Female athletes participating in sports that carry higher risk for ACL tear (eg. Basketball, volleyball, soccer) have a 4-6 fold higher rate of ACL injury than their male counterparts.\u00a0 Much research has been attempted trying to determine the reasons for the difference in injury rates among the sexes.\u00a0 One of the group of possible causes that has shown the most promise in this area are specific muscle weakness patterns in the hips and thigh.\u00a0 Good muscle control is essential to protect the leg during activities involving jumping, pivoting and landings.\u00a0 Hip weakness can result in a lack of proper control of the femur during landings, allowing the knee to drop into a position that excessively tensions the ACL, putting it at risk for rupture.\u00a0 Women also tend to come down from landings more straight-legged than men.\u00a0 When this is combined with a forceful contraction of the quadriceps, the shin bone (or tibia) is pulled sharply forward.\u00a0 If the hamstrings (which provide a counterforce to the tibia) fail to prevent this forward movement, and if the ACL is excessively tightened for the reasons outlined above, the ligament can tear.\u00a0 For this reason, investigators have looked at the ratio of hamstring strength to quadricep strength as a possible predictor of the risk of ACL tear (Low hamstring strength and higher quadriceps strength equals a low Ham-to-Quad ratio [H:Q] and correlates to a higher risk for tears), and when the uninjured legs of females who have suffered an ACL tear are evaluated, generally these athletes have lower H:Q than uninjured peers.\u00a0 Male athletes as a group have a higher H:Q ratio than their female peers.<\/p>\n
This study followed athletes prospectively, meaning that the strength measurements were taken before injury occurred in approximately 1700 athletes, who were then followed for up to two years.\u00a0 Athletes who sustained an ACL injury during this time were then compared with four selected uninjured (previously screened) athletes (the control group) who were otherwise similar with respect to sport, developmental stage, height and weight.\u00a0 The strength of this study is the control group, since the uninjured controls are more closely matched to injured athletes than in previous studies.\u00a0 This increases the likelihood that any differences observed in leg strength are meaningful.<\/p>\n
The findings of this study showed that female athletes who went on to tear their ACL had significantly lower hamstring strength at baseline than athletes who did not injure their ACL when both groups were compared to male peers.\u00a0 Quadricep strength did not differ between the two groups.\u00a0 Thus, the decrease in hamstring to quadricep strength ratio came from weak hamstrings, not over-strong quadriceps.<\/p>\n
We also know from prior research that while male athletes tend to increase hamstring strength past puberty, female athletes tend to remain plateaued.\u00a0 This results in a lower H:Q in females with sports activities as they move past puberty, indicating an increased risk starting around 12 to 13 years of age.\u00a0 Thus, strengthening programs aimed at increasing hamstring strength in females should be targeted to females just entering their teens or older.<\/p>\n
There are simple ways to increase hamstring strength in young athletes.\u00a0 One of the most effective is an exercise developed by the Norwegian National Soccer Team\u2019s strength and conditioning coaches, known as \u201cNordic Hamstrings.\u201d \u00a0This exercise has been shown to significantly decrease the risk for hamstring injury in-season, and has also been shown to result in better hamstring strength gains than traditional hamstring curls in the gym.\u00a0 Go to the following URL (http:\/\/stadiasportsmedicine.com\/info\/2017\/hamstring-injury-prevention-nordic-hamstrings\/#.WimzUUqnHIU<\/a>) to access a free copy of the Nordic Hamstring Strength protocol or links to Tim Hewett\u2019s ACL risk reduction program (http:\/\/www.usatoday.com\/sports\/gallery\/acl\/flash.htm<\/a>).\u00a0 If you would like to discuss screening for ACL injury risk or have specific questions about injury risk reduction, contact Stadia Sports Medicine at (515)221-1102.\u00a0 We\u2019re happy to help!<\/p>\n","protected":false},"excerpt":{"rendered":" Myer GD, Hewett TE et al.\u00a0 The Relationship of Hamstrings and Quadriceps Strength to Anterior Cruciate Ligament Injury in Female […]<\/p>\n","protected":false},"author":4,"featured_media":833,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[75],"tags":[14,68,15,98,38,136,89],"class_list":["post-831","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sport-med-research","tag-athlete-safety","tag-hamstring","tag-injury-prevention","tag-knee-pain","tag-leg-pain","tag-research","tag-training"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/posts\/831","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/comments?post=831"}],"version-history":[{"count":2,"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/posts\/831\/revisions"}],"predecessor-version":[{"id":842,"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/posts\/831\/revisions\/842"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/media\/833"}],"wp:attachment":[{"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/media?parent=831"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/categories?post=831"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stadiasportsmedicine.com\/info\/wp-json\/wp\/v2\/tags?post=831"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}