Abstract
Purpose
Cortical mechanisms may contribute to weakness in participants with previous hamstring strain injury. This study aims to examine intra-cortical inhibition (SICI) and corticospinal excitability in previously injured participants.
Methods
In this cross-sectional study, TMS was used to examine SICI, silent period, silent period: MEP ratios and area under the stimulus response curve in the biceps femoris and medial hamstrings. Comparisons were made between participants with (n = 10) and without (n = 10) previous hamstring strain injury. Motor threshold and isometric knee flexor strength were also compared between participants and the relationship between strength and SICI in control and previously injured participants was examined.
Results
Isometric knee flexor strength was lower in previously injured limbs compared with control limbs (mean difference = − 41 Nm (− 26%) [95% CI = − 80 to − 2 Nm], p = 0.04, Cohen’s d = − 1.27) and contralateral uninjured limbs (mean difference = − 23 Nm (− 17%), [95% CI = − 40 to − 6 Nm], p = 0.01, Cohen’s d = − 0.57). Previously injured limbs exhibited smaller responses to paired pulse stimulation (i.e. greater levels of SICI) in the biceps femoris compared with control limbs (mean difference = − 19%, [95% CI = − 34 to − 5%], p = 0.007, Cohen’s d = − 1.33). Isometric knee flexor strength was associated with the level of SICI recorded in the biceps femoris in previously injured participants (coefficient = 23 Nm [95% CI = 7–40 Nm], adjusted R2 = 0.31, p = 0.01). There were no differences in markers of corticospinal excitability between previously injured and control limbs (all p > 0.24, all Cohen’s d < 0.40).
Conclusion
Athletes with previous injury in the biceps femoris exhibit increased SICI in this muscle compared with control participants. Increased SICI is related to lower levels of hamstring strength, and rehabilitation programs targeting the removal of intra-cortical inhibition should be considered.
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Availability of data and material
The datasets generated and analysed during the current study are available from the corresponding author on reasonable request.
Code availability
Original code used for statistical analysis are available from the corresponding author on request.
Abbreviations
- ACL:
-
Anterior cruciate ligament
- GABA:
-
Gamma amino-butyric acid
- MEP:
-
Motor-evoked potential
- sEMG:
-
Surface electromyography
- SICI:
-
Short interval intra-cortical inhibition
- Nm:
-
Newton meter
- TMS:
-
Transcranial magnetic stimulation
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Acknowledgements
Authors would like to thank Dr. David Borg for his specialist advice during the statistical analysis of this data.
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Rob Buhmann was supported by the Australian Government Research Training Program Scholarship.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by RB. The first draft of the manuscript was written by RB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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All testing procedures were approved by the Queensland University of Technology Human Research Ethics Committee (Approval Number: 1600001056).
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Buhmann, R., Trajano, G.S., Kerr, G.K. et al. Increased short interval intracortical inhibition in participants with previous hamstring strain injury. Eur J Appl Physiol 122, 357–369 (2022). https://doi.org/10.1007/s00421-021-04839-6
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DOI: https://doi.org/10.1007/s00421-021-04839-6