Journal of Sports Sciences

ISSN: 0264-0414 (Print) 1466-447X (Online) Journal homepage: http://www.tandfonline.com/loi/rjsp20

Is there really an eccentric action of the

hamstrings during the swing phase of high-speed
running? Part II: Implications for exercise

Bas Van Hooren & Frans Bosch

To cite this article: Bas Van Hooren & Frans Bosch (2017) Is there really an eccentric action of the
hamstrings during the swing phase of high-speed running? Part II: Implications for exercise, Journal
of Sports Sciences, 35:23, 2322-2333, DOI: 10.1080/02640414.2016.1266019

To link to this article: http://dx.doi.org/10.1080/02640414.2016.1266019

Published online: 09 Dec 2016.

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 JOURNAL OF SPORTS SCIENCES, 2017
VOL. 35, NO. 23, 2322–2333
https://doi.org/10.1080/02640414.2016.1266019

REVIEW

Is there really an eccentric action of the hamstrings during the swing phase of high-
speed running? Part II: Implications for exercise
Bas Van Hooren and Frans Bosch
School of Sport Studies, Fontys University of Applied Sciences, Eindhoven, The Netherlands

ABSTRACT ARTICLE HISTORY

We have previously argued that there may actually be no significant eccentric, but rather predomi- Accepted 23 November
nantly an isometric action of the hamstring muscle fibres during the swing phase of high-speed running 2016
when the attachment points of the hamstrings are moving apart. Based on this we suggested that KEYWORDS
isometric rather than eccentric exercises are a more specific way of conditioning the hamstrings for Eccentric hamstring exer-
high-speed running. In this review we argue that some of the presumed beneficial adaptations cises; isometric hamstring
following eccentric training may actually not be related to the eccentric muscle fibre action, but to exercises; high-speed run-
Downloaded by [University of Connecticut] at 02:54 06 October 2017

other factors such as exercise intensity. Furthermore, we discuss several disadvantages associated with ning; hamstring strain injury;
commonly used eccentric hamstring exercises. Subsequently, we argue that high-intensity isometric hamstring conditioning
exercises in which the series elastic element stretches and recoils may be equally or even more effective programme
at conditioning the hamstrings for high-speed running, since they also avoid some of the negative side
effects associated with eccentric training. We provide several criteria that exercises should fulfil to
effectively condition the hamstrings for high-speed running. Adherence to these criteria will guarantee
specificity with regards to hamstrings functioning during running. Practical examples of isometric
exercises that likely meet several criteria are provided.

Introduction pants was provided. It can be questioned to what extent

results of these studies can be generalised across popula-
Evidence from animal research shows that the fascicles of the
tions and to varying situations of high-speed running. For
hamstrings generally passively lengthen during the initial swing
example, sprinters have been found to adopt a different
phase, while they remain predominantly isometric during the late
running technique when running at maximum speed com-
swing phase when the electromyographic (EMG) activity and
pared with untrained or endurance trained individuals
forces are the highest (Gillis & Biewener, 2001, 2002; Gillis, Flynn,
(Bushnell & Hunter, 2007). Furthermore, several studies
McGuigan, & Biewener, 2005; Gregersen, Silverton, & Carrier,
have reported small, but statistically significant kinematic
1998). In addition, in a previous narrative review, we argued that
differences in sagittal plane knee and hip joint angles
the assumed contractile element lengthening of the hamstrings
between overground and treadmill running (Frishberg,
as computed by modelling studies in humans should not be
1983; McKenna & Riches, 2007; Riley et al., 2008;
interpreted as an eccentric action, but rather as an predominantly
Rozumalski, Novacheck, Griffith, Walt, & Schwartz, 2015;
isometric action of the hamstrings due to the influence of muscle
Schache et al., 2001; Sinclair et al., 2013). These differences
slack (Van Hooren & Bosch, in press). Furthermore, a loss of
in joint angles between overground and treadmill running
coordinative control of the pelvic area and an inability of the
or between well trained and relatively untrained individuals
muscle fibres to remain isometric when the forces are high during
may well alter the length of the muscle–tendon unit
the late swing phase were proposed as possible mechanisms for a
(Chleboun, France, Crill, Braddock, & Howell, 2001; Thelen
hamstring injury. These findings can have several implications for
et al., 2005; Visser, Hoogkamer, Bobbert, & Huijing, 1990).
exercise selection. For example, isometric rather than eccentric
Based on this, it can be argued that hamstring functioning
exercises may strengthen the hamstrings in a more specific way
is not similar among different forms of high-speed running
by mimicking the action during high-speed running.
and hence that the hamstrings should be trained in a
variety of ways. However, there are several reasons to
Is hamstring functioning similar among a variety of assume that the muscle action of the hamstrings does not
high-speed running movements? change between most situations of high-speed running,
because the adaptations to varying circumstances are not
Most computational modelling studies have been per-
done in the hamstrings but in other segments of the mus-
formed on a treadmill, using constant speed running and
culoskeletal system.
usually no information on the training status of the partici-

CONTACT Bas Van Hooren [email protected] School of Sport Studies, Fontys University of Applied Sciences, Theo Koomenlaan 3, Eindhoven,
5644 HZ, The Netherlands
© 2016 Informa UK Limited, trading as Taylor & Francis Group
 JOURNAL OF SPORTS SCIENCES 2323

Attractors and fluctuators Presumed benefits of eccentric exercises

According to dynamic systems theory, movements consist of Practitioners and scientists favouring eccentric exercises use
robust, invariant components with high stability (so-called several arguments as to why these exercises are perhaps
attractors) and variant components with low stability (so-called superior to exercises using other contraction types. However,
fluctuators) (Davids, Button, & Bennett, 2008). This distribution we will show that some of the presumed adaptations follow-
of attractors and fluctuators within the body emerges as self- ing eccentric training may actually not be related to the
organised components of a movement pattern. In technically eccentric muscle functioning, but to other factors such as
good performed movements, this distribution of attractors and the intensity of the exercise. Based on this we argue that
fluctuations changes as little as possible when going from one high-intensity isometric exercises in which the series elastic
variation of a movement pattern to another (e.g., when increas- element stretches and recoils are perhaps equally or even
ing running speed or from straight-line running to change of more beneficial for conditioning the hamstrings in a way
direction patterns). Therefore, even when the execution of a that reflects its functioning during high-speed running.
motor pattern is varied, stable attractor components will not
change, whereas unstable fluctuator components may change
to adapt to the changing task or changing environment.
Eccentric hamstrings training versus no specific
Consequently, during high-speed running in a (slightly) differ-
hamstrings training
ent environment such as in overground versus treadmill run-
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ning, only a limited number of components will be used to The most frequently used argument in favour of eccentric
adapt the movement to the changing demands. If the function- hamstring exercises is that the implementation of exercises
ing of the hamstrings during high-speed running is an attractor, thought to produce eccentric muscle actions (e.g., the Nordic
its functioning will be similar (i.e., isometric/elastic) for all varia- hamstring exercise) can reduce the incidence of hamstring
tions of high-speed running. strain injuries (Arnason, Andersen, Holme, Engebretsen, &
There are 2 major reasons to assume that the hamstrings Bahr, 2008; Askling, Karlsson, & Thorstensson, 2003; de Hoyo
indeed act as an attractor during high-speed running. First, it et al., 2014; Petersen, Thorborg, Nielsen, Budtz-Jørgensen, &
is extremely difficult to voluntary alter the timing of the ham- Hölmich, 2011; Seagrave et al., 2014; van der Horst, Smits,
strings activity during high-speed running. For example, Petersen, Goedhart, & Backx, 2015) and re-injuries (Petersen
although the magnitude of activation may be lower in tread- et al., 2011). It should be noted though, that the implementa-
mill running, the timing of hamstring activity during the swing tion of the Nordic hamstring exercise did not reduce the rate
phase of high-speed running is similar during overground and of hamstring strain injuries in all studies (Engebretsen,
treadmill running (Rozumalski et al., 2015; Wang, Hong, & Li, Myklebust, Holme, Engebretsen, & Bahr, 2008; Gabbe,
2014). Other components such as the motion of the ankles are Branson, & Bennell, 2006), although this may have been at
probably easier to alter and hence more suitable as fluctua- least partially due to low programme compliance (Goode
tors. Second, the external forces acting on the hamstrings et al., 2015).
during the late swing phase of running are very high Studies reporting reduced injury rates following eccentric
(Chumanov, Heiderscheit, & Thelen, 2007; Schache, Dorn, hamstring training have some limitations. For example, in
Blanch, Brown, & Pandy, 2012). This probably puts the ham- some studies the control group performed no additional exer-
strings at the limit of their load capacity and therefore the cise (Askling et al., 2003; de Hoyo et al., 2014; Petersen et al.,
hamstrings likely function isometric and close to their opti- 2011; Seagrave et al., 2014; van der Horst et al., 2015).
mum length because this is where they can produce optimal Therefore, these studies can only conclude that training spe-
(protecting) force. For example, research in animals previously cifically for the hamstrings reduces injury occurrence.
found that length changes in the hamstring fascicles were However, whether eccentric training is more effective than
larger during walking than during galloping (Gillis & training that involves other muscle action types (e.g., iso-
Biewener, 2001; Gillis et al., 2005), suggesting that the fascicles metric) remains unknown. Furthermore, some studies
work closer to their optimum length at higher speeds. In recruited amateur-level athletes (Petersen et al., 2011; van
addition, in a recent study it was shown that cane toad der Horst et al., 2015) and any (strength) training intervention
plantaris muscle fibres operate closer to their optimum length will likely help these individuals to reduce injury risk since
at high activation levels, with high activation levels being the some training will always work better than no training at all.
result of high movement intensities (Holt & Azizi, 2016). In addition, when trained participants were used (Askling
Finally, a large body of research has shown that the fascicles et al., 2003; de Hoyo et al., 2014; Petersen et al., 2011;
work predominantly isometric during elastic muscle function- Seagrave et al., 2014), the study details did not mention
ing (i.e., when the series elastic components of the muscle whether the participants already performed strength training
stretch and recoil) since this optimally facilitates the storage or specific (high intensity) hamstring exercises. Therefore, it is
and reuse of elastic energy (Roberts & Konow, 2013). These unknown whether the addition of eccentric hamstring exer-
findings suggest that the hamstrings function in a similar way cises is also beneficial when strength training is already being
in all manifestations of technical good running. Therefore, the performed. However, Brooks, Fuller, Kemp and Reddin (2006)
attractor state of hamstrings – isometric/elastic action in its analysed the incidence of hamstring injuries among rugby
optimum length – should be the aim of all running training union players and found that players who incorporated the
with the goal of better hamstring functioning. Nordic hamstring exercise in their strength training showed a
 2324 B. VAN HOOREN AND F. BOSCH

significant reduction in the incidence of hamstring injuries appropriate than eccentric exercises because isometric exer-
compared with players who performed strength training with- cises strengthen the hamstrings in a specific way. In support of
out the Nordic hamstring exercise. This suggests an exercise the specificity of adaptation, a recent study among amateur
specifically targeting the hamstrings is beneficial to reduce the football players found that the 20 m sprint and maximum
incidence of hamstring injuries. However, since they did not sprint velocity did not show a practical relevant improvement
compare the eccentric exercise with another equal intensity after 7 weeks of combined eccentric, plyometric and accelera-
muscle action, it remains unknown whether the beneficial tion training, despite improvements in the eccentric and con-
effect is due to the intensity or contraction type. It may simply centric hamstrings strength measured in a isokinetic
be the high recruitment levels during the eccentric hamstring dynamometer (Mendiguchia et al., 2015). These findings sug-
exercises that cause the positive effects on injury prevention. gest that improvements in the eccentric strength as measured
Isometric hamstring exercises that provide a high neuromus- during isokinetic measurements have a limited transfer to
cular demand may prove equally effective or even more effec- actual sporting performance. In addition, a recent meta-analy-
tive than eccentric exercises as they are likely to mimic the sis (Freckleton & Pizzari, 2013) and a 4-year cohort study (van
action of the hamstrings during the swing phase of high- Dyk et al., 2016) also found eccentric and concentric hamstring
speed running. In parallel, the findings of a recent meta-ana- strengths to be weak risk factors for hamstring strain injuries.
lysis suggest that loading intensity and not the type of con- Therefore, the use of isokinetic tests to measure hamstrings
traction is the stimulus for improved neuromuscular function strength as an indicator for sport performance or injury risk is
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in Achilles and patella tendinopathy (Malliaras, Barton, Reeves, very questionable. It should be noted however that these
& Langberg, 2013). Similarly, loading intensity rather than the findings can also indicate that increasing the maximum force
contraction type may also be the primary stimulus for mole- of the hamstrings is not so important to improve sprint per-
cular responses in both muscle and tendinous tissues (Garma formance or prevent injuries. These findings may actually
et al., 2007; Heinemeier et al., 2007). Therefore, isometric indicate that a well-timed force development, with a well-
exercises with a high loading intensity may be equally or controlled amount of muscle slack (Van Hooren & Bosch,
even more effective than eccentric exercises. 2016) or force production in other muscles is more important
to improve sprint performance. In a sensitivity analysis Miller,
Umberger, and Caldwell (2012) found that the maximum iso-
Are eccentric exercises really eccentric?
metric muscle strength needed to be doubled for the model
It is thought that the Nordic hamstring exercise produces an to reach world-class sprint speeds, indicating that maximum
eccentric muscle action and hence conditions the hamstrings force is important to improve high-speed running perfor-
in a contextual way for high-speed running. However, it is mance. However, they did not provide further information
important to note that no study has investigated whether on which muscle(s) this accounted for and they provided no
the hamstring fascicles indeed increase in length while being exact details of the analysis. Although it is very unlikely that an
activated during this exercise, or during several other exercises amateur athlete can become a word-class sprinter by simply
which are thought to produce an eccentric muscle action. All increasing the maximum isometric force, this suggests that
mechanisms described in part I (e.g., slack in the contractile improving the maximum (isometric) force will benefit sprint
and series elastic element, muscle gearing and compliance of performance.
the series elastic element) could cause the hamstring fascicles Isometric training may also be more suitable from a
to remain predominantly isometric during at least a part of dynamic systems-based motor control point of view.
some exercises. In addition, during the Nordic hamstring exer- According to this theory, muscle actions need to be bottom-
cise, some athletes lower to the point at which they almost up self-organised, based upon optimal stability in muscle
drop down and hold this position briefly. In this case, the actions. Isometric exercises (discussed later in this review)
(possible) eccentric muscle action becomes isometric and as may provide help to solve the problem of self-organisation
a consequence, isometric rather than eccentric force is being whereas eccentric exercises do not, given the isometric elastic
measured and incorrectly referred to as eccentric strength. muscle action in high-speed running.

Specificity of adaptation at an intramuscular level Changes in fascicle length

It is well known that the adaptations to exercise are quite Biceps femoris fascicle length has been reported to increase
specific (Morrissey, Harman, & Johnson, 1995). For example, by 16–34% following eccentric training (Potier, Alexander, &
eccentric training does mostly improve the eccentric force, Seynnes, 2009; Timmins et al., 2016). This adaptation is con-
while concentric training mostly improves the concentric sidered important for injury prevention, because less work is
force and when the intensity between contraction modes is completed on the descending part of the force–length rela-
matched they result in equal total strength gains (Roig et al., tionship where a reduced force-generating capacity may
2009). In addition, 2 recent studies found that concentric and increase injury risk (Proske & Morgan, 2001) and shorter fas-
eccentric training resulted in equal isometric strength gains, cicle lengths have been related to an increased hamstring
despite the absolute training load being higher for the injury risk (Timmins et al., 2015). However, increases in fascicle
eccentric group (Franchi et al., 2014, 2015). Because the ham- length have also been found following concentric (Blazevich,
strings likely act predominantly isometric during the swing Cannavan, Coleman, & Horne, 2007; Franchi et al., 2014) and
phase, incorporating isometric exercises may be more isometric training (Noorkõiv, Nosaka, & Blazevich, 2014).
 JOURNAL OF SPORTS SCIENCES 2325

Recently, a larger increase in fascicle length has been found Swanson, & Heiderscheit, 2005), which may increase the
following eccentric training compared with concentric train- chance of an excessive muscle fibre strain. However, excessive
ing, although the absolute training intensity and contraction muscle fibre strain as a result of an increase in tendon/apo-
duration were higher for the eccentric group (Franchi et al., neurosis stiffness may be overcome by minor adjustments in
2014, 2015). Based on these findings, it is not clear whether the timing of hamstring recruitment during the swing phase.
and how contraction type influences changes in fascicle Furthermore, an increase in tendon/aponeurosis stiffness also
length. Fascicle length changes may actually be caused by results in a decreased tendon/aponeurosis strain, which may
the length (Blazevich et al., 2007; Guex, Degache, Morisod, protect the tendon/aponeurosis from excessive strain.
Sailly, & Millet, 2016; McMahon, Morse, Burden, Winwood, & Additionally, an increase in stiffness would also reduce the
Onambele, 2014) or velocity (Sharifnezhad, Marzilger, & influence of muscle slack and hence be beneficial from a
Arampatzis, 2014) at which the muscle is trained rather than performance enhancement perspective (Van Hooren & Bosch,
the contraction type, although these issues are still controver- 2016). Therefore, an increase in tendon stiffness may be ben-
sial (Alegre, Ferri-Morales, Rodriguez-Casares, & Aguado, 2014; eficial for both sport performance and injury prevention. The
Franchi et al., 2014; Timmins et al., 2016). findings of several studies suggest that loading intensity and
duration rather than the type of contraction are the most
important stimuli for adaptations of the tendon/aponeurosis
Changes in pennation angle
(Arampatzis, Karamanidis, & Albracht, 2007; Arampatzis, Peper,
Muscles with a large pennation angle may be better protected Bierbaum, & Albracht, 2010; Bohm, Mersmann, Tettke, Kraft, &
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against injuries than muscles with a small pennation angle Arampatzis, 2014; Garma et al., 2007; Heinemeier et al., 2007;
due to the effects of muscle gearing during eccentric muscle Malliaras et al., 2013). Therefore, high-intensity isometric exer-
actions (Azizi & Roberts, 2014). For example, during an isolated cises may be at least equally effective to condition the ham-
eccentric action, the gearing ratio of the bullfrog plantaris strings tendon/aponeurosis.
muscle has been found to be such that fascicle lengthening
occurred at less than 25% the rate of muscle–tendon unit
Disadvantages of eccentric exercises
lengthening (Azizi & Roberts, 2014). A decrease or increase in
pennation angle following training could therefore influence Exercises that are thought to produce an eccentric muscle
the injury susceptibility of the hamstrings by altering the action also have some disadvantages, which are usually not
effect of muscle gearing. Biceps femoris pennation angles considered by advocates of these exercises.
have been shown to decrease, albeit not significant, with
approximately 3–8% following eccentric training (Potier
Training at too short and too long muscle–tendon unit
et al., 2009; Timmins et al., 2016). In contrast, concentric train-
lengths
ing of the biceps femoris resulted in an increased pennation
angle of approximately 17% (Timmins et al., 2016). Other Regardless of the muscle action, a correct performance
studies have shown an increase in pennation angle following throughout the full Nordic hamstring exercise range of motion
both eccentric and concentric training (Blazevich et al., 2007; is often too difficult for untrained or recreationally trained
Duclay, Martin, Duclay, Cometti, & Pousson, 2009), with con- individuals (Ditroilo, De Vito, & Delahunt, 2013) and adjusting
centric training leading to the largest increase (Franchi et al., the load is also difficult. Especially when someone starts ham-
2014, 2015). Moreover, in a recent study, plyometric training string training for the first time and is not capable of produ-
did not lead to significant changes (1% increase) in pennation cing high forces, the Nordic hamstring exercise will be
angle (Fouré, Nordez, McNair, & Cornu, 2011). Therefore, simi- executed at these mainly non-specific muscle–tendon unit
larly to the changes in fascicle length, it is not clear whether lengths. For example, the hamstrings are typically trained at
and how contraction type influences the changes in pennation short muscle–tendon unit lengths with an extended hip and
angle. Changes in pennation angle may also be related to the 90–70° of knee flexing before dropping down (Ditroilo et al.,
length at which the muscle is trained, with larger lengths 2013). In contrast, during high-speed running the highest
inducing larger changes in pennation angle (Alegre et al., forces act on the hamstrings at longer (i.e., optimum) mus-
2014; Guex et al., 2016; McMahon et al., 2014). cle–tendon unit lengths (Chumanov et al., 2007). Therefore,
even if the hamstrings would function isometric during this
exercise, it does not reflect the high force at optimum muscle–
Adaptations of the tendon/aponeurosis
tendon unit lengths condition during high-speed running.
Since most hamstring injuries occur at the proximal and distal Recently, it has been acknowledged that eccentric exercises
musculotendinous junction, with a smaller proportion occur- should be performed at longer muscle–tendon unit lengths to
ring at the muscle belly (De Smet & Best, 2000; Wangensteen reflect the running demands (Brukner, 2015) and eccentric
et al., 2016), it is also important to know how adaptations of exercises at longer muscle–tendon unit lengths are now
the tendon/aponeurosis influence hamstring functioning. The increasingly being incorporated into the training programme.
effects of adaptations such as an increased stiffness of the However, some of these exercises are performed at too long
tendon/aponeurosis in relation to hamstring functioning and muscle–tendon unit lengths (e.g., stiff-leg dead lift, hip hinge,
injury risk are however largely unknown. An increase in the 45° hip extension, good morning), while others are performed
stiffness of the hamstrings tendon/aponeurosis leads to at both too short and too long muscle–tendon unit lengths
greater strain of the muscle fibres (Thelen, Chumanov, Best, (e.g., glute-ham raise). Finally, most exercises are performed
 2326 B. VAN HOOREN AND F. BOSCH

bilaterally, while running is an unilateral activity. During bilat- perspective, contextual exercises rather than isolated exercises
eral exercises, the stronger limb can compensate for the may be more appropriate. For the hamstrings, contextual in
weaker limb, which may leave the weaker limb vulnerable to relation to high-speed running means: resisting knee exten-
injuries. In addition, during some bilateral exercises, the erec- sion and assisting high torque for hip extension.
tor spinae may be the performance limiting factor rather than
the hamstrings.
Delayed onset muscle soreness
Finally, eccentric exercises may lead to delayed onset of mus-
Specificity of adaptation at an intermuscular level
cle soreness, especially in the first weeks of the training pro-
One of the functions of the bi-articular hamstrings is to trans- gramme (Askling et al., 2003; Petersen et al., 2011) and in
port energy from the hip to the knee. The hamstrings resist several studies this has been a reason for some participants
knee extension and assist hip extension (of the gluteus mus- to cease the programme (Arnason et al., 2008; Gabbe et al.,
cle) to counteract a large flexing torque at the hip. During the 2006; van der Horst et al., 2015). Isometric exercises are less
Nordic hamstring exercise and leg curl, the hamstrings only likely to lead to muscle soreness, which may lead to more
have to resist torque at the knee joint, without there being a players performing the exercise and eventually more players
great demand for hip extending torque. This differs from high- benefiting from the training effects.
speed running where the hamstrings are most active when
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there is great hip flexing torque (i.e., in the late swing phase
Criteria for specifically conditioning the hamstrings
and during stance). Therefore, another argument against the
use of commonly used isolated eccentric exercises such as the Effective conditioning of the hamstrings for high-speed run-
leg curl or Nordic hamstring exercise is that they improve the ning should involve exercises that fulfil a number of criteria of
force production of the hamstrings only around 1 joint while a specificity. Adherence to these criteria will guarantee specifi-
comprehensive training programme should include exercises city with regards to hamstring functioning during running.
that target the hamstrings at both the hip and knee joint. In
addition, some exercises such as the leg curl improve the force
High force production and activation
production without improving the coordination and this may
actually be detrimental to performance. For example, using The external forces acting on the muscle–tendon unit of the
forward dynamic simulation, Bobbert and Van Soest (1994) hamstrings during the late swing phase are very high. For
showed that an increase in muscle strength without addres- example, Chumanov et al. (2007) found the average net ham-
sing timing (i.e., coordination) resulted in a decrease in vertical string force to be 36 N · kg at 80% of maximum speed and
jump performance. This intermuscular coordination may 52 N · kg at maximum speed. In another computational mus-
become especially critical at higher skill levels. culoskeletal modelling study, the average peak muscle–ten-
The iliopsoas of the contralateral hip has been found to don unit force ranged from 5.49 N · kg for the semitendinosus
have a large influence on stretch of the biceps femoris during to 46.8 N · kg for the semimembranosus (Schache et al., 2012).
high-speed running because it can induce anterior pelvic tilt, To resist such high forces, the hamstrings have to be highly
which causes larger lengths of the hamstrings (Chumanov active. Indeed, during the swing phase of high-speed running,
et al., 2007), making the function of the hamstrings in high- the hamstrings are activated up to approximately 100%
speed running greatly depending on intermuscular coordina- (biceps femoris) and 150% (semitendinosus and semimembra-
tion. Other muscles such as the oblique abdominal and erector nosus) of their maximum activation during maximum volun-
spinae can also have substantial effects, while more distal tary isometric actions (Higashihara, Ono, Kubota, Okuwaki, &
located muscles such as the vastus lateralis had less influence Fukubayashi, 2010; Jonhagen, Ericson, Nemeth, & Eriksson,
(Chumanov et al., 2007). Therefore, training of the hamstrings 1996; Kyröläinen, Avela, & Komi, 2005). This peak activity
for high-speed running should involve multi-joint exercises occurs during the late swing phase, when the external forces
rather than isolated single-joint exercises. These exercises acting on the hamstrings are the highest and when the mus-
should also involve the control of the pelvic area. A study cle–tendon unit is around its optimum length. Contextual
that used a more contextual approach (e.g., involving coordi- training should therefore reflect these demands.
nation of the pelvic area) in the rehabilitation of hamstring The peak activity of the biceps femoris long head and
strain injuries found the rate of re-injury to be lower compared semitendinosus can occur at different percentages of the
with a less contextual approach (Sherry & Best, 2004). gait cycle, depending on the running speed (Higashihara
Especially, better control of forward rotation of the pelvis et al., 2010). In addition, running in a swerve probably
around toe-off may be key in improving hamstring function. requires an increased activity of the biceps femoris for the
It has been shown that even minor deficits in the coordination inner leg and more activity of the semitendinosus and semi-
between the different hamstring muscles can cause some of membranosus for the outer leg to accelerate the body in the
the muscles to fail, which may lead to injuries (Schuermans, required direction. These differences in activity of specific
Van Tiggelen, Danneels, & Witvrouw, 2014). In addition, a hamstring muscles should also be mimicked in training to
recent study found that an increased activation of the gluteus prepare the hamstrings for these demands. Traditionally, this
medius during treadmill running was a risk factor for ham- has been done by manipulating tibia rotation. For example,
string injuries (Franettovich Smith et al., in press). Therefore, the activity of the biceps femoris long head can be increased
both from a performance enhancement and injury prevention by laterally rotating the tibia, while the activity of the
 JOURNAL OF SPORTS SCIENCES 2327

semitendinosus and semimembranosus can be increased by There are two ways to achieve an isometric hamstring
medially rotating the tibia (Jonasson, Helgason, Ingvarsson, muscle action. The first way involves activation of the muscles
Kristjansson, & Briem, 2016; Mohamed, Perry, & Hislop, 2003). without accompanied joint movement (i.e., static action). Note
However, the tibia is fixed during the ground contact phase however that even during static actions, shortening of the
of running and an increased activity of the biceps femoris or fascicles occurs initially and therefore a static action is not
semitendinosus and semimembranosus will therefore result purely isometric (Ito, Kawakami, Ichinose, Fukashiro, &
in internal and external hip rotation, respectively. Therefore, Fukunaga, 1998). Nevertheless, this static muscle action may
upper body rotation to increase the torque at the hip rather be performed at different joint configurations to train the
than tibia rotation may be more suited to specifically target hamstrings at both short and long muscle–tendon unit
the biceps femoris or semitendinosus and semimembrano- lengths. However, since the highest forces act on the ham-
sus. Rotation of the upper body will likely increase the strings when they are around their optimum length, training
torque at the hip and hence require high activation of the should be performed at muscle–tendon unit lengths that
hamstrings to resist hip rotation. reflect this optimum length. Furthermore, since all hamstring
A general guideline which has recently been proposed to muscles except for the biceps femoris short head span 2 joints,
determine whether an individual is at risk for hamstring strain simultaneous movement at the hip and knee joint can cause
injuries is an eccentric hamstring strength during the Nordic the muscles to remain at a similar length. Therefore, the
hamstring exercise of >3.2 N · kg at the start of the season or second way to achieve an isometric muscle action is to allow
>3.5 N · kg at the end of the preseason (Opar et al., 2015). Failing movement at both the knee and hip joint. For example, hip
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to reach such cut-off points may increase injury risk by 3.1–5.0 extension causes the hamstrings to shorten, while knee exten-
fold (Opar et al., 2015). Similarly, such cut-off points may be used sion causes the hamstrings to lengthen. However, because the
for isometric force production during an isometric hamstring moment arm of the hamstrings is greater at the hip joint
exercise where resisting knee flexion is accompanied by assisting (Chleboun et al., 2001; Visser et al., 1990), movement at the
hip flexion (e.g., Razor curls). However, Timmins et al. (2015) hip joint has a larger influence on the muscle–tendon unit
showed that the maximum isometric hamstring force measured length than movement at the knee joint.
in a prone position with a neutral hip and fully extended knee did Stretch and recoil of the series elastic elements during
not show a significant association with future hamstring injuries isometric actions may be achieved by briefly increasing the
in elite male football players, while eccentric hamstring strength external forces acting on the muscle. The impact caused by
measured during the Nordic hamstring exercise did. These find- this brief application of external force likely stretches the
ings suggest that the measurement of isometric force may not series elastic elements while the contractile element stays
be very useful for differentiating individuals with a low and high isometrically. In contrast, when the external force is slowly
risk for injuries, although this may partially be related to the increased and decreased the elastic energy is dissipated into
position in which the isometric force was measured. heat (Roberts & Konow, 2013).

Intermuscular cooperation
Isometric hamstring functioning in optimum length with
The hamstrings are not the only muscles that are activated
stretch and recoil of the series elastic elements
during the swing phase. When we consider the swing phase
Since there may be a predominantly isometric action of the only, the activity of the hamstrings and gluteus maximus gen-
hamstrings fascicles with the series elastic elements stretch- erally peaks at approximately the same time during the late
ing and recoiling during the swing phase of high-speed swing phase, while the activity of the medial and lateral gastro-
running, we suggested previously that hamstring training cnemius peaks later, just before ground contact (Jonhagen
should mimic this functioning to condition the hamstrings et al., 1996; Kyröläinen, Komi, & Belli, 1999). This intermuscular
in a contextual way (Van Hooren & Bosch, in press). coordination pattern may be interpreted as a proximal to distal
Isometric hamstring exercises should be such that the func- sequence in which proximal located muscle reach their max-
tion of the hamstrings during the exercise is to resist/reduce imum activity before the distal located muscles. A similar prox-
knee extension and to assist hip extension. Due to the imal to distal activation pattern is observed during the push of
function of the bi-articular hamstrings – transporting energy in the stance phase (Prilutsky & Zatsiorsky, 1994). Such proximal
from the knee to the hip – exercises should be designed in to distal activation pattern requires a well-integrated timing of
such a way that the hip flexing torque generated by the all involved muscle to optimise energy transport from the hip
resistance is the most challenging problem to overcome. to the knee and from the knee to the ankle (Bobbert & Van
Moreover, the muscle fibres probably function close to Soest, 1994). Since this timing is likely of paramount importance
their optimum length (where force production is the high- for maximum performance and injury prevention, the ham-
est) when the forces are the highest during the late swing strings should also be trained in complex intermuscular pat-
phase (Holt & Azizi, 2016). This optimum length should be terns to improve the pelvic control and cooperation with the
mimicked during the isometric exercises by allowing forward gastrocnemius during knee extension. This intermuscular coor-
and backward pelvis rotation so that the optimum length dination may be trained by using more complex types of
can be self-organised by the athlete. strength training and running drills.
 2328 B. VAN HOOREN AND F. BOSCH

Examples of isometric exercises may be used as a target for sufficient recruitment is a weight
that is equal to 50% bodyweight. During all Roman chair
In the following paragraph we will provide some examples of
exercises, the back extension equipment should be adjusted
exercises that likely fulfil some of the criteria discussed in the
to the participants length so that the spina iliaca anterior
previous section, although research has not yet investigated
superior is supported, but the trunk unsupported. In addition,
these exercises. The list is limited and contains almost no
the knee of the supported leg should be almost fully extended
running drills, because they will depend a lot on the interac-
(approximately 170 degrees) and the unsupported leg should
tion between the athlete and coach with an important role for
be held above the leg support and cannot serve as
error correcting feedback. For more information and practical
counterbalance.
examples regarding running drills we refer to Bosch (2015);
A variation to this exercise involves medial and lateral
Bosch and Klomp (2005).
rotation of the upper body to increase the overload on the
semitendinosus and semimembranosus or biceps femoris,
respectively, (Figure 2). The positions shown in image B and
Single-leg Roman chair C can be held for approximately 3 s.
The first exercise we propose to contextually strengthen the Another variation to the single-leg Roman chair hold exer-
hamstrings for high-speed running is the single-leg Roman cise involves the use of a lower external load with brief
chair hold (Figure 1). In this exercise, one leg is fixed to over- impacts to mimic the elastic functioning of the hamstrings
during high-speed running. This brief impact can be created
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load the hamstrings rather than the erector spinae. The upper
body is unsupported and held in this position for approxi- by quickly extending and retracting the arms in front of the
mately 3 s per repetition, after the weight (if used) is dropped chest while holding a weight (Figure 3). The load should be
and the upper body returns to a relaxed position. The range of low enough to allow a quick extension and retraction.
motion between lifting the weight from the floor and the
required isometric position should be small. The goal of the Split step squat with forward lean
exercise is to quantitatively overload the hamstrings by using
a large external load. If a large (i.e., allowing a maximum of Another exercise that we propose for contextually strengthening
approximately 5 repetitions) external load is used during the the hamstrings is the split step squat with forward lean (Figure 4).
exercise, the hamstrings are required to be highly active and In this exercise, the athlete stands in a split step squat position
exert a large amount of force. Furthermore, the hamstrings with the barbell placed at the shoulders. The athlete descends
work isometric because they try to extend the hip and prevent until the front leg thigh is almost horizontal. Thereafter, the
knee extension, while the pelvis can rotate to allow self-orga- barbell is moved to a position above the front knee by flexing
nisation of the optimum hamstring length. A benchmark that the hip. At the same time, knee flexion is changed to allow the
hamstrings to remain in their optimum length. In this way, the
torque of the external load will increase at the hip, while it
decreases at the knee joint. As a result, a high force production
from the gluteus maximus and hamstrings is required to prevent
further hip flexion. The goal of this exercise is to quantitatively
overload the hamstrings by using a large external load. If a large
(i.e., allowing a maximum of 5 repetitions) external load is used
during the exercise, the hamstrings are required to be highly
activated and exert a large amount of force. Furthermore, the
hamstrings work isometric because they try to extend the hip
and prevent knee extension, while the pelvis can rotate to allow
self-organisation of the optimum hamstring length. The final
position can be held for 3 s after which the athlete returns to
the previous position or after which the athlete explosively
Figure 1. Single-leg Roman chair hold. extends the knee and hip to get to the start position.

Figure 2. Single-leg Roman chair plate rotations. Starting position (a), medial upper body rotation (b) and lateral upper body rotation (c).
 JOURNAL OF SPORTS SCIENCES 2329

Figure 3. Single-leg Roman chair elastic loading. Starting position (a), quickly extending (b) and retracting (c) the arms.
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Figure 4. Split step squat with forward lean. Starting position (a), front leg almost horizontal (b), hip flexion (c) and extension (d).

Furthermore, forceful extension at the end of the exercise may keep the stick as still as possible. Controlling pelvic
train the intermuscular cooperation between the bi-articular rotation at toe of is crucial, because good pelvic control
muscles. allows for self-organisation of the optimum fascicle
length of the hamstrings;
● The ground contact and swing phase should be brief to
optimise stretch and recoil of the series elastic elements.
Low-hurdle running
Practical experience suggests that during a too long
The exercises discussed so far primarily emphasise high force ground contact, hamstring functioning may be taken
production and activation in optimum length. However, opti- over by the adductors, while the contraction speed of
mising intermuscular coordination is also of paramount impor- the adductors is too slow to be effective during short
tance to maximise performance and minimise injury risk. One ground contacts and therefore short ground contact will
exercise we propose to improve the intermuscular coordina- force the hamstrings to be more active.
tion is running over low (approximately 10 cm) hurdles
(Figure 5). The exercise should meet a number of technical
The intermuscular coordination is similar to high-speed run-
requirements:
ning because the exercise involves a brief elastic bounce at
ground contact and a flight phase during which the swing-leg
● The running speed should be fairly high to maximise
after the hamstring loading phase forcefully retracts with a
hamstrings activity;
precisely timed proximal to distal sequence of extension. The
● The upper body should remain upright and pelvic rota-
distance between the hurdles is critical: too short and hor-
tion forward around toe-off should be controlled. This
izontal force production is low, which does not put the ham-
technical component can be put under pressure by run-
strings under pressure. Too long and the runner will
ning with a light stick behind the neck, while trying to

Figure 5. Low-hurdle running. Full body weight support during ground contact (a) and toe-off (b).
 2330 B. VAN HOOREN AND F. BOSCH

overstride, making good elastic hamstring functioning unli- running, isometric exercises with a high neuromuscular
kely. Therefore one may consider to execute the upright, demand may be equally or even more effective. Several of
short ground contact runs without hurdles and with gradually the presumed beneficial adaptations following eccentric train-
increasing horizontal speed, or with constant speed but with ing have also been found following training with other con-
changing step rhythms. Furthermore, for those who are pre- traction types. Therefore, we provided a number of criteria
pared to invest time into running technique, learning how to that exercises should fulfil for effective conditioning of the
run with a skipping rope (one step each rope cycle) provides hamstrings for high-speed running. Based on these criteria,
an intuitive tool to improve hamstring action in the running we provided examples of exercises that likely mimic important
cycle. Mastering this skill at higher speeds will take time. For components of the action of the hamstrings during high-
all other variations good coaching on technique is paramount. speed running and hence can be used to strengthen the
Exercises that aim to improve the intermuscular coordination hamstrings in an effective way to enhance performance and
are very much dependent on a correct performance and prevent injuries. Future research should compare the perfor-
hence feedback from a coach to correct possible errors. This mance enhancing and injury prevention effects of isometric
feedback can be provided in a bandwidth way, which means and eccentric exercises with a high neuromuscular stimulus
that the augmented feedback is based on a specific band- among a sample of well-trained individuals.
width or an acceptable range of error.

Acknowledgements
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Incorporation of the exercises into a hamstring

conditioning programme We would like to thank Craig Ranson for his comments on a preliminary
version of the manuscript. No funding was received for this manuscript.
Since there are no studies that compared different eccentric or
isometric hamstring training protocols on their effectiveness in
preventing hamstring injuries or improving high-speed run- Disclosure statement
ning performance, based on practical experience we suggest The authors disclose no conflict of interest and also they do not constitute
that a maximum of 2–3 exercises, with each 3–4 sets of 1–6 endorsement by the Journal of Sports Sciences.
repetitions are used per training. This will probably provide an
effective stimulus, but prevent excessive fatigue and allow
combination of the hamstring conditioning programme with Funding
other training. It has been found that the Nordic hamstring No funding was received for this manuscript.
exercise causes acute fatigue such as a decrease in hamstring
force and EMG activity (Lovell, Siegler, Knox, Brennan, &
Marshall, 2016), which may increase injury risk in subsequent ORCID
training sessions. Therefore, although high-intensity isometric Bas Van Hooren http://orcid.org/0000-0001-8163-693X
hamstring exercises may result in less fatigue compared with
eccentric exercises, the hamstring conditioning programme
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