肌力訓練對預防不同運動型態誘發腿後腱肌群損傷之探討

Strength training for preventing hamstrings strain induced by different specific sports

10.3966/102473002018123204005

翁明嘉(Ming-Chia Weng)；戴翔(Xiang Dai)；陳哲修(Che-Hsiu Chen)

疲勞 ； 速度 ； 柔軟度 ； examination for secondary schools ； PE curriculum ； physical education

中華體育季刊

32卷4期（2018 / 12 / 01）

271 - 279

繁體中文

腿後腱肌群泛指股二頭肌長頭與短頭、半腱肌及半膜肌等四條肌肉所構成的複合肌群；其功能兼具伸髖與屈膝。而腿後腱肌群的損傷更是運動場上常見的一種運動傷害，尤其更好發在該肌群處於屈髖與膝伸直的離心收縮期時，仍須展現高爆發力與高速度的動作。目前針對肌力訓練提升運動表現與預防運動傷害發生機率的科學研究佐證已不勝枚舉。本文係透過收集並整理相關主題文獻方式，探討肌力訓練對不同運動型態所誘發腿後腱肌群損傷的影響。綜觀文獻結果發現開放鏈型態的肌力訓練動作可讓股二頭肌長頭誘發較大刺激，而閉鎖鍊式動作則針對半腱肌產生較大刺激。此外，針對介入腿後腱肌群訓練的短期與長期效益而言，選擇高強度腿後腱肌群熱身動作，則可能易增加衝刺跑所造成腿後腱肌群損傷風險；但就長期規律性的訓練則可有效降低運動損傷發生機率。本文建議教練在選擇提升腿後腱肌群肌力訓練動作及實施傷後復健時，應先考量運動專項特殊性，以降低腿後腱肌群損傷的風險及提升運動表現。

The hamstring muscle group consists of the biceps femoris long head (BFL), the biceps femoris short head (BFS), the semitendinosus (ST), and the semimembranosus (SM). These muscles are primarily responsible for knee flexion and hip extension movement. Hamstrings strains are common injuries in sports field. Usually, it occurs during eccentric contraction with both hip flexed and knee extended while exerting the maximal explosive and high-speed efforts,. Currently, scientific evidences have shown benefits of improving performance and injury prevention via conducting strength training on the hamstring muscle group. The purpose of this study was to provide a comprehensive review of the effects of the strength training on the hamstrings injuries induced by different types of sports, which was vital for optimizing hamstrings care. It elucidated that the open kinetic chain exercises in strength training may stimulate greater BFL electromyography (EMG) signals, whereas the closed-kinetic chain exercises could induce greater activation in the ST. In addition, based on the short-term and long-term efficiency focusing on the hamstrings-stimulation (HS) in strength training, the evidences revealed that adding high intensity HS exercises in warm-up may increase the sprint-induced hamstring muscle damage risk. However a planned and regulated program could decrease the rate of injures. It is suggested that coaches should prioritize the sport-specific facet first when designing the strength training program for hamstrings and performing the rehabilitation, to eliminate the risk of injury and enhance the performance.

1. Agre, J. C.(1985).Hamstring injuries. Proposed aetiological factors, prevention, and treatment.Sports Medicine,2(1),21-33.
2. Arnason, A.,Andersen, T. E.,Holme, I.,Engebretsen, L.,Bahr, R.(2008).Prevention of hamstring strains in elite soccer: An intervention study.Scandinavian Journal of Medicine and Science in Sports,18(1),40-48.
3. Askling, C. M.,Malliaropoulos, N.,Karlsson, J.(2012).High-speed running type or stretching-type of hamstring injuries makes a difference to treatment and prognosis.British Journal of Sports Medicine,46(2),86-87.
4. Askling, C.,Karlsson, J.,Thorstensson, A.(2003).Hamstring injury occurrence in elite soccer players after preseason strength training with eccentric overload.Scandinavian Journal of Medicine and Science in Sports,13(4),244-250.
5. Askling, C.,Saartok, T.,Thorstensson, A.(2006).Type of acute hamstring strain affects flexibility, strength, and time to return to pre-injury level.British Journal of Sports Medicine,40(1),40-44.
6. Bourne, M. N.,Duhig, S. J.,Timmins, R. G.,Williams, M. D.,Opar, D. A.,Al Najjar, A.,Shield, A. J.(2017).Impact of the Nordic hamstring and hip extension exercises on hamstring architecture and morphology: Implications for injury prevention.British Journal of Sports Medicine,51(5),469-477.
7. Bourne, M. N.,Timmins, R. G.,Opar, D. A.,Pizzari, T.,Ruddy, J. D.,Sims, C.,Shield, A. J.(2018).An evidence-Based framework for strengthening exercises to prevent hamstring injury.Sports Medicine,48(2),251-267.
8. Chen, C. H.,Nosaka, K.,Chen, H. L.,Lin, M. J.,Tseng, K. W.,Chen, T. C.(2011).Effects of flexibility training on eccentric exercise-induced muscle damage.Medicine and Science in Sports and Exercise,43(3),491-500.
9. Chen, C. H.,Ye, X.,Wang, Y. T.,Chen, Y. S.,Tseng, W. C.(2017).Differential effects of different warm-up protocols on repeated sprints-induced muscle damage.Journal of Strength and Conditioning Research
10. Chen, T. C.,Lin, M. J.,Chen, H. L.,Yu, H. Y.,Nosaka, K.(2018).Contralateral repeated bout effect of the knee flexors.Medicine and Science in Sports and Exercise,50(3),542-550.
11. Croisier, J. L.(2004).Factors associated with recurrent hamstring injuries.Sports Medicine,34(10),681-695.
12. Ekstrand, J.,Walden, M.,Hagglund, M.(2016).Hamstring injuries have increased by 4% annually in men's professional football, since 2001: A 13-year longitudinal analysis of the UEFA Elite Club injury study.British Journal of Sports Medicine,50(12),731-737.
13. Goldman, E. F.,Jones, D. E.(2010).Interventions for preventing hamstring injuries.Cochrane Database Syst Rev,1,CD006782.
14. Guex, K.,Millet, G. P.(2013).Conceptual framework for strengthening exercises to prevent hamstring strains.Sports Medicine,43(12),1207-1215.
15. Jonhagen, S.,Ackermann, P.,Saartok, T.(2009).Forward lunge: A training study of eccentric exercises of the lower limbs.Journal of Strength and Conditioning Research,23(3),972-978.
16. Jonhagen, S.,Halvorsen, K.,Benoit, D. L.(2009).Muscle activation and length changes during two lunge exercises: Implications for rehabilitation.Scandinavian Journal of Medicine and Science in Sports,19(4),561-568.
17. Lin, M. J.,Chen, T. C.,Chen, H. L.,Wu, B. H.,Nosaka, K.(2015).Low-intensity eccentric contractions of the knee extensors and flexors protect against muscle damage.Applied Physiology Nutrition Metabolism,40(10),1004-1011.
18. Malliaropoulos, N.,Mendiguchia, J.,Pehlivanidis, H.,Papadopoulou, S.,Valle, X.,Malliaras, P.,Maffulli, N.(2012).Hamstring exercises for track and field athletes: Injury and exercise biomechanics, and possible implications for exercise selection and primary prevention.British Journal of Sports Medicine,46(12),846-851.
19. McAllister, M. J.,Hammond, K. G.,Schilling, B. K.,Ferreria, L. C.,Reed, J. P.,Weiss, L. W.(2014).Muscle activation during various hamstring exercises.Journal of Strength and Conditioning Research,28(6),1573-1580.
20. McCurdy, K.,O'Kelley, E.,Kutz, M.,Langford, G.,Ernest, J.,Torres, M.(2010).Comparison of lower extremity EMG between the 2-leg squat and modified single-leg squat in female athletes.Journal of Sport Rehabilitation,19(1),57-70.
21. Mendiguchia, J.,Alentorn-Geli, E.,Brughelli, M.(2012).Hamstring strain injuries: Are we heading in the right direction?.British Journal of Sports Medicine,46(2),81-85.
22. Mendiguchia, J.,Garrues, M. A.,Cronin, J. B.,Contreras, B.,Arcos, A. L.,Malliaropoulos, N.,Idoate, F.(2013).Non-uniform changes in MRI measurements of the thigh muscles following two hamstring strengthening exercises.Journal of Strength and Conditioning Research,27(3),574-581.
23. Mjolsnes, R.,Arnason, A.,Osthagen, T.,Raastad, T.,Bahr, R.(2004).A 10-week randomized trial comparing eccentric vs. concentric hamstring strength training in well-trained soccer players.Scandinavian Journal of Medicine and Science in Sports,14(5),311-317.
24. Ono, T.,Higashihara, A.,Fukubayashi, T.(2011).Hamstring functions during hip-extension exercise assessed with electromyography and magnetic resonance imaging.Research in Sports Medicine,19(1),42-52.
25. Ono, T.,Okuwaki, T.,Fukubayashi, T.(2010).Differences in activation patterns of knee flexor muscles during concentric and eccentric exercises.Research in Sports Medicine,18(3),188-198.
26. Petersen, J.,Thorborg, K.,Nielsen, M. B.,Budtz-Jorgensen, E.,Holmich, P.(2011).Preventive effect of eccentric training on acute hamstring injuries in men's soccer: A cluster-randomized controlled trial.The American Journal of Sports Medicine,39(11),2296-2303.
27. Pinniger, G. J.,Steele, J. R.,Groeller, H.(2000).Does fatigue induced by repeated dynamic efforts affect hamstring muscle function?.Medicine and Science in Sports and Exercise,32(3),647-653.
28. Potier, T. G.,Alexander, C. M.,Seynnes, O. R.(2009).Effects of eccentric strength training on biceps femoris muscle architecture and knee joint range of movement.European Journal of Applied Physiology and Occupational Physiology,105(6),939-944.
29. Prior, M.,Guerin, M.,Grimmer, K.(2009).An evidence-based approach to hamstring strain injury: A systematic review of the literature.Sports Health,1(2),154-164.
30. Reurink, G.,Goudswaard, G. J.,Tol, J. L.,Verhaar, J. A.,Weir, A.,Moen, M. H.(2012).Therapeutic interventions for acute hamstring injuries: A systematic review.British Journal of Sports Medicine,46(2),103-109.
31. Schache, A.(2012).Eccentric hamstring muscle training can prevent hamstring injuries in soccer players.Journal of Physiotherapy,58(1),58.
32. Schache, A. G.,Dorn, T. W.,Blanch, P. D.,Brown, N. A.,Pandy, M. G.(2012).Mechanics of the human hamstring muscles during sprinting.Medicine and Science in Sports and Exercise,44(4),647-658.
33. Schmitt, B.,Tim, T.,McHugh, M.(2012).Hamstring injury rehabilitation and prevention of reinjury using lengthened state eccentric training: a new concept.International Journal of Sports Physical Therapy,7(3),333-341.
34. Seagrave, R. A.,3rd, Perez, L.,McQueeney, S.,Toby, E. B.,Key, V.,Nelson, J. D.(2014).Preventive effects of eccentric training on acute hamstring muscle injury in professional baseball.Orthopaedic Journal of Sports Medicine,2(6)
35. Small, K.,McNaughton, L. R.,Greig, M.,Lohkamp, M.,Lovell, R.(2009).Soccer fatigue, sprinting and hamstring injury risk.International Journal of Sports Medicine,30(8),573-578.
36. Sugiura, Y.,Saito, T.,Sakuraba, K.,Sakuma, K.,Suzuki, E.(2008).Strength deficits identified with concentric action of the hip extensors and eccentric action of the hamstrings predispose to hamstring injury in elite sprinters.Journal of Orthopaedic & Sports Physical Therapy,38(8),457-464.
37. Tsaklis, P.,Malliaropoulos, N.,Mendiguchia, J.,Korakakis, V.,Tsapralis, K.,Pyne, D.,Malliaras, P.(2015).Muscle and intensity based hamstring exercise classification in elite female track and field athletes: Implications for exercise selection during rehabilitation.Open Access Journal Sports Medicine,6,209-217.
38. van der Horst, N.,Smits, D. W.,Petersen, J.,Goedhart, E. A.,Backx, F. J.(2015).The preventive effect of the nordic hamstring exercise on hamstring injuries in amateur soccer players: A randomized controlled trial.The American Journal of Sports Medicine,43(6),1316-1323.
39. van der Horst, N.,Smits, D. W.,Petersen, J.,Goedhart, E. A.,Backx, F. J.(2014).The preventive effect of the nordic hamstring exercise on hamstring injuries in amateur soccer players: Study protocol for a randomized controlled trial.Injury Prevention,20(4),e8.
40. Woods, C.,Hawkins, R. D.,Maltby, S.,Hulse, M.,Thomas, A.,Hodson, A.(2004).The football association medical research programme: An audit of injuries in professional football-analysis of hamstring injuries.British Journal of Sports Medicine,38(1),36-41.
41. Zebis, M. K.,Skotte, J.,Andersen, C. H.,Mortensen, P.,Petersen, H. H.,Viskaer, T. C.,Andersen, L. L.(2013).Kettlebell swing targets semitendinosus and supine leg curl targets biceps femoris: An EMG study with rehabilitation implications.British Journal of Sports Medicine,47(18),1192-1198..