Hamstring strain injury (HSI) accounts for a large proportion of non-contact injuries in team sports including soccer, Australian Rules Football, rugby union, and American Football. |
The Nordic hamstring exercise (NHE) has been shown to provide positive architectural and strength adaptations in the hamstrings. |
Interventions utilising the NHE have been poorly adopted, particularly by professional soccer teams; potentially due to the high volume prescribed in early interventions. |
Despite many interventions prescribing high volumes of the NHE, a larger magnitude of change has been reported using lower, more consistent volumes. |
1 Background
2 Methods
2.1 Study Design
2.2 Literature Search
2.3 Inclusion and Exclusion Criteria
2.4 Quality and Risk of Bias Assessment
2.5 Analysis and Interpretation of Results
3 Results
3.1 Search Results
3.2 Study Quality and Bias Results
3.3 Systematic Review and Meta-analyses Findings
4 Discussion
Study | 1 (1 point) | 2 (1 point) | 3 (1 point) | 4 (1 point) | 5 (1 point) | 6 (3 points) | 7 (1 point) | 8 (2 points) | 9 (1 point) | 10 (1 point) | 11 (1 point) | 12 (1 point) | Total |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
TESTEX criterion | |||||||||||||
Alonso-Fernandez et al. [58] | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 4 |
Alt et al. [58] | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 1 | 0 | 1 | 1 | 6 |
Anastasl and Hamzeh [56] | 1 | 0 | 0 | 1 | 0 | 0 | 0 | 2 | 1 | 0 | 1 | 1 | 7 |
Clark et al. [51] | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 4 |
Delahunt et al. [53] | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 5 |
Freeman et al. [47] | 0 | 0 | 0 | 1 | 0 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 6 |
lga et al. [50] | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 2 | 1 | 0 | 1 | 1 | 6 |
Ishøi et al. [35] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 2 | 1 | 0 | 1 | 1 | 11 |
Mjolsnes et al. [33] | 0 | 0 | 0 | 0 | 0 | 2 | 0 | 2 | 1 | 0 | 1 | 1 | 7 |
Presland et al. [54] | 1 | 0 | 0 | 1 | 0 | 2 | 0 | 2 | 1 | 0 | 1 | 1 | 9 |
Ribeiro-Alvares et al. [51] | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 2 | 1 | 0 | 1 | 1 | 8 |
Seymore et al. [55] | 1 | 0 | 0 | 1 | 0 | 0 | 0 | 2 | 1 | 0 | 1 | 1 | 7 |
Tansel et al. [58] | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 3 |
4.1 The Effect of Volume on Eccentric Strength
4.2 The Effect of Volume on Muscle Architecture
Study | Subjects | Population | Duration (weeks) | Intervention (reps × sets × frequency) | Total volume (reps) | Average weekly volume (reps) | Outcomes |
---|---|---|---|---|---|---|---|
Alonso-Fernandez et al. [58] | n = 23 | Recreationally active males | 8 | Week 1–2 = 2 × 6 × 2 Week 3–4 = 3 × 4–6 × 3 Week 5–6 = 3 × 8 × 3 Week 7–8 = 3 × 10 × 3 | 480 | 60 | Significant increases in FL and MT of the BFlh and significant decreases in PA |
Alt et al. [48] | n = 16 | Regional to national level male sprinters | 4 | Week 1–4 = 3 × 3 × 3 | 108 | 27 | No significant increases in peak torque as a result of the intervention |
Anastasi and Hamzeh [56] | n = 24 | Amateur female rugby union players | 10 | Week 1–2 = 3 × 6 × 3 Week 3–4 = 3 × 7 × 3 Week 5–7 = 3 × 8 × 3 Week 8–10 = 3 × 10 × 3 | 720 | 72 | Increases in peak torque of both limbs pre to post |
Clark et al. [51] | n = 9 | Amateur Australian Rules Football players | 4 | Week 1 = 2 × 5 × 1 Week 2 = 2 × 6 × 2 Week 3 = 3 × 6 × 3 Week 4 = 3 × 8 × 3 | 160 | 40 | Significant reductions in peak torque pre to post |
Delahunt et al. [53] | n = 29 | Recreationally active males | 6 | Week 1 = 2 × 5 × 1 Week 2 = 2 × 6 × 2 Week 3 = 3 × 6 × 3 Week 4 = 3 × 8 × 3 Week 5–6 = 3 × 12, 10, 8 × 3 | 340 | 57 | Significant increases in peak torque pre to post, with large effect sizes |
Freeman et al. [47] | n = 28 | Team sport adolescent athletes | 4 | Week 1 = 2 × 5 × 2 Week 2 = 3 × 4 × 2 Week 3 = 3 × 5 × 2 Week 4 = 3 × 6 × 2 | 110 | 28 | Significant increases in peak eccentric force pre to post, with small effect sizes |
Iga et al. [50] | n = 18 | English professional male soccer players | 4 | Week 1 = 2 × 5 × 1 Week 2 = 2 × 6 × 2 Week 3 = 3 × 6 × 3 Week 4 = 3 × 8 × 3 | 160 | 40 | Significant increases in peak torque at 3 different angular velocities pre to post |
Ishøi et al. [35] | n = 35 | Amateur male soccer players | 10 | Week 1 = 2 × 5 × 1 Week 2 = 2 × 6 × 2 Week 3 = 3 × 6–8 × 3 Week 4 = 3 × 8–1 × × 3 Week 5–10 = 3 × 12, 10, 8 × 3 | 700 | 70 | Significant increases in peak eccentric hamstring force pre to post |
Mjølsnes et al. [33] | n = 21 | Competitive male soccer players | 10 | Week 1 = 2 × 5 × 1 Week 2 = 2 × 6 × 2 Week 3 = 3 × 6–8 × 3 Week 4 = 3 × 8–10 × 3 Week 5–10 = 3 × 12, 10, 8 × 3 | 700 | 70 | Significant increases in peak torque pre to post. Significantly greater increases compared to concentric exercise |
Presland et al. [54] (high volume) | n = 20 | Recreationally active males | 6 | Baseline week 1–2 = 4 × 6 × 2 Week 3 = 4 × 8 × 2 Week 4 = 4 × 10 × 2 Week 5–6 = 5 × 10 × 2 | 392 | 73 | Significant increases in BFFL for both groups, and decreases in PA in the pre to post for the low volume group. No significant differences were observed for MT. Eccentric hamstring force also increased significantly in both groups |
Presland et al. [54] (low volume) | Baseline week 1–2 = 4 × 6 × 2 Week 3–6 = 2 × 4 × 1 | 80 | 21 | ||||
Ribeiro-Alvares et al. [51] | n = 20 | Healthy young adults (aged 18–35) | 4 | Week 1 = 3 × 6 × 2 Week 2 = 3 × 7 × 2 Week 3 = 3 × 8 × 2 Week 4 = 3 × 10 × 2 | 186 | 47 | Significant increases in peak torque pre to post, with moderate effect sizes. BFMT did not change pre to post, FL did increase and PA decrease to a very large and large effect size, respectively |
Seymore et al. [55] | n = 20 | Recreationally active adults | 6 | Week 1 = 2 × 5 × 1 Week 2 = 2 × 6 × 2 Week 3 = 3 × 6 × 3 Week 4 = 3 × 8 × 3 Week 5–6 = 3 × 12, 10, 8 × 3 | 340 | 57 | No significant increases in peak torque as a result of the intervention. BF FL and PA both increased without significance, CSA increased significantly |
Tansel et al. [58] | n = 26 | Healthy boys (aged 10–12) | 5 | Week 1 = 2 × 5 × 1 Week 2 = 2 × 6 × 2 Week 3 = 3 × 6–8 × 3 Week 4 = 3 × 8–10 × 3 Week 5 = 3 × 12, 10, 8 × 3 | 286 | 57 | Significant increases in hamstring peak torque pre to post |