Persistent neuromuscular deficits in the posterior kinetic chain following hamstring strain injury: EMG insights from nordic hamstring curl, kettlebell swing, and supine sliding leg curl

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dc.contributor.authorGulgosteren, Erkan
dc.contributor.authorYuksel, Oguzhan
dc.contributor.authorGurol, Baris
dc.contributor.authorYildirim, Onur
dc.contributor.authorAtar, Ozdemir
dc.contributor.authorSoylu, Caglar
dc.contributor.authorAltundag, Emre
dc.date.accessioned2026-02-03T12:00:26Z
dc.date.available2026-02-03T12:00:26Z
dc.date.issued2025
dc.departmentÇanakkale Onsekiz Mart Üniversitesi
dc.description.abstractBackground Hamstring strain injuries (HSIs) are among the most common non-contact injuries in football, often resulting in prolonged rehabilitation, high recurrence rates, and persistent neuromuscular deficits. Although rehabilitation focuses on restoring strength and flexibility, alterations in posterior chain muscle activation patterns may remain undetected, potentially contributing to reinjury risk. This study aimed to compare posterior chain muscle activation patterns between football players with a history of hamstring injury and healthy controls during three functional exercises: Nordic Hamstring Curl (NHC), Kettlebell Swing (KS), and Sliding Single-Leg Curl (SSLC). Methods Forty-two male football players (mean age: 23.4 +/- 3.1 years; 21 previously injured, 21 healthy controls) participated in the study. Surface electromyography (sEMG) was used to record activation of the biceps femoris long head (BF), gluteus maximus (GM), latissimus dorsi (LD), and iliocostalis lumborum (IL) during each exercise. Results Mean activation values were Across all exercises, injured players demonstrated significantly lower muscle activation compared with healthy controls. In NHC, BF (- 23.9%, p < 0.001), GM (- 21.3%, p < 0.001), LD (- 15.4%, p = 0.005), and IL (- 14.6%, p = 0.001) activations were reduced in the injured group. During KS, reductions were observed in BF (- 28.7%, p < 0.001), GM (- 24.3%, p < 0.001), LD (- 17.3%, p = 0.008), and IL (- 16.8%, p = 0.007). In SSLC, BF (- 20.8%, p < 0.001), GM (- 19.7%, p < 0.001), LD (- 12.5%, p = 0.008), and IL (- 15.8%, p = 0.004) activations were significantly lower in injured participants. Conclusion The largest differences were found in BF and GM during hip-dominant exercises, with consistent but smaller deficits in LD and IL, indicating a widespread neuromuscular inhibition beyond the hamstring itself. Conclusions: Football players with a history of hamstring injury present persistent deficits in posterior chain muscle activation, particularly in BF and GM, even after return to play. These impairments extend to trunk musculature (LD, IL), suggesting that rehabilitation should incorporate multi-segmental posterior chain retraining, especially in hip-dominant tasks, to mitigate reinjury risk. Clinical trial registration: The clinical trial was registered retrospectively on 09 June 2025 under the identifier NCT07171385.
dc.identifier.doi10.1186/s13102-025-01435-5
dc.identifier.issn2052-1847
dc.identifier.issue1
dc.identifier.pmid41318473
dc.identifier.scopus2-s2.0-105026482546
dc.identifier.scopusqualityN/A
dc.identifier.urihttps://doi.org/10.1186/s13102-025-01435-5
dc.identifier.urihttps://hdl.handle.net/20.500.12428/34614
dc.identifier.volume18
dc.identifier.wosWOS:001654580600003
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherBmc
dc.relation.ispartofBmc Sports Science Medicine and Rehabilitation
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20260130
dc.subjectHamstring injury
dc.subjectPosterior chain
dc.subjectElectromyography
dc.subjectKettlebell swing
dc.subjectNordic hamstring curl
dc.titlePersistent neuromuscular deficits in the posterior kinetic chain following hamstring strain injury: EMG insights from nordic hamstring curl, kettlebell swing, and supine sliding leg curl
dc.typeArticle

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