Smaller Biceps Femoris Aponeurosis Size in Legs with a History of
                    Hamstring Strain Injury

Thomas G. Balshaw; Emmet J. McDermott; Garry J Massey; Chris Hartley; Pui Wah Kong; Tom Maden-Wilkinson; Jonathan Folland

doi:10.1055/a-2348-2605

International Journal of Sports Medicine, Table of Contents

Int J Sports Med 2024; 45(13): 871-883
DOI: 10.1055/a-2348-2605

Orthopedics & Biomechanics

Smaller Biceps Femoris Aponeurosis Size in Legs with a History of Hamstring Strain Injury

Authors

Thomas G. Balshaw

¹School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom of Great Britain and Northern Ireland
Emmet J. McDermott

¹School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom of Great Britain and Northern Ireland
Garry J Massey

²School of Sport & Health Sciences, University of Exeter, Exeter, United Kingdom of Great Britain and Northern Ireland
Chris Hartley

³Department of Health Sciences, Birmingham City University, Birmingham, United Kingdom of Great Britain and Northern Ireland
Pui Wah Kong

⁴National Institute of Education, Nanyang Technological University, Singapore, Singapore
Tom Maden-Wilkinson

⁵Academy of Sport and Physical Activity, Faculty of Health and Wellbeing, Collegiate Campus, Sheffield Hallam University, Sheffield, United Kingdom of Great Britain and Northern Ireland
Jonathan Folland

¹School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom of Great Britain and Northern Ireland

Abstract

Biceps femoris long head (BF_LH) aponeurosis size was compared between legs with and without prior hamstring strain injury (HSI) using two approaches: within-group (injured vs. uninjured legs of previous unilateral HSI athletes) and between-group (previously injured legs of HSI athletes vs. legs of No Prior HSI athletes). MRI scans were performed on currently healthy, competitive male athletes with Prior HSI history (n=23;≥1 verified BF_LH injury; including a sub-group with unilateral HSI history; most recent HSI 1.6±1.2 years ago) and pair-matched athletes with No Prior HSI history (n=23). Anonymized axial images were manually segmented to quantify BF_LH aponeurosis and muscle size. Prior unilateral HSI athletes’ BF_LH aponeurosis maximum width, aponeurosis area, and aponeurosis:muscle area ratio were 14.0–19.6% smaller in previously injured vs. contralateral uninjured legs (paired t-test, 0.008≤P≤0.044). BF_LH aponeurosis maximum width and area were also 9.4–16.5% smaller in previously injured legs (n=28) from Prior HSI athletes vs. legs (n=46) of No Prior HSI athletes (unpaired t-test, 0.001≤P≤0.044). BF_LH aponeurosis size was smaller in legs with prior HSI vs. those without prior HSI. These findings suggest BF_LH aponeurosis size, especially maximum width, could be a potential cause or consequence of HSI, with prospective evidence needed to support or refute these possibilities.

Keywords

magnetic resonance imaging - internal tendon - muscle volume - risk factors

Full Text

References

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