Department of Rehabilitation, Nutrition and Sport, La Trobe Sport and Exercise Medicine Research Centre, Melbourne, VIC, Australia.
School of Exercise Science, Australian Catholic University, Melbourne, VIC, Australia.
Sports Med. 2018 Feb;48(2):251-267. doi: 10.1007/s40279-017-0796-x.
Strength training is a valuable component of hamstring strain injury prevention programmes; however, in recent years a significant body of work has emerged to suggest that the acute responses and chronic adaptations to training with different exercises are heterogeneous. Unfortunately, these research findings do not appear to have uniformly influenced clinical guidelines for exercise selection in hamstring injury prevention or rehabilitation programmes. The purpose of this review was to provide the practitioner with an evidence-base from which to prescribe strengthening exercises to mitigate the risk of hamstring injury. Several studies have established that eccentric knee flexor conditioning reduces the risk of hamstring strain injury when compliance is adequate. The benefits of this type of training are likely to be at least partly mediated by increases in biceps femoris long head fascicle length and improvements in eccentric knee flexor strength. Therefore, selecting exercises with a proven benefit on these variables should form the basis of effective injury prevention protocols. In addition, a growing body of work suggests that the patterns of hamstring muscle activation diverge significantly between different exercises. Typically, relatively higher levels of biceps femoris long head and semimembranosus activity have been observed during hip extension-oriented movements, whereas preferential semitendinosus and biceps femoris short head activation have been reported during knee flexion-oriented movements. These findings may have implications for targeting specific muscles in injury prevention programmes. An evidence-based approach to strength training for the prevention of hamstring strain injury should consider the impact of exercise selection on muscle activation, and the effect of training interventions on hamstring muscle architecture, morphology and function. Most importantly, practitioners should consider the effect of a strength training programme on known or proposed risk factors for hamstring injury.
力量训练是腘绳肌拉伤预防计划的重要组成部分；然而，近年来大量研究表明，不同运动的训练急性反应和慢性适应是不同的。不幸的是，这些研究结果似乎并没有一致影响到腘绳肌拉伤预防或康复计划中运动选择的临床指南。本综述的目的是为从业者提供一个证据基础，以便开出处方强化运动来降低腘绳肌受伤的风险。有几项研究已经证实，当依从性足够时，离心膝屈肌训练可以降低腘绳肌拉伤的风险。这种训练的好处可能至少部分是由于股二头肌长头肌束长度的增加和离心膝屈肌力量的提高。因此，选择对这些变量有明显益处的运动应该是有效的预防损伤方案的基础。此外，越来越多的研究表明，不同运动之间的腘绳肌肌肉激活模式有很大的差异。通常，在髋关节伸展运动中观察到相对较高水平的股二头肌长头和半膜肌活动，而在膝关节弯曲运动中则报告了优先的半腱肌和股二头肌短头激活。这些发现可能对预防损伤计划中针对特定肌肉有影响。预防腘绳肌拉伤的力量训练的循证方法应考虑运动选择对肌肉激活的影响，以及训练干预对腘绳肌肌肉结构、形态和功能的影响。最重要的是，从业者应该考虑力量训练计划对已知或建议的腘绳肌受伤风险因素的影响。
