Knee Extension Strength and Hamstrings-to-Quadriceps Imbalances in Elite Soccer Players

Abstract

This study examined the relationship between hamstrings-to-quadriceps strength ratio (H:Q) and relative strength of the knee extensors in elite soccer players. Peak torque was measured during isokinetic knee extension/flexion at angular velocities of 60°·s⁻¹, 180°·s⁻¹ and 300°·s⁻¹. 18 professional players were divided into 2 groups, depending on their H:Q at 60°·s⁻¹. Players in the lower H:Q group (n=7) had significantly smaller H:Q ratios compared with the higher H:Q group (n=11) at all angular velocities (60°·s⁻¹: 49.2%; 95% CI: 61.3–57.8% vs. 59.5%; 95% CI: 52.2–46.2%, p=0.001). Players in the lower H:Q group had greater knee-extension peak torque compared with the higher H:Q group (60°·s⁻¹: 313; 95% CI: 335–291 vs. 269; 95% CI: 289–250 N·m, p=0.01). No differences were found in hamstrings’ strength between the 2 groups (60°·s⁻¹: 156; 95% CI: 170–143 vs. 160; 95% CI: 173–148 N·m, p=0.96). Negative correlations between knee extension peak torque and H:Q ratio were observed at all angular velocities (r=−0.65 to −0.67, p<0.01). In conclusion, a low H:Q strength ratio measured during isokinetic strength testing in professional soccer players, is observed mainly in those with strong quadriceps muscles, while players with lower quadriceps strength have H:Q ratios around the recommended values.

Key words

isokinetic dynamometry - hamstrings-to-quadriceps ratio - peak torque

• References

• 1 Aagaard P, Simonsen EB, Andersen JL, Magnusson P, Dyhre-Poulsen P. Increased rate of force development and neural drive of human skeletal muscle following resistance training. J Appl Physiol 2002; 93: 1318-1326
• 2 Aagaard P, Trolle M, Simonsen EB, Klausen K, Bangsbo J. High speed knee extension capacity of soccer players after different kinds of strength training. In: Reilly T, Clarys J, Stibbe A. (eds.) Science and football II. London, New York: E & FN Spon; 1993: 92-94
• 3 Bahr R, Thorborg K, Ekstrand J. Evidence-based hamstring injury prevention is not adopted by the majority of Champions League or Norwegian Premier League football teams: the Nordic Hamstring survey. Br J Sports Med 2015;
• 4 Bangsbo J, Mohr M, Krustrup P. Physical and metabolic demands of training and match-play in the elite football player. J Sports Sci 2006; 24: 665-674
• 5 Baratta R, Solomonow M, Zhou BH, Letson D, Chuinard R, A’Ambrosia R. Muscular coactivation. The role of the antagonist musculature in maintaining knee stability. Am J Sports Med 1988; 16: 113-122
• 6 Camarda SRA, Denadai BS. Does muscle imbalance affect fatigue after soccer-specific intermittent protocol?. J Sci Med Sport 2012; 15: 355-360
• 7 Cerrah AO, Gungor EO, Soylu AR, Ertan H, Lees A, Bayrak C. Muscular activation patterns during the soccer in-step kick. Isokinet Exerc Sci 2011; 19: 181-190
• 8 Cometti G, Maffiuletti NA, Pousson M, Chatard JC, Maffulli N. Isokinetic strength and anaerobic power of elite, subelite and amateur French soccer players. Int J Sports Med 2001; 22: 45-51
• 9 Coombs R, Garbutt G. Developments in the use of the hamstring/quadriceps ratio for the assessment of muscle balance. J Sports Sci Med 2002; 1: 56-62
• 10 Coratella G, Bellin G, Beato M, Schena F. Fatigue affects peak joint torque angle in hamstrings but not in quadriceps. J Sports Sci 2014; 17: 1-7
• 11 Croisier JL, Forthomme B, Namurois MH, Vanderthommen M, Crielaard JM. Hamstring muscle strain recurrence and strength performance disorders. Am J Sports Med 2002; 30: 199-203
• 12 Croisier JL, Ganteaume S, Binet J, Genty M, Ferret JM. Strength imbalances and prevention of hamstring injury in professional soccer players: a prospective study. Am J Sports Med 2008; 36: 1469-1475
• 13 Denadai BS, de Oliveira FB, Camarda SR, Ribeiro L, Greco CC. Hamstrings-to-quadriceps strength and size ratios of male professional soccer players with muscle imbalance. Clin Physiol Funct Imaging 2014;
• 14 DeProft E, Cabri J, Dufour W, Clarys JP. Strength training and kick performance in soccer players. In: Science & Football – Proceedings of the 1^st World Congress of Science and Football. Reilly T, Lees A, Davids K, Murphy W, London E, Spon FN, (Eds.) 1988: 108-113
• 15 Ekstrand J, Hegglund M, Waldin M. Epidemiology of muscle injuries in professional football (soccer). Am J Sports Med 2011; 39: 1226-1232
• 16 Fousekis K, Tsepis E, Vagenas G. Lower limb strength in professional soccer players: profile, asymmetry, and training age. J Sports Sci Med 2010; 9: 364-373
• 17 Goode AP, Reiman MP, Harris L, DeLisa L, Kauffman A, Beltramo D, Poole C, Ledbetter L, Taylor AB. Eccentric training for prevention of hamstring injuries may depend on intervention compliance: a systematic review and meta-analysis. Br J Sports Med 2015; 49: 349-356
• 18 Greco CC, Da Silva WL, Camarda SRA, Denadai BS. Rapid hamstrings/quadriceps strength capacity in professional soccer players with different conventional isokinetic muscle strength ratios. J Sports Sci Med 2012; 11: 418-422
• 19 Gur H, Akova B, Punduk Z, Kuçukoglu S. Effects of age on the reciprocal peak torque ratios during knee muscle contractions in elite soccer players. Scand J Med Sci Sports 1999; 9: 81-87
• 20 Hagood S, Solomonow M, Baratta R, Zhou BH, D’Ambrosia R. The effect of joint velocity on the contribution of the antagonist musculature to knee stiffness and laxity. Am J Sports Med 1990; 18: 182-187
• 21 Harriss DJ, Atkinson G. Ethical standards in sport and exercise science research: 2014 update. Int J Sports Med 2013; 34: 1025-1028
• 22 Hawkins RD, Hulse MA, Wilkinson C, Hodson A, Gibson M. The association football medical research programme: an audit of injuries in professional football. Br J Sports Med 2001; 35: 43-47
• 23 Hopkins WG. Estimating sample size for magnitude based inferences. Sportscience 2006; 10: 63-70
• 24 Hoshikawa Y, Muramatsu M, Iida T, Uchiyama A, Nakajima Y, Kanehisa H. Event-related differences in the cross-sectional areas and torque generation capabilities of quadriceps femoris and hamstrings in male high school athletes. J Physiol Anthropol 2010; 29: 13-21
• 25 Iga J, Fruer CS, Deighan M, Croix MD, James DV. ‘Nordic’ hamstrings exercise – engagement characteristics and training responses. Int J Sports Med 2012; 33: 1000-1004
• 26 Kim D, Hong J. Hamstrings to quadriceps strength ratio and non-contact leg injuries: a prospective study during one season. Isokinet Exerc Sci 2011; 19: 1-6
• 27 Levanon J, Dapena J. Comparison of the kinematics of the full-instep and pass kicks in soccer. Med Sci Sports Exerc 1998; 30: 917-927
• 28 Magalhaes J, Oliveira J, Ascensao A, Soares J. Concentric quadriceps and hamstrings isokinetic strength in volleyball and soccer players. J Sports Med Phys Fitness 2004; 44: 119-125
• 29 Manolopoulos E, Papadopoulos C, Kellis E. Effects of combined strength and kick coordination training on soccer kick biomechanics in amateur players. Scand J Med Sci Sports 2006; 16: 102-110
• 30 Nimphius S, McGuigan MR, Newton RU. Changes in muscle architecture and performance during a competitive season in female softball players. J Strength Cond Res 2012; 26: 2655-2666
• 31 Oberg B, Moller M, Gillquist J, Ekstrand J. Isokinetic torque levels for knee extensors and knee flexors in soccer players. Int J Sports Med 1986; 7: 50-53
• 32 Rodano R, Tavana R. Three dimensional analysis of the instep kick in professional soccer players. In: Science and Football II. Reilly T, Clarys J, Stibbe A, (Eds.) London: E & FN Spon; 1993: 357-363
• 33 Ruas CV, Minozzo F, Pinto MD, Brown LE, Pinto RS. Lower-extremity strength ratios of professional soccer players according to field position. J Strength Cond Res 2015; 29: 1220-1226
• 34 Stolen T, Chamari K, Castagna C, Wisloff U. Physiology of soccer. Sports Med 2005; 35: 501-536
• 35 Tsuda E, Okamura Y, Otsuka H, Komatsu T, Tokuya S. Direct evidence of the anterior cruciate ligament-hamstring reflex arc in humans. Am J Sports Med 2001; 29: 83-87
• 36 Woods C, Hawkins RD, Maltby S, Hulse M, Thomas A, Hodson A. The Football Association Medical Research Programme: an audit of injuries in professional football – analysis of hamstring injuries. Br J Sports Med 2004; 38: 36-41