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The late swing and early stance of sprinting are most hazardous for hamstring
injuries

Article  in  Journal of Sport and Health Science · January 2017

DOI: 10.1016/j.jshs.2017.01.011

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Journal of Sport and Health Science 6 (2017) 133–136
www.jshs.org.cn

Opinion
The late swing and early stance of sprinting are most hazardous for
hamstring injuries
Yu Liu a,*, Yuliang Sun b, Wenfei Zhu b, Jiabin Yu c
a
Key Laboratory of Exercise and Health Sciences of the Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
b
School of Physical Education, Shaanxi Normal University, Xi’an 710119, China
c
Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Ningbo 315211, China
Received 31 August 2016; revised 8 November 2016; accepted 21 November 2016
Available online 26 January 2017

Hamstring strain injury is one of most prevalent noncontact string during running alone.7–9 Limited attempts have been
injuries in sports that involve high-speed running, such as made to measure the GRFs during overground sprinting and use
sprinting, soccer, and rugby.1 In order to optimize prevention these data to estimate the hamstring kinetics during stance.3,4 To
strategies and injury rehabilitation, studies have been con- fill this gap, we investigated the loading conditions of the ham-
ducted to understand hamstring function during sprinting.2–4 string muscles during maximum-effort overground running.2
However, differences have long existed in the literature as to the Our results suggest that the hamstrings are most susceptible to
cause of hamstring strain injuries. One of the most controversial injury during the swing and stance transitions of sprinting.
topics is the debate over which phase of high-speed running is We used a lower extremity intersegmental dynamics analysis
most associated with hamstring injuries.5 for each body segment.2,13 The intersegmental dynamics analy-
Studies of running biomechanics indicate that the ham- sis we used allows for torques at each joint to be separated into
strings are active for the entire gait cycle, with peaks in activa- 5 categories: gravitational torque (GTT), motion-dependent
tion during the early stance and the late swing phases.6,7 Mann torque (MDT), external contact torque (EXT), generalized
and Sprague3 reported that the highest torques of hip extension muscle torque (MST), and net joint torque (NET), which is the
and knee flexion occur secondary to a peak value of the ground vector sum of the 4 previous components. Detailed interactions
reaction forces (GRFs) during the initial stance phase. Based on between the active muscle torques and the passive torque com-
this information, they concluded that the early stance was ponents could be quantified, giving us insight into how the
highly associated with hamstring strains. In contrast, many hamstrings’ function switches during the running cycle.
subsequent researchers held the view that the late swing phase Using this approach, we reached 3 main conclusions. First,
of sprinting is the most hazardous.4,6–9 These studies found that the MST primarily countered the MDT during the swing phase
the hamstrings contract forcefully while reaching maximum for the knee and hip joints (Fig. 1A). In late swing, the leg was
length during the late swing phase. They ignored Mann’s argu- swinging forward due to its inertia, which cause a large hip-
ment of high torques as an indicator of hamstring injury risk flexion MDT and a knee-extension MDT at the same time.
and preferred the hypothesis that hamstring strains occur during Therefore, the hamstrings were active and started to extend the
eccentric contractions.10 hip and flex the knee joints to counteract these passive effects
However, most previous observers used treadmill sprinting for the subsequent ground contact (Fig. 1B). Further analysis of
rather than overground sprinting in their studies.6,8,9 Although the components of the MDT showed that MDT at both joints
the treadmill is a convenient tool for assessment of running was caused mainly by torques due to the leg angular accelera-
biomechanics, it has been shown that the biomechanics of tion. These passive torques applied stress to the hamstring
treadmill running differ significantly from those of overground muscles in the opposite direction of contraction at both joints.
running, and thus may lead to erroneous conclusions about To counter this negative effect, the hamstrings encountered
overground running.11,12 Additionally, much of the previous enormous loads, approximately 10 times the subjects’ average
research was aimed at investigating the kinematics of the ham- body weight, to control the rapid leg rotation, which created
conditions for hamstring injuries. Previous studies reported that
the hamstrings stretch to their maximum length and the muscle
Peer review under responsibility of Shanghai University of Sport.
force reaches its maximal value in this phase.6–8 Our results
* Corresponding author. confirmed these findings and showed how they happened. The
E-mail address: yuliu@sus.edu.cn (Y. Liu) key contributor to these high torques was the MDT created
http://dx.doi.org/10.1016/j.jshs.2017.01.011
2095-2546/© 2017 Production and hosting by Elsevier B.V. on behalf of Shanghai University of Sport. This is an open access article under the CC BY-NC-ND
license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
134 Y. Liu et al.

Fig. 1. Averaged time-normalized graphs for joint torques at knee and hip joints during the swing (A) and stance (C) phases of sprinting. The top panels show
positions of the lower extremity during the swing (A) and stance (C) phases. Data represent the group mean (lines) with 1SD (shading). (B) Diagram of sprinting
during the late swing phase: the inertial loads (MDT) produced by segment motion at the knee and hip joints. (D) Diagram of sprinting during the initial stance phase:
the GRF passes anteriorly to the knee and hip joints. EXT = external contact torque; GRF = ground reaction force; GTT = gravitational torque;
MDT = motion-dependent torque; MST = muscle torque; NET = net torque. (Positive value indicates extension; negative value indicates flexion.) Adapted with
permission.2

mainly due to the leg angular acceleration.2 Although there is hamstrings, which encounter at least 8 times the subjects’ body
debate as to whether eccentric muscle strain or muscle stress is weight in the initial stance phase, are susceptible to strain injury
the causative factor in muscle strain injuries,1,10 it is known that in this phase. This conclusion supports Mann’s finding.3 Addi-
an eccentric contraction occurs when the external force is tionally, we discovered that the external GRF passing anteriorly
greater than the muscle contraction force, that is, the eccentric to the knee and hip generate the peak loads on the hamstrings.2
muscle action is induced by an external force. During late As the early stance is a continuation of the late swing, the
swing, the leg angular acceleration led to a tremendous MDT, hamstrings were contracting concentrically after being fully
which caused the hamstring muscles to work eccentrically. This extended. The muscles were suffering from enormous loads
suggests that hamstring strains are associated with high loading caused by 2 different factors (the inertia and the GRFs)
caused by the inertial torque MDT. throughout this eccentric–concentric transition.
Second, the dominant passive torque switched to EXT in the Chumanov et al.6 indicated an increased loading for the
transition from late swing to initial stance (Fig. 1C). We noticed hamstring muscles during the initial stance phase. However,
that the GRFs passed anteriorly to the knee and hip joints they did not regard this phase as injurious because negative
during the initial stance phase, which generates a large exten- work (i.e., energy absorbed) during eccentric contraction has
sion torque at the knee and a flexion torque at the hip at the been shown to correlate best with muscle injuries in animal
same time (Fig. 1D). As with the knee flexors and hip extensors models. This is a widely held belief, despite experimental evi-
in the late swing phase, the hamstring muscles serve both roles dence of muscle strains being produced during concentric
required to counteract the effect of the GRFs. It is likely that the (shortening) contractions.14 However, we currently cannot know
Hamstring injuries in sprinting 135

for certain if muscle strains are produced by the tremendous from inverse dynamics analysis. However, they did not find
external forces during concentric contractions in the early peak values during the early stance phase. Peak musculotendon
stance of sprinting. In addition, we are aware of the evidence forces for the bi-articular hamstrings would seem to have been
suggesting that loads on their own are not necessarily indicative underestimated in the early stance phase, and the authors attri-
of injury risk, but accumulated effects of biomechanical loads bute this to the limitations of the inverse dynamics-based static
(i.e., musculotendon strain, velocity, force, power, and work) optimization combined with a minimum-stress performance
experienced by the hamstrings may result in hamstring strain criterion. However, in our opinion, this is a typical case in
injuries. We cannot state conclusively that high loading creates which over-filtered data were used for an inverse dynamics
injury. However, we have evidence that the risk factors for calculation. Compared with their previous results, which also
hamstring injuries are high in both the late swing and the early indicated a peek knee flexion torque during the early stance
stance phase for different loading mechanisms. phase,19 the peak values might have been attenuated artificially.
Finally, unlike most previous research in which GRFs were To sum up, during both the late swing and the initial stance
not determined,7–9 we took both kinematic and kinetic data into phase, the large passive torques at the knee and hip joints acted
consideration2 and examined overground sprinting at maximum to lengthen the hamstring muscles. The values of the flexion
effort in elite athletes. The average maximum speed in our study MST at the knee and the extension MST at the hip in those 2
was 9.7 m/s, which approaches typical maximum sprinting phases were considerable, indicating that the knee flexors and
speeds and associated enormous GRFs, and is higher than hip extensors play an important role in sprint running, espe-
speeds achieved in previous studies.4,6 It has been suggested cially during the initial stance phase and the late swing phase.
that the hip and knee torques, which are estimated via the The active muscle torques generated mainly by the hamstrings
inverse dynamics approach, are particularly sensitive to the counteracted the passive effects generated by the inertia of the
filter cutoff frequency, and the early portion of the stance phase leg (swing) and the external GRF (stance). Although different
is the most affected period.15,16 Exaggerated fluctuations in the causes led to the high loads in the hamstrings in these 2 phases,
knee joint torques are data-processing artifacts rather than we might think of these 2 phases as 1 period, the swing–stance
genuine characteristics of the joint kinetics. Therefore, it has transition period, because the motions of the lower-extremity
been suggested that matched cut-off frequencies be used for are continuous and the hamstring muscles function to extend
both kinematic and kinetic data (i.e., 20–20 Hz) when applying the hip and flex the knee throughout the entire phase. As a
inverse dynamics. Filtering at unmatched cutoff frequencies result, during sprinting or high-speed locomotion, the ham-
might affect, to some extent, the results obtained in our lab. string muscles may be more susceptible to strain injury during
However, one should not universally dismiss studies that use the swing–stance transition than during any other phase in
unmatched cutoff frequencies. Based on our results, the joint sprint running.
muscle torques counteract the EXT, which was caused by the One limitation of our research is that the method for esti-
GRFs during the stance phase. Careful examination of the raw mating muscle torques across a joint does not reveal an indi-
curves of the GRFs reveal that the GRFs switch between vidual muscle’s contributions to the joint torque. In addition,
passing in front and behind the knee joint during early stance. passive structures also contribute to the joint torques at the knee
This phenomenon contributes to the fluctuations of the GRFs and hip. Because the hamstring muscles are the most injured
and affects the derivation of the joint muscle torque. Therefore, muscles during sprinting20 and are the only bi-articular muscles
the peak values of the MST in early stance are not all artifacts. that flex the knee and extend the hip, we focused our MST-
In addition, the aim of data filtering is to remove noise and related discussion on the hamstring musculature. Future studies
reduce the attenuation of signals as much as possible. Data need to consider the role of other active and passive structures
filtering must be based on the raw signals. To estimate if the that cross the hip and knee joints.
filtered data are optimally processed, we need to compare the
Acknowledgments
smoothed curve with the raw data curve. In the current study,
we strictly followed the protocol for estimating optimum cutoff This study was supported partly by the National Natural
frequency.17,18 The optimum cutoff frequency is not only a func- Science Foundation of China (No. 11372194, 81572213). It
tion of the residual between the filtered and unfiltered data but was also supported by the Fundamental Research Funds for the
is also a function of the sampling frequency. Matched combi- Central Universities (No. GK201603128, GK201603129) and
nations of cutoff frequencies (i.e., 20–20 Hz) can potentially the Ministry of Education in China Project of Humanities and
“over-smooth” the kinetic data, thereby removing crucial peak Social Sciences (No. 16XJC890001).
values of joint torques at the instant of foot strike, which
Authors’ contributions
explains why there were no fluctuations when using matched
cutoff frequencies. YL designed and carried out the study and drafted the manu-
Schache et al.4 studied the mechanics of the hamstring script; YS performed the literature review and helped to draft
muscles during overground sprinting, using an advanced mus- the manuscript; WZ helped to draft and revise the manuscript;
culoskeletal model accessed from OpenSim. They estimated the JY participated in the design and coordination of the study and
loads acting on individual muscles (semitendinosus, semimem- helped to draft the manuscript. All authors have read and
branosus, biceps femoris long head, and biceps femoris short approved the final version of the manuscript, and agree with the
head) based on the joint torques at the knee and hip obtained order of presentation of the authors.
136 Y. Liu et al.

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