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Medial hamstring muscle activation patterns are affected 1–6 years after ACL reconstruction using hamstring autograft

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Although changes in hamstring muscle morphology after anterior cruciate ligament reconstruction (ACLR) using a semitendinosus autograft hamstrings-gracilis (HG) of the ipsilateral limb are recognized, alterations in muscle activation patterns have not been extensively studied. The purpose of this controlled laboratory trial was therefore to monitor muscle activation levels of the medial (MH) and lateral (LH) hamstring muscles in athletes who had undergone ACLR using a HG autograft and to contrast these to activation levels demonstrated by healthy controls.

Methods

Surface electromyography (EMG) was sampled from bilateral hamstring muscles of 18 athletes 1–6 years after ACLR and 18 matched controls (CTRL) during the performance of two dissimilar exercises, both involving eccentric knee flexor activity. Peak normalized muscle activation levels were identified for MH and LH of both limbs during the performance of the Nordic Hamstring (NH) exercise and TRX® hamstring curl (TRX) exercise.

Results

A statistically significant limb by exercise interaction was found for peak activation levels of LH, due to significant interlimb differences in activation during the performance of the TRX exercise compared to more symmetrical activation during the NH (p < 0.001). A three-way interaction was found for peak activation levels of MH, due to group differences in peak muscle activation between limbs and exercise type (p = 0.025). Whereas CTRL group participants consistently favoured one limb over the other during the performance of both exercises, ACLR participants demonstrated dissimilar peak MH activation patterns between limbs during the performance of the NH exercise compared to the TRX.

Conclusions

In light of these results and considering the surgical procedure, patients who undergo ACLR using a HG autograft from the ipsilateral limb may benefit from post-operative rehabilitation that involves muscle activation and strengthening specifically targeting the MH component.

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Acknowledgments

The authors would like to acknowledge Dr. Thorarinn Sveinsson, Professor at the School of Health Sciences, University of Iceland for his assistance during EMG data processing.

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Authors and Affiliations

  1. Department of Physical Therapy, School of Health Sciences, University of Iceland, Saemundargata 2, 101, Reykjavik, Iceland

    Stefán Magni Árnason, Bjartmar Birnir, Tómas Emil Guðmundsson, Garðar Guðnason & Kristín Briem

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  1. Stefán Magni Árnason
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Correspondence to Kristín Briem.

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Árnason, S.M., Birnir, B., Guðmundsson, T.E. et al. Medial hamstring muscle activation patterns are affected 1–6 years after ACL reconstruction using hamstring autograft. Knee Surg Sports Traumatol Arthrosc 22, 1024–1029 (2014). https://doi.org/10.1007/s00167-013-2696-4

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  • DOI: https://doi.org/10.1007/s00167-013-2696-4

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