Application of Shear-Wave Elastography in the Evaluation of Hamstring Stiffness in Young Basketball Athletes.
Paige Cummings, Nathan D Schilaty, Takashi Nagai and 3 others
PMID 36518841WHAT IT FOUND
A multi-component hamstring warm-up lowered measured hamstring stiffness in female basketball athletes.
Males did not show a clear change. Injury counts were too small to prove prevention.
Key findings
01The targeted neuromuscular training group showed lower post-season hamstring stiffness than pre-season at the 80% and 60% flexibility orientations, but not at the 40% orientation.
02Females had lower post-season stiffness after training at the 60% orientation, and the 80% orientation showed a similar but less clear change. Males did not show a clear change at any orientation.
03Injury tracking covered 286 athletes, and all three hamstring injuries occurred in the control group, with none in the targeted neuromuscular training group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was not blinded, and whole teams were assigned to groups in a predetermined order rather than by random allocation. Post-season stiffness was measured in only 103 athletes, and the paper says control-group reluctance and COVID shutdowns caused substantial attrition. Injury tracking covered 286 athletes, but collegiate injury follow-up was lost, and only three hamstring injuries occurred. The training and control groups started the season with different stiffness values, which makes the intervention effect harder to interpret. The warm-up included several exercise components at once, so the contribution of any single component cannot be separated. Shear-wave ultrasound was used as a surrogate for hamstring tissue stiffness, and many measurements reached the 120 kPa ceiling while hamstring elastic modulus exceeds 2500 kPa. The intra-session standard error of the mean for lower extremity shear-wave measurements was 8-12 kPa, so small stiffness differences may not be clinically meaningful. No collegiate athletes were assigned to the training group, and strength and pubertal status were not measured.
Declared interests
The authors reported no financial disclosures or conflicts of interest.
The easy way to misread this
Do not conclude that the warm-up prevents hamstring injuries. The training program included several exercise components at once, so the contribution of any single component cannot be separated. The study also reported too few injuries to establish prevention.