Muscle Activity and Activation in Previously Strain-Injured Lower Limbs: A Systematic Review.

Joel D Presland, Ryan G Timmins, Nirav Maniar, Paul J Tofari, Dawson J Kidgell, Anthony J Shield, Jessica Dickson, David A Opar

Journal: Sports medicine (Auckland, N.Z.) 2021;51(11):2311-2327

PMID: 34309803

Abstract

BACKGROUND

Lower limb muscle strain injury is highly prevalent in running-based sports and is considered a risk factor for recurrent injury. It is possible that differences in muscle activity and activation in previously strain-injured limbs may contribute to the elevated risk of reinjury.

OBJECTIVES

To systematically review available literature investigating whether muscle activity and/or activation is different in previously strain-injured muscles compared to contralateral uninjured muscles or uninjured controls.

METHODS

A systematic review of literature in SPORTDiscus, MEDLINE Complete, CINAHL and Web of Science was conducted. Full-text English articles which compared indicators of neuromuscular function between injured and uninjured contralateral limbs or control groups in those with a history of muscle strain injury were included.

RESULTS

Twelve studies were included in the review after eligibility criteria were applied. A best evidence synthesis revealed moderate to limited evidence suggesting differences in surface electromyography (sEMG) amplitude, integrated sEMG amplitude, inter-muscle sEMG ratios and voluntary activation in injured limbs, most often during eccentric contractions. Studies utilising sprinting assessments demonstrated conflicting evidence when comparing late swing phase biceps femoris sEMG amplitude between limbs with a history of hamstring strain injury and uninjured contralateral limbs.

CONCLUSIONS

Differences in muscle activity and activation were observed between injured and uninjured limbs across a variety of strength assessments. The evidence supporting these differences was most often moderate or limited and was generally observed during eccentric contractions. Mostly conflicting or limited evidence was found to suggest that participants with previous hamstring strain injury demonstrate no differences in muscle activity during running tasks when compared with their uninjured counterparts or contralateral limbs.

TRIAL REGISTRY

PROSPERO (ID, CRD42019135681).

© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.

Address: School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Melbourne, VIC, 3065, Australia. [email protected].; School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Melbourne, VIC, 3065, Australia.; Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, VIC, Australia.; School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia.; School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.; Library and Academic Research Services, Australian Catholic University, Melbourne, VIC, Australia.

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