 125 Players

Purpose: Increasing age, high quadriceps strength, and low hamstring muscle strength are associated with hamstring strain injury in soccer. The authors investigated the age-related variation in maximal hamstring and quadriceps strength in male elite soccer players from under-13 (U-13) to the senior level. Methods: A total of 125 elite soccer players were included from a Danish professional soccer club and associated youth academy (first tier; U-13, n = 19; U-14, n = 16; U-15, n = 19; U-17, n = 24; U-19, n = 17; and senior, n = 30). Maximal voluntary isometric force was assessed for the hamstrings at 15° knee joint angle and for the quadriceps at 60° knee joint angle (0° = full extension) using an external-fixated handheld dynamometer. Hamstring-to-quadriceps strength (H:Q) ratio and hamstring and quadriceps maximal voluntary isometric force levels were compared across age groups (U-13 to senior). Results: Senior players showed 18% to 26% lower H:Q ratio compared with all younger age groups (P ≤ .026). Specific H:Q ratios (mean [95% confidence interval]) were as follows: senior, 0.45 (0.42–0.48); U-19, 0.61 (0.55–0.66); U-17, 0.56 (0.51–0.60); U-15, 0.59 (0.54–0.64); U-14, 0.54 (0.50–0.59); and U-13, 0.57 (0.51–0.62). Hamstring strength increased from U-13 to U-19 with a significant drop from U-19 to the senior level (P = .048), whereas quadriceps strength increased gradually from U-13 to senior level. Conclusion: Elite senior soccer players demonstrate lower H:Q ratio compared with youth players, which is driven by lower hamstring strength at the senior level compared with the U-19 level combined with a higher quadriceps strength. This discrepancy in hamstring and quadriceps strength capacity may place senior-level players at increased risk of hamstring muscle strain injuries.

Hamstring-to-Quadriceps Ratio in Female Athletes with a Previous Hamstring Injury, Anterior Cruciate Ligament Reconstruction, and Controls

Muscle strength imbalances around the knee are often observed in athletes after anterior cruciate ligament (ACL) surgery and hamstring muscle injury. This study examined three hamstrings-to-quadriceps (H:Q) strength ratio types (conventional, functional, and mixed) in thirteen female athletes with a history of hamstring injury, fourteen basketball players following ACL reconstruction and 34 controls. The conventional (concentric H:Q) peak torque ratio was evaluated at 120°·s−1 and 240°·s−1. The functional (eccentric hamstring to concentric quadriceps) torque ratio was evaluated at 120°·s−1. Finally, the mixed (eccentric hamstrings at 30°·s−1 to concentric quadriceps at 240°·s−1) torque ratio was calculated. Both ACL and the hamstring-injured groups showed a lower quadriceps and hamstrings strength compared with controls (p < 0.05). However, non-significant group differences in the H:Q ratio were found (p > 0.05). Isokinetic assessment of muscle strength may be useful for setting appropriate targets of training programs for athletes with a history of ACL surgery or hamstring strain. However, isokinetic evaluation of the H:Q ratio is not injury—specific and it does not vary between different methods of calculating the H:Q ratio.

Modeling the Angle-Specific Isokinetic Hamstring to Quadriceps Ratio Using Multilevel Generalized Additive Models

Background and Objectives: This study considered the use of a generalized additive multilevel model to describe the joint-angle-specific functional hamstring to quadriceps ratio (H:Q ratio) in the knee, using all of the available truly isokinetic data within the range. Materials and Methods: Thirty healthy male basketball players aged 15.0 (1.4) years (average stature = 180.0 cm, SD = 11.1 cm; average body mass = 71.2, SD = 14.9 kg) years were considered. All players considered had no history of lower extremity musculoskeletal injury at the time of testing or during the 6 months before testing, and had been engaged in formal basketball training and competition for 5.9 (2.4) years. Moments of force of the reciprocal concentric and eccentric muscular actions for the knee extensors and flexors assessed by isokinetic dynamometry at 60°∙s−1 were used. Results: Maximum moments of force were attained at different angle positions for knee extension. For knee flexion, it was apparent that there was an ability to maintain high levels of moment of force between 30° and 60° in the concentric muscular action, corresponding to the concentric action of the hamstrings. However, for the eccentric knee flexion, corresponding to the quadriceps action, there was a marked peak of moment of force at about 55°. The functional H:Q ratio for the knee extension was non-linear, remaining higher than 1.0 (i.e., point of equality) from the beginning of the extension until approximately 40° of the knee extension, leveling off below the point of equality thereafter. On average, the functional H:Q ratio for the knee flexion did not attain 1.0 across the range of motion. The functional H:Q ratio for the knee in the present sample peaked at 20° and 80°, declining between these angle positions to below 0.50 at about 0.54. Conclusions: Estimating the form of the non-linear relationship on-the-fly using a generalized additive multilevel model provides joint-angle-specific curves and joint-angle-specific functional H:Q ratio patterns, allowing the identification and monitoring of strength development, with potential implications for injury and performance.

Contralateral Muscle Imbalances and Physiological Profile of Recreational Aerial Athletes

Background: Aerial fitness is quickly gaining popularity; however, little is known regarding the physiological demands of aerial athletes. The purpose of the study was to examine contralateral muscle imbalances, compare dominant versus non-dominant hamstrings-to-quadriceps (H:Q) ratios, and to establish a physiological profile of recreational aerial athletes. Methods: Thirteen aerialist women visited a local aerial studio to participate in a data collection session to examine isometric levels of upper and lower body strength, muscle endurance, flexibility, balance, and cardiovascular fitness. Results: No significant differences were found between dominant and non-dominant hand grip strength (p = 0.077), dominant and non-dominant isometric knee flexion (p = 0.483), dominant and non-dominant isometric knee extension (p = 0.152), or dominant and non-dominant isometric H:Q ratios (p = 0.102). In addition, no significant difference was found between isometric dominant H:Q ratio and the widely-used value of 0.60 (p = 0.139). However, isometric non-dominant H:Q ratio was significantly lower than the 0.60 criterion (p = 0.004). Aerial athletes demonstrated to have excellent flexibility, balance, cardiorespiratory fitness, and average strength. Conclusions: Aerial fitness may be another recreational activity that could be used to maintain higher levels of flexibility, balance, cardiorespiratory fitness, and strength. Aerialists may want to consider focusing on strengthening the lower body and balancing the hamstrings and quadriceps muscle strength.

Effect of Sports and Growth on Hamstrings and Quadriceps Development in Young Female Athletes: Cross-Sectional Study

Context: Lower extremity muscular strength may vary by different sport participation during growth process. Objective: To investigate effect of sport participation and growth by comparing strength of the hamstrings, quadriceps, and hamstrings to quadriceps strength ratio (H:Q ratio) between young female figure skaters and soccer players. Design: Cross-sectional. Settings: Laboratory affiliated with regional sports medicine center. Participants: pediatric and adolescent female athletes. Procedures: Isometric hamstrings and quadriceps strength were measured. Main Outcome Measures: Strength of the hamstrings, quadriceps, and hamstrings to quadriceps strength ratio (H:Q ratio). Statistical Analysis: Effect of sport participation and growth was analyzed through a two-way (two sports: figure skaters and soccer players; three age groups: <12 years, 13–16 years, and >17 years) analysis of covariance. Results: Hamstrings strength was significantly greater in figure skaters than soccer players. Also, hamstring strength of 13–16 years and >17 years was higher compared to <12 years. Additionally, significantly higher H:Q ratio in figure skaters compared to soccer players. Conclusions: There is effect of growth on hamstrings strength among 13–16 years and >17 years compared to <12 years. Figure skaters showed greater hamstrings strength and H:Q ratio than female soccer players.

Effect of Hip Flexion Angle on the Hamstring to Quadriceps Strength Ratio

The purpose of this study was to compare the hamstring to quadriceps ratio (H:Q) obtained from three different hip flexion angles. Seventy-three young athletes performed maximum isokinetic concentric and eccentric knee extension and flexion efforts at 60 °·s−1 and 240 °·s−1 from hip flexion angles of 90°, 60°, and 120°. The conventional (concentric to concentric), functional (eccentric to concentric) and mixed (eccentric at 30 °·s−1 to concentric torque at 240 °·s−1) H: Q torque ratios and the electromyographic activity from the rectus femoris and biceps femoris were analyzed. The conventional H:Q ratios and the functional H:Q ratios at 60 °·s−1 did not significantly differ between the three testing positions (p > 0.05). In contrast, testing from the 90° hip flexion angle showed a greater functional torque ratio at 240 °·s−1 and a mixed H:Q torque ratio compared with the other two positions (p < 0.05). The hip flexion angle did not influence the recorded muscle activation signals (p > 0.05). For the range of hip flexion angles tested, routine isokinetic assessment of conventional H:Q ratio and functional H:Q ratio at slow speed is not angle-dependent. Should assessment of the functional H:Q ratio at fast angular velocity or the mixed ratio is required, then selection of hip flexion angle is important.

Knee Muscle Torque and H:Q Ratio Changes before ACL Surgery and after Rehabilitation

Research background and hypothesis. Anterior cruciate ligament (ACL) of the knee joint is often quite a fragile structure of the knee. After the rupture of ACL neuromuscular control worsens and sensorimotor system breaks down (Risberg et al., 2007), muscle activation is poor and muscle strength decreases (Croce, Miller, 2006). Some authors have reported greater strength loss in quadriceps femoris than in hamstring femoris muscle (Busch-Joseph et al., 2001; Neeter et al., 2006), therefore we hypothesized that strength loss in knee extensors may affect hamstring/quadriceps torque (H:Q) ratio. Research aim of this study was to investigate knee extensors and fl exors isometric and dynamic torque and H:Q ratio alterations before ACL surgery and after rehabilitation.Research methods. Ten volunteers with ACL ruptured knee where tested before surgery and after rehabilitation. Isokinetic dynamometer was used for this testing. Maximal isometric torque was performed during fl exion and extension at 90°, 60º knee angles. Dynamic torque was performed at 30, 180, 300º/s angular velocities.Research results. Results of this study show that after rehabilitation isometric and dynamic torque of the involved leg decreased. Isometric fl exion and extension torque of the uninjured leg was greater than that of the injured leg, but after rehabilitation the extension torque of the injured leg was lower than that before surgery. Discussion and conclusions. Before ACL surgery and after rehabilitation quadriceps femoris muscle torque of the uninjured leg was more affected than hamstring femoris muscle torque. After rehabilitation H:Q ratio of the injured leg was not dependent on angular velocity and knee joint angle.Keywords: maximal voluntary torque, muscle balance, muscle contraction.

Influence of Isokinetic Knee Muscle Torque at Different Angular Velocities on Standing Posture Stability in Healthy Adults

Objectives Knee muscle groups contribute to proper and safe static and dynamic standing posture stability. The impact of isokinetic knee muscle torque at various angular velocities on standing posture stability is poorly understood. We investigated the influence of isokinetic knee muscle torque at different angular velocities on standing posture stability. Design Cross-sectional study. Setting King Saud University Campus labs. Method The study population was a convenience sample of 30 healthy volunteer college students with a mean age of 20±2 years. Isokinetic concentric peak torque (PT) of knee extensor (Q) and flexor (H) muscle groups as well as the flexor to extensor (H:Q) ratio at three different angular velocities: (60, 180, and 300°/s) were measured, respectively. The postural stability was also measured in both static and dynamic components. The Pearson correlation coefficient was used to examine the association between the different isokinetic components and postural stability (both static and dynamic). Results The PT of Q and H muscle groups and the H:Q ratio at the 3 different angular velocities were significantly associated with static standing balance with eye open on a firm surface (p<0.033). Moreover, the PT of Q at 60 and 180°/s angular velocities was significantly associated with maximum and endpoint excursion components of dynamic standing balance (p<0.044). Conclusions The PT of both Q and H muscle groups at different angular velocities are associated with maintenance of standing static balance. PT of Q only is significantly associated with control of dynamic standing balance in the lower angular velocities.

Effect of Muscular Strength, Asymmetries and Fatigue on Kicking Performance in Soccer Players

The aim of this study was to determine the effect of muscular strength, strength asymmetries, and fatigue on the speed and accuracy of an instep kick in soccer players. We measured ball velocity (BV) and kicking accuracy (KA) in the preferred (PL) and non-preferred leg (NPL) before (PRE) and after (POST) physical load in the PL. Maximum peak muscle torque of the knee extensors and flexors in the PL and NPL as well as ipsilateral knee flexors and knee extensors ratio (H:Q ratio) for both legs were assessed. BV was significantly decreased in POST physical load (5.82%, BVPRE=30.79±1.70 m·s−1, BVPOST=29.00±1.70 m·s−1, t19=3.67, p=0.00, d=1.05). Instep kick accuracy after the physical load worsened by an average of 10% in the most accurate trials. Results revealed a significant decrease in instep kick accuracy after physical loading (KAPRE=2.74±0.70 m, KAPOST=3.85±1.24 m, t19=–3.31, p=0.00, d=1.10). We found an insignificant correlation between H:Q ratio and KA in PRE test value, whereas a lower ipsilateral ratio (higher degree of strength asymmetry) in the POST physical load significantly correlated with KA in all angular velocities (r=–0.63 up to –0.67, p=0.00).