Sports Medicine Research: In the Lab & In the Field: Exercises Which Target Specific Hamstring Muscle Groups (Sports Med Res)
Wednesday, August 15, 2012

Exercises Which Target Specific Hamstring Muscle Groups

Kettelbell swing targets semitendinosus and supine leg curl targets biceps femoris: an EMG study with rehabilitation implications.

Zebis MK, Skotte J, Andersen CH, Mortensen P, Petersen MH, Viskaer TC, Jensen TL, Benecke J and Andersen LL. Br J Sports Med. 2012; [Eup Ahead of Print].

With knee injuries, such as anterior cruciate ligament ruptures, being increasingly seen in sports, more and more emphasis has been placed on prophylactic exercises to reduce the risk of injury. Unfortunately, little is known about how different exercises challenge the hamstring muscles, which may be a key muscle group to optimize in prophylactic or rehabilitation programs. Therefore, Zebis and colleagues evaluated the levels of medial and lateral hamstring activation during selected exercises that are commonly used in rehabilitation and prophylactic exercise programs. They selected elite female handball (n=8) and soccer players (n=8) with no previous hamstring or knee injuries. Prior to testing, all participants underwent a familiarization session where they performed 3 maximum voluntary isometric hamstring muscle contractions (MVC) on a Biodex isokinetic dynamometer. The highest of the 3 MVC values was used as a reference for the exercises. Surface electromyography was performed by placing electrodes on the skin over the biceps femoris and semitendinosus muscles. The exercise protocols were divided into 9 strength and 5 balance exercises. Balance exercises consisted of one-leg jump onto balance mat, one-leg landing from box on balance mat, one-leg drop jump on balance mat, one-leg forward jump, and one-leg side jump. Strength exercises were two-hand kettlebell swing, Nordic hamstring lowers, supine pelvis lifts, Romanian deadlift, hyperextensions off table, hyperextensions off table with barbell, seated leg curls, prone leg curl, and supine one-leg curls. All exercises were performed by the participants in a random order with a 3 minute rest period between exercises to avoid fatigue. The overall results are reported in the table below.

Exercises Targeting Biceps Femoris
Exercises Targeting Semitendinosus
1 = least muscle activity (from the top 10)
1. one-leg drop jump on balance
1. one-leg jump onto balance mat
2. one-leg jump onto balance mat
2. hyperextensions off table
3. supine pelvis lifts
3. Romanian deadlift
4. hyperextensions off table
4. supine pelvis lifts
5. Nordic hamstring lowers
5. Nordic hamstring lowers
6. prone leg curl,
6. prone leg curl
7. kettlebell swing
7. seated leg curls
8. hyperextensions off table with barbell
8. hyperextensions off table with barbell
9. seated leg curls
9. supine one-leg curls
10. supine one-leg curls
10. kettlebell swing
10 = most muscle activity

Overall, this study provides and interesting look at how effective various exercises are at activating different hamstring muscles. Clinically, these data can help clinicians choose the exercises to target the hamstrings group and specific muscles leading to more beneficial strength gains but their efficacy in aiding prevention programs is less clear. Exercises used in this study were not sport specific, a potentially vital element in any injury prevention program. Therefore, one must assume that while these exercises are beneficial to use in an injury prevention program, the clinician must make an effort to implement sport-specific exercises as well. Furthermore, a note of caution must be made regarding incorrectly performed trials. The authors mentioned that if a participant performed a trial incorrectly, that trial was disqualified and a new trial was performed; however, no mention was made to if this occurred and if so, how often. One could surmise that adding more trials could increase the participant’s fatigue. Tell us what you think about the exercises you choose for your patients. What criterion goes into choosing the exercises you use? Do you find that the exercises you typically choose are more or less effective according to the data in this study?

Written by: Kyle Harris
Reviewed by: Jeffrey Driban

Related Posts:

Zebis MK, Skotte J, Andersen CH, Mortensen P, Petersen MH, Viskær TC, Jensen TL, Bencke J, & Andersen LL (2012). Kettlebell swing targets semitendinosus and supine leg curl targets biceps femoris: an EMG study with rehabilitation implications. British Journal of Sports Medicine PMID: 22736206

6 comments:

Mike Wilson said...

Its interesting but I would like to see a similar study looking at the activation ratios of multiple muscle groups occurring during these and other functional exercises. Ex. hams, quads, glutes during the romanian deadlift or squat or anything else. Isolation is very rarely a rehab goal of mine today.

Kristal Nelson said...

Good stuff but I would like to see a comparison with males with regard to the closed chained exercises because we know many females have poor NM control in closed chain with poor firing of the posterior chain.

Kyle said...

Mike,

Thanks for the post. I agree that a big sticking point of this study is the lack of functionality. I believe that it is a good first step but including a single sport with sports specific exercises for each would be a much more translational to current rehabilitation practices.

Kyle said...

Kristal,

Just like I remarked to Mike I think your point is well received. I think another thing to consider in conjunction with the differences between open and closed kinetic chain activities, for this specific study, is that half of the subjects included competed in upper an extremity sport while the other half was from a lower extremity sport. Perhaps these subjects came into the study with drastically different NM control capabilities. I definitively think this is something to look into in the future. Thanks for the post!

Tasher said...

I'm surprised to see the nordic hamstring lowers had an average score for both muscles. They have been shown to be useful in much of the literature that F-MARC, representing soccer's governing body, included them in their trademark warm-up program, "11+". Perhaps a look at activation levels in the semimembranosus muscle as well?

Kyle said...

Tasher,

Great comment. I think that looking at other muscle activation levels beyond the ones included in this study would give us a better understanding of if there may be more muscle activation in other muscles. I would also be curious to see what would happen if the nordic hamstring lowers were repeated and practiced, would that change the level of muscle activation. When completig the 11+ program, there are three levels of experience (beginner, intermediate, and advnaced). Perhaps there is a larger learning curve that this study was not able to pick up on. Great clinical comparison.

Also, keep checking back with us at SMR. There may be some F-MARC (11+) specific topic being covered soon. Sounds like you have experience with this program. It would be great to hear from you again!

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