Original articleThe difference in passive tension applied to the muscles composing the hamstrings – Comparison among muscles using ultrasound shear wave elastography
Introduction
Hamstring muscle strain is one of the most common injuries in sports (Bishop and Fallon, 1999, Brooks et al., 2006, Gabbe et al., 2006, Feeley et al., 2008, Ekstrand et al., 2011) and results in considerable time lost from training and competition (Brooks et al., 2006, Ekstrand et al., 2011). Many studies have investigated the risk factors and epidemiological features of hamstring muscle strain to identify preventive measures. Some have suggested that hamstring muscle strain is particularly likely to occur during the terminal swing phase of sprinting (Heiderscheit et al., 2005, Schache et al., 2009). The biceps femoris is the most commonly injured muscle among the hamstring muscles (Verrall et al., 2003, Koulouris et al., 2007). A previous study (Thelen et al., 2005) using a computer simulation reported that the percentage change in the length of the biceps femoris muscle tendon unit from standing upright to the terminal swing phase during running was higher than that of the semitendinosus and semimembranosus muscles, and this has been considered one of the reasons for some of the epidemiological features of hamstring muscle strain.
An ultrasound technology, ultrasound shear wave elastography, has enabled us to noninvasively and reliably measure the muscle shear elastic modulus (Bercoff et al., 2004). Previous studies have reported a strong linear relationship between the shear elastic modulus measured using ultrasound shear wave elastography and the passive muscle tension (Maisetti et al., 2012, Chernak et al., 2013, Koo et al., 2013). Therefore, the shear elastic modulus measured using ultrasound shear wave elastography was used as an index of the indirect passive tension. Using this technique, our previous study (Umegaki et al., 2015) reported that the passive tension applied to the semimembranosus was the highest among those applied to the hamstring muscle components at 45° knee flexion and 90° hip flexion. To reveal the cause of this inconsistency, it is important to investigate the in vivo differences in the passive tension applied to the muscles composing the hamstring at the same knee and hip positions as during the terminal swing phase.
The increases in the passive tension applied to the hamstring muscles and in hamstring muscle strain occur mostly during the terminal swing phase of sprinting, in which the hamstring muscle is greatly elongated, in accordance with the hip flexion and knee extension seen in this phase (Yu et al., 2008, Chumanov et al., 2011). If the increase in passive muscle tension during this phase is an important factor in hamstring muscle strain, an anterior or a posterior tilt of the pelvis should likewise be an important factor affecting the passive tension applied to the hamstrings, considering that the hamstring muscles originate from the ischial tuberosity (Abebe et al., 2009). In addition, although the hip joint angle, which is defined as the angle of the trunk with respect to the femur, remains the same, it is possible that the anterior or posterior tilt of the pelvis is different. Therefore, we hypothesized that an anterior tilt of the pelvis can increase the passive tension applied to the hamstring muscles at the same hip joint angle. However, to the best of our knowledge, no study has investigated the effect of pelvic tilt on the passive tension applied to the hamstring muscles.
The aims of this study were to investigate the differences in the passive tension applied to the individual muscles (semitendinosus, semimembranosus, and biceps femoris) composing the hamstrings during passive elongation with the knee and hip angles simulating those seen during the terminal swing phase, and to investigate the effect of pelvic tilt on the passive tension by measuring the shear elastic modulus.
Section snippets
Subjects
Fifteen healthy males (age, 22.6 ± 1.4 years; height, 172.7 ± 3.8 cm; weight, 68.1 ± 5.0 kg) volunteered for this study. Subjects with a history of neuromuscular disease or musculoskeletal injury involving their lower limbs were excluded from the study. In addition, the subjects recruited were participants in recreational sports but not in any strength or flexibility training at the time of the study. All subjects were fully informed of the procedures and purpose of the study, and then written
Joint angle
The results for the T–F and P–F angles are shown in Table 1 as mean ± SD (standard deviation). For the T–F angle, one-way ANOVA indicated no significant main effect of the three pelvic positions (F = 0.04, p = 0.961). On the other hand, for the P–F angle, one-way ANOVA indicated a significant main effect of the three pelvic positions (F = 21.9, p < 0.01). Bonferroni's post hoc test indicated that the P–F angle was significantly larger in Anterior Tilt than in Non-Tilt and Posterior Tilt, and
Comparison among muscles
In this study, we investigated the differences in the passive tension applied during passive elongation to the individual muscles (semitendinosus, semimembranosus, and biceps femoris) composing the hamstring muscle by measuring the shear elastic modulus in vivo. Previous studies have reported a strong linear relationship between the shear elastic modulus measured using ultrasound shear wave elastography and the passive muscle tension (Maisetti et al., 2012, Chernak et al., 2013, Koo et al., 2013
Conclusion
Our results suggest that the passive tension applied to the semimembranosus is higher than that applied to the semitendinosus and biceps femoris when the hamstring muscles are passively elongated, and that the passive tension applied to the hamstring muscles increases under an anterior tilt of the pelvis.
Conflicts of interest
This work was supported by a Grant-in-Aid for Scientific Research (B) 15H03043.
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