Exercise selection for hamstring injury prevention

1. Exercise selection for
hamstring injury prevention
Dr Matthew Bourne

2. An evidence based framework…
Exercise selection
Effect on risk
factors??
Adaptations
Acute
activation
patterns
Results of
RCTs

3. Bourne et al, Br J Sports Med 2017, 48(3):337-45 & 51(5):469-477
Our approach
sEMG study (10 exercises)
Lateral v medial sEMG
fMRI study (2 exercises)
Best lateral v best medial Ex
10/52 Training study
Comparing the 2 exercises
M Vol, ACSA, strength &
BFLH fascicle lengths

4. Bourne et al, Br J Sports Med 2017, 48(3):337-45
(SDL) Bilateral stiff-leg deadlift, (HH) hip hinge, (USDL) unilateral stiff-leg deadlift, (L) lunge, (bKb) unilateral bent knee
bridge, (SKB) unilateral straight knee bridge, (LC) leg curl, (HE) 45° hip extension, (GHR) glute-ham-raise, (NHE) Nordic.
Target the right muscle(s)

5. * Each dot represents an individual study
Can we trust surface EMG?

6. fMRI changes after 5 ´ 10 reps

7. Hypertrophy after 10/52 training
0
10
20
30
BFLH BFSH ST SM
0
10
20
30
BFLH BFSH ST SM
% volume change
% volume change
Acute T2
changes
(fMRI)
predict
hypertrophy
within (not
across)
exercises

8. Bourne et al, Sports Med 2018, 48(2): 251-267
fMRI: Hip vs knee differences?

9. Bourne et al, Sports Med 2018, 48(2): 251-267
Does hypertrophy matter? 4 years post BFLH injury
National champion T&F athlete

10. Timmins et al, Br J Sports Med 2016, 50:1524-1535.
2. Target the right adaptations
n=131 A League
soccer players
Ultrasound &
eccentric
strength test in
pre-season

11. Timmins et al, Med Sci Sports Exerc 2015, 48(3):499-508
Impact of contraction mode on FL
Recreationally
active men
(n=14 / group)

12. Timmins et al, Med Sci Sports Exerc 2015, 48(3):499-508
Impact of contraction mode on Ecc strength
Recreationally
active men
(n=14 / group)
Concentric
group
Eccentric
group

13. Bourne et al, Br J Sports Med 2017, 48(3):337-45 & 51(5):469-477
Impact of exercise selection on FL
­ 2.2cm
­ 1.3cm
Week Sessions
/ week
Sets ×
Reps
1 2 2 × 6
2 2 3 × 6
3 2 4 × 8
4 2 4 × 10
5-8 2 5 × 8-10
9 2 6 × 6
10 2 5 × 5

14. Bourne et al, Br J Sports Med 2017, 48(3):337-45 & 51(5):469-477
Impact of exercise selection on Ecc strength
Week Sessions
/ week
Sets ×
Reps
1 2 2 × 6
2 2 3 × 6
3 2 4 × 8
4 2 4 × 10
5-8 2 5 × 8-10
9 2 6 × 6
10 2 5 × 5

15. Presland et al, Scand J Med Sci Sports 2018
Impact of training volume on FL
Week High volume
(reps)
Low volume
(reps)
1 48 48
2 48 48
3 64 8
4 80 8
5 100 8
6 100 8

16. Presland et al, Scand J Med Sci Sports 2018
Impact of training volume on strength
Week High volume
(reps)
Low volume
(reps)
1 48 48
2 48 48
3 64 8
4 80 8
5 100 8
6 100 8

17. Bourne et al, Sports Med 2018, 48(2): 251-267
Reducing injury risk via strength training
Ecc-only Conc-only
Ecc-Conc ~Isometric

18. Take home messages
1. Benefits of eccentric conditioning likely mediated by increased
fascicle length and improvements in eccentric strength (+ others?)
2. Acute responses & adaptations are heterogeneous when training
with different exercises
3. Muscle activation may be an important determinant of hypertrophy
4. Contraction mode appears to be the largest driver of architectural
changes within the hamstrings

19. @mbourne5