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High school male basketball athletes exhibit greater hamstring muscle stiffness than females as assessed with shear wave elastography

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The purpose of this study was to characterize lower extremity passive muscle stiffness in a young, healthy, athletic population. It was hypothesized that males would exhibit greater stiffness than females and that hamstring stiffness would increase with increased passive hamstring stretch.


Male (n = 52, age 16.0 ± 1.3 years, height 180.3 ± 7.9 cm, weight 73.1 ± 11.8 kg) and female (n = 89, age 15.6 ± 1.3 years, height 169.7 ± 8.1 cm, weight 65.2 ± 13.2 kg) high school basketball athletes were recruited for this study. Shear wave elastography (SWE) was used to measure shear wave velocity (m/s) of the biceps femoris muscle at three leg positions (40%, 60%, and 80%) of the maximum passive 90–90 straight-leg raise position for each leg. Hamstring stiffness (kPa) was quantified from the SWE elastogram using custom processing software.


Hamstring stiffness was significantly greater for males than females at every position on both the dominant and non-dominant limbs (p < 0.05). Hamstring stiffness was greater on the non-dominant limb than the dominant for females at the 40% position. Stiffness at 60% was greater than stiffness at 40% for males on both the dominant and non-dominant limbs. However, stiffness at 60% was greater than stiffness at 80% on the male non-dominant limb. Females demonstrated higher stiffness at 40% than both 60% and 80% for the dominant and non-dominant limbs.


Healthy male basketball players had higher hamstring muscle stiffness than female players. Future studies may investigate what factors contribute to the large variability observed in muscle stiffness, resulting in mixed results on the effects of leg dominance and stretching positions.

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Funding provided by an NBA/GE Collaboration grant. Fellowship funding (ALM) provided by the Mayo Clinic Graduate School of Biomedical Sciences. NIH funding includes: K12HD065987 and L30AR070273 (NDS), T32AR056950 (RH), R01AR055563 (NAB), and R01AR056259 (TEH).

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Correspondence to Nathan D. Schilaty.

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The study was approved by the Mayo Clinic Institutional Review Board (IRB 17-003905). Informed consents were obtained from each high school basketball player and his/her parent if under 18 years old.

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McPherson, A.L., Nagai, T., Schilaty, N.D. et al. High school male basketball athletes exhibit greater hamstring muscle stiffness than females as assessed with shear wave elastography. Skeletal Radiol 49, 1231–1237 (2020).

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