Pain-free versus pain-threshold rehabilitation following acute hamstring strain injury : A randomized controlled trial

Journal article

Hickey, Jack T., Timmins, Ryan G., Maniar, Nirav, Rio, Ebonie, Hickey, Peter F., Pitcher, Christian A., Williams, Morgan D. and Opar, David A.. (2020). Pain-free versus pain-threshold rehabilitation following acute hamstring strain injury : A randomized controlled trial. Journal of Orthopaedic and Sports Physical Therapy. 50(2), pp. 91-103. https://doi.org/10.2519/jospt.2020.8895
AuthorsHickey, Jack T., Timmins, Ryan G., Maniar, Nirav, Rio, Ebonie, Hickey, Peter F., Pitcher, Christian A., Williams, Morgan D. and Opar, David A.
Abstract

Objective
The primary aim was to compare time from acute hamstring strain injury (HSI) to return-to-play (RTP) clearance following a standardized rehabilitation protocol performed within either pain-free or pain-threshold limits. Secondary aims were to compare isometric knee flexor strength, biceps femoris long head (BFLH) fascicle length, fear of movement, and reinjury occurrence at the 6-month follow-up between pain-free and pain-threshold groups.

Design
Randomized controlled trial.

Methods
Forty-three men with acute HSIs were randomly allocated to a pain-free (n = 22) or pain-threshold (n = 21) rehabilitation group. Days from HSI to RTP clearance, isometric knee flexor strength, BFLH fascicle length, fear of movement, and reinjury occurrence at the 6-month follow-up were reported.

Results
Median time from HSI to RTP clearance was 15 days (95% confidence interval [CI]: 13, 17) in the pain-free group and 17 days (95% CI: 11, 24) in the pain-threshold group, which was not significantly different (P = .37). Isometric knee flexor strength recovery at 90° of hip and 90° of knee flexion was greater in the pain-threshold group at RTP clearance by 15% (95% CI: 1%, 28%) and by 15% (95% CI: 1%, 29%) at 2-month follow-up, respectively. Improvement in BFLH fascicle length from baseline was 0.91 cm (95% CI: 0.34, 1.48) greater at 2-month follow-up in the pain-threshold group. Two reinjuries occurred in both the pain-free and pain-threshold groups between RTP clearance and the 6-month follow-up.

Conclusion
Pain-threshold rehabilitation did not accelerate RTP clearance, but resulted in greater recovery of isometric knee flexor strength and better maintenance of BFLH fascicle length, compared to pain-free rehabilitation.

Keywordshamstring strain injury; muscle; pain; rehabilitation; return to play
Year2020
JournalJournal of Orthopaedic and Sports Physical Therapy
Journal citation50 (2), pp. 91-103
PublisherJournal of Orthopaedic & Sports Physical Therapy, Inc.
ISSN1938-1344
Digital Object Identifier (DOI)https://doi.org/10.2519/jospt.2020.8895
Scopus EID2-s2.0-85078864075
Page range91-103
Author's accepted manuscript
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Output statusPublished
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Online31 Jan 2020
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Deposited27 Aug 2021
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Presland, Joel D., Opar, David A., Williams, Morgan D., Hickey, Jack T., Maniar, Nirav, Lee Dow, Connor, Bourne, Matthew N. and Timmins, Ryan G.. (2020). Hamstring strength and architectural adaptations following inertial flywheel resistance training. Journal of Science and Medicine in Sport. 23(11), pp. 1093-1099. https://doi.org/10.1016/j.jsams.2020.04.007
Determinants of hamstring fascicle length in professional rugby league athletes
McGrath, Timothy M., Hulin, Billy T., Pickworth, Nathan, Clarke, Alex and Timmins, Ryan G.. (2020). Determinants of hamstring fascicle length in professional rugby league athletes. Journal of Science and Medicine in Sport. 23(5), pp. 524-528. https://doi.org/10.1016/j.jsams.2019.12.006
Factors that impact self-reported wellness scores in elite Australian Footballers
Ruddy, Joshua D., Cormack, Stuart, Timmins, Ryan G., Sakadjian, Alex, Pietsch, Samuel, Carey, David L., Williams, Morgan D. and Opar, David A.. (2020). Factors that impact self-reported wellness scores in elite Australian Footballers. Medicine & Science in Sports & Exercise. 52(6), pp. 1427-1435. https://doi.org/10.1249/MSS.0000000000002244
Differences in lower limb strength and structure after 12 weeks of resistance, endurance, and concurrent training
Timmins, Ryan G., Shamim, Baubak, Tofari, Paul J., Hickey, Jack T. and Camera, Donny M.. (2020). Differences in lower limb strength and structure after 12 weeks of resistance, endurance, and concurrent training. International Journal of Sports Physiology and Performance. 15(9), pp. 1223-1230. https://doi.org/10.1123/IJSPP.2019-0788
The relationship of family characteristics, parental beliefs and parenting behaviours with the fundamental movement proficiency of primary school children in South East Wales
Jarvis, Stuart, Williams, Morgan, Rainer, Paul, Saunders, John and Mullen, Richard. (2020). The relationship of family characteristics, parental beliefs and parenting behaviours with the fundamental movement proficiency of primary school children in South East Wales. European Physical Education Review. 26(4), pp. 970-986. https://doi.org/10.1177/1356336X20915225
Hamstring myoelectrical activity during three different kettlebell swing exercises
Del Monte, Michael J., Opar, David, Timmins, Ryan G., Ross, James A., Keogh, Justin W. L. and Lorenzen, Christian. (2020). Hamstring myoelectrical activity during three different kettlebell swing exercises. Journal of Strength and Conditioning Research. 34(7), pp. 1953-1958. https://doi.org/10.1519/JSC.0000000000002254
Systematically searching and reviewing the literature
Maniar, Nirav, Duncan, Kathryn and Opar, David. (2019). Systematically searching and reviewing the literature. In In Bird, Stephen R. (Ed.). Research methods in physical activity and health pp. 28-44 Routledge. https://doi.org/10.4324/9781315158501-5
Modeling the risk of team sport injuries : A narrative review of different statistical approaches
Ruddy, Joshua D., Cormack, Stuart J., Whiteley, Rod, Williams, Morgan D., Timmins, Ryan G. and Opar, David A.. (2019). Modeling the risk of team sport injuries : A narrative review of different statistical approaches. Frontiers in Physiology. 10, p. Article 829.
Infographic. The effect of high-speed running on hamstring strain injury risk
Duhig, Steven John, Shield, Anthony J., Opar, David, Gabbett, Tim J., Ferguson, Cameron and Williams, Morgan. (2019). Infographic. The effect of high-speed running on hamstring strain injury risk. British Journal of Sports Medicine. 53(16), pp. 1034-1035. https://doi.org/10.1136/bjsports-2018-099358
Session availability as a result of prior injury impacts the risk of subsequent non-contact lower limb injury in elite male australian footballers
Ruddy, Joshua D., Pietsch, Samuel, Maniar, Nirav, Cormack, Stuart J., Timmins, Ryan G., Williams, Morgan D., Carey, David L. and Opar, David A.. (2019). Session availability as a result of prior injury impacts the risk of subsequent non-contact lower limb injury in elite male australian footballers. Frontiers in Physiology. 10, p. 737. https://doi.org/10.3389/fphys.2019.00737
A novel device to assess hip strength : Concurrent validity and normative values in male athletes
O'Brien, Michael, Bourne, Matthew, Heerey, Joshua, Timmins, Ryan G. and Pizzari, Tania. (2019). A novel device to assess hip strength : Concurrent validity and normative values in male athletes. Physical Therapy in Sport. 35, pp. 63-68. https://doi.org/10.1016/j.ptsp.2018.11.006
Effect of concentric and eccentric hamstring training on sprint recovery, strength and muscle architecture in inexperienced athletes
Duhig, Steven J., Bourne, Matthew N., Buhmann, Robert L., Williams, Morgan, Minett, Geoffrey M., Roberts, Llion A., Timmins, Ryan Gregory, Sims, Casey and Shield, Anthony J.. (2019). Effect of concentric and eccentric hamstring training on sprint recovery, strength and muscle architecture in inexperienced athletes. Journal of Science and Medicine in Sport. 22(7), pp. 769 - 774. https://doi.org/10.1016/j.jsams.2019.01.010
Hamstring muscle activation and morphology are significantly altered 1-6 years after anterior cruciate ligament reconstruction with semitendinosus graft
Messer, Daniel J., Shield, Anthony J., Williams, Morgan D., Timmins, Ryan Gregory and Bourne, Matthew N.. (2019). Hamstring muscle activation and morphology are significantly altered 1-6 years after anterior cruciate ligament reconstruction with semitendinosus graft. Knee Surgery, Sports Traumatology, Arthroscopy. 27. https://doi.org/10.1007/s00167-019-05374-w
Razor hamstring curl and Nordic hamstring exercise architectural adaptations : Impact of exercise selection and intensity
Pollard, Christopher W., Opar, David A., Williams, Morgan D., Bourne, Matthew N. and Timmins, Ryan Gregory. (2019). Razor hamstring curl and Nordic hamstring exercise architectural adaptations : Impact of exercise selection and intensity. Scandinavian Journal of Medicine & Science in Sports. 29(5), pp. 706-715. https://doi.org/10.1111/sms.13381
Lower-limb muscle function during sidestep cutting
Maniar, Nirav, Schache, Anthony G., Cole, Michael H. and Opar, David. (2019). Lower-limb muscle function during sidestep cutting. Journal of Biomechanics. 82, pp. 186 - 192. https://doi.org/10.1016/j.jbiomech.2018.10.021
Effect of acute augmented feedback on between limb asymmetries and eccentric knee flexor strength during the Nordic hamstring exercise
Wade J. Chalker, Anthony J. Shield, David Opar, Evelyne N. Rathbone and Justin Keogh. (2018). Effect of acute augmented feedback on between limb asymmetries and eccentric knee flexor strength during the Nordic hamstring exercise. PeerJ. (e4972). https://doi.org/10.7717/peerj.4972
The Cape Town declaration on access to cardiac surgery in the developing world
Zilla, Peter, Bolman, R. Morton, Yacoub, Magdi H., Beyersdorf, Friedhelm, Sliwa, Karen, Zühlke, Liesl, Higgins, Robert S. D., Mayosi, Bongani, Carpentier, Alain and Williams, David. (2018). The Cape Town declaration on access to cardiac surgery in the developing world. Cardiovascular Journal of Africa. 29(4), pp. 256 - 259. https://doi.org/10.5830/CVJA-2018-046
Non-knee-spanning muscles contribute to tibiofemoral shear as well as valgus and rotational joint reaction moments during unanticipated sidestep cutting
Maniar, Nirav, Schache, Anthony, Sritharan, Prasanna and Opar, David. (2018). Non-knee-spanning muscles contribute to tibiofemoral shear as well as valgus and rotational joint reaction moments during unanticipated sidestep cutting. Scientific Reports. 8(1), pp. 1 - 10. https://doi.org/10.1038/s41598-017-19098-9
Interpreting measures of fundamental movement skills and their relationship with health-related physical activity and self-concept
Jarvis, Stuart, Williams, Morgan, Rainer, Paul, Jones, Eleri Sian, Saunders, John and Mullen, Richard. (2018). Interpreting measures of fundamental movement skills and their relationship with health-related physical activity and self-concept. Measurement in Physical Education and Exercise Science. 22(1), pp. 88 - 100. https://doi.org/10.1080/1091367X.2017.1391816
An evidence-based framework for strengthening exercises to prevent hamstring injury
Bourne, Matthew N., Timmins, Ryan Gregory, Opar, David, Pizzari, Tania, Ruddy, Joshua D., Sims, Casey, Williams, Morgan D. and Shield, Anthony J.. (2018). An evidence-based framework for strengthening exercises to prevent hamstring injury. Sports Medicine. 48(2), pp. 251 - 267. https://doi.org/10.1007/s40279-017-0796-x
The effect of Nordic hamstring exercise training volume on biceps femoris long head architectural adaptation
Presland, J. D., Timmins, R. G., Bourne, M. N., Williams, M. D. and Opar, D. A.. (2018). The effect of Nordic hamstring exercise training volume on biceps femoris long head architectural adaptation. Scandinavian Journal of Medicine & Science in Sports. 28(7), pp. 1775-1783. https://doi.org/10.1111/sms.13085
The Cape Town declaration on access to cardiac surgery in the developing world
Zilla, Peter, Bolman, R. Morton, Yacoub, Magdi H., Beyersdorf, Friedhelm, Sliwa-Hahnle, Karen, Zuhlke, Liesl Joanna, Higgins, Robert S.D., Mayosi, Bongani, Carpentier, Alain and Williams, David. (2018). The Cape Town declaration on access to cardiac surgery in the developing world. European Journal of Cardio-Thoracic Surgery. 54(3), pp. 407 - 410. https://doi.org/10.1093/ejcts/ezy272
Hamstring strain injury: objective assessment tools and exercise-specific progression criteria during pain-threshold rehabilitation
Hickey, Jack Thomas. (2018). Hamstring strain injury: objective assessment tools and exercise-specific progression criteria during pain-threshold rehabilitation [Thesis]. https://doi.org/10.26199/5b87746aba291
The Cape Town declaration on access to cardiac surgery in the developing world
Zilla, Peter, Bolman, R M., Yacoub, Magdi H., Beyersdorf, Friedhelm, Sliwa-Hahnle, Karen, Zuhlke, Liesl J., Higgins, Robert, Mayosi, Bongani, Carpentier, Alain and Williams, David. (2018). The Cape Town declaration on access to cardiac surgery in the developing world. SAMJ South African Medical Journal. 108(9), pp. 702 - 704. https://doi.org/10.7196/SAMJ.2018.v108i9.13102
Muscle morphology of the lower leg in ambulant children with spastic cerebral palsy
Pitcher, Christian A., Elliott, Catherine M., Valentine, Jane P., Stannage, Katherine, Williams, Sian A., Shipman, Peter J. and Reid, Siobhán L.. (2018). Muscle morphology of the lower leg in ambulant children with spastic cerebral palsy. Muscle & Nerve. 58(6), pp. 818 - 823. https://doi.org/10.1002/mus.26293
The Cape Town declaration on access to cardiac surgery in the developing world
Zilla, Peter, Bolman, R. Morton, Yacoub, Magdi H., Beyersdorf, Friedhelm, Sliwa, Karen, Zühlke, Liesl, Higgins, Robert S. D., Mayosi, Bongani, Carpentier, Alain and Williams, David. (2018). The Cape Town declaration on access to cardiac surgery in the developing world. The Annals of Thoracic Surgery. 106(3), pp. 930 - 933. https://doi.org/10.1016/j.athoracsur.2018.05.020
Infographic. Impact of the Nordic hamstring and hip extension exercises on hamstring architecture and morphology: Implications for injury prevention
Bourne, Matthew N., Pope, David, Duhig, Steven J., Timmins, Ryan G., Williams, Morgan D., Al Najjar, Aiman, Kerr, Graham K. and Shield, Anthony J.. (2018). Infographic. Impact of the Nordic hamstring and hip extension exercises on hamstring architecture and morphology: Implications for injury prevention. British Journal of Sports Medicine. 52(23), pp. 1490 - 1491. https://doi.org/10.1136/bjsports-2017-098730
A novel apparatus to measure knee flexor strength during various hamstring exercises: A reliability and retrospective injury study
Hickey, Jack T., Hickey, Peter F., Maniar, Nirav, Timmins, Ryan G., Williams, Morgan D., Pitcher, Christian A. and Opar, David A.. (2018). A novel apparatus to measure knee flexor strength during various hamstring exercises: A reliability and retrospective injury study. Journal of Orthopaedic and Sports Physical Therapy. 48(2), pp. 72 - 80. https://doi.org/10.2519/jospt.2018.7634
Adaptations to concurrent training in combination with high protein availability: A comparative trial in healthy, recreationally active men
Shamim, Baubak, Devlin, Brooke L., Timmins, Ryan G., Tofari, Paul, Dow, Connor Lee, Coffey, Vernon G., Hawley, John A. and Camera, Donny M.. (2018). Adaptations to concurrent training in combination with high protein availability: A comparative trial in healthy, recreationally active men. Sports Medicine. 48(12), pp. 2869 - 2883. https://doi.org/10.1007/s40279-018-0999-9
Non-knee-spanning muscles contribute to tibiofemoral shear as well as valgus and rotational joint reaction moments during unanticipated sidestep cutting
Maniar, Nirav, Schache, Anthony G., Sritharan, Prasanna and Opar, David. (2018). Non-knee-spanning muscles contribute to tibiofemoral shear as well as valgus and rotational joint reaction moments during unanticipated sidestep cutting. Scientific Reports. 8(2501), pp. 1 - 10. https://doi.org/10.1038/s41598-017-19098-9
Impact of exercise selection on hamstring muscle activation
Bourne, Matthew N., Williams, Morgan, Opar, David, Najjar, Aiman Al, Kerr, Graham K. and Shield, Anthony J.. (2017). Impact of exercise selection on hamstring muscle activation. British Journal of Sports Medicine. 51, pp. 1021 - 1028. https://doi.org/10.1136/bjsports-2015-095739
Muscle force contributions to knee joint loading
Maniar, Nirav. (2017). Muscle force contributions to knee joint loading [Thesis]. https://doi.org/10.26199/5cb7ada848286
Impact of the Nordic hamstring and hip extension exercises on hamstring architecture and morphology: Implications for injury prevention
Bourne, Matthew N., Duhig, Steven J., Timmins, Ryan, Williams, Morgan, Opar, David, Najjar, Aiman Al, Kerr, Graham K. and Shield, Anthony 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), pp. 469 - 477. https://doi.org/10.1136/bjsports-2016-096130
Biceps femoris architecture : The association with injury and response to training
Timmins, Ryan. (2017). Biceps femoris architecture : The association with injury and response to training. British Journal of Sports Medicine. 51(6), pp. 547-548. https://doi.org/10.1136/bjsports-2016-097044
There is strength in numbers for muscle injuries it is time to establish an international collaborative registry
Van Dyke, Nicol, Van der Made, Anne D., Timmins, Ryan, Opar, David and Tol, Johannes L.. (2017). There is strength in numbers for muscle injuries it is time to establish an international collaborative registry. British Journal of Sports Medicine. https://doi.org/10.1136/bjsports-2016-097318
Effect of prior injury on changes to biceps femoris architecture across an Australian football league season
Timmins, Ryan, Bourne, Matthew N., Hickey, Jack, Maniar, Nirav, Tofari, Paul, Williams, Morgan and Opar, David. (2017). Effect of prior injury on changes to biceps femoris architecture across an Australian football league season. Medicine and Science in Sports and Exercise. 49(10), pp. 2102 - 2109. https://doi.org/10.1249/MSS.0000000000001333
Criteria for progressing rehabilitation and determining return to play clearance following hamstring strain injury: A systematic review
Hickey, Jack, Timmins, Ryan G., Maniar, Nirav, Williams, Morgan and Opar, David. (2017). Criteria for progressing rehabilitation and determining return to play clearance following hamstring strain injury: A systematic review. Sports Medicine. 47(7). https://doi.org/10.1007/s40279-016-0667-x
Predictive modeling of hamstring strain injuries in elite Australian footballers
Ruddy, Joshua, Shield, Anthony J., Maniar, Nirav, Williams, Morgan D., Duhig, Steven J., Timmins, Ryan, Hickey, Jack, Bourne, Matthew N. and Opar, David. (2017). Predictive modeling of hamstring strain injuries in elite Australian footballers. Medicine and Science in Sports and Exercise. 50(5), pp. 1 - 30. https://doi.org/10.1249/MSS.0000000000001527
Running exposure is associated with the risk of hamstring strain injury in elite Australian footballers
Ruddy, Joshua D., Pollard, Christopher, Timmins, Ryan, Williams, Morgan, Shield, Anthony and Opar, David. (2017). Running exposure is associated with the risk of hamstring strain injury in elite Australian footballers. British Journal of Sports Medicine. https://doi.org/10.1136/bjsports-2016-096777
Drop punt kicking induces eccentric knee flexor weakness associated with reductions in hamstring electromyographic activity
Duhig, Steven J., Williams, Morgan, Minett, Geoffrey M., Opar, David and Shield, Anthony J.. (2017). Drop punt kicking induces eccentric knee flexor weakness associated with reductions in hamstring electromyographic activity. Journal of Science and Medicine in Sport. 20(6), pp. 595 - 599. https://doi.org/10.1016/j.jsams.2016.09.006
Muscle activation patterns in the Nordic hamstring exercise: Impact of prior strain injury
Bourne, Matthew N., Opar, David, Williams, Morgan, Najjar, Aiman Al and Shield, Anthony J.. (2016). Muscle activation patterns in the Nordic hamstring exercise: Impact of prior strain injury. Scandinavian Journal of Medicine & Science in Sports. 26(6). https://doi.org/10.1111/sms.12494
Muscle histopathology in children with spastic cerebral palsy receiving botulinum toxin type A
Valentine, Jane P., Stannage, Katherine, Fabian, Vicki, Ellis, Kevin, Reid, Siobhan L., Pitcher, Christian Andrew and Elliott, Catherine M.. (2016). Muscle histopathology in children with spastic cerebral palsy receiving botulinum toxin type A. Muscle & Nerve. 53(3), pp. 407 - 414. https://doi.org/10.1002/mus.24763
Biceps femoris architecture and strength in athletes with a prior ACL reconstruction
Timmins, Ryan G., Bourne, Matthew N., Shield, Anthony J., Williams, Morgan, Lorenzen, Christian and Opar, David A.. (2016). Biceps femoris architecture and strength in athletes with a prior ACL reconstruction. Medicine and Science in Sports and Exercise. 48(3), pp. 337-345. https://doi.org/10.1249/MSS.0000000000000783
Hamstring strength and flexibility after hamstring strain injury: A systematic review and meta-analysis
Maniar, Nirav, Shielf, Anthony J., Williams, Morgan D., Timmins, Ryan G. and Opar, David A.. (2016). Hamstring strength and flexibility after hamstring strain injury: A systematic review and meta-analysis. British Journal of Sports Medicine. 50(15), pp. 909-920. https://doi.org/10.1136/bjsports-2015-095311
Is there evidence to support the use of the angle of peak torque as a marker of hamstring injury and re-injury risk?
Timmins, Ryan G., Shield, Anthony J., Williams, Morgan D. and Opar, David A.. (2016). Is there evidence to support the use of the angle of peak torque as a marker of hamstring injury and re-injury risk? Sports Medicine. 46(1), pp. 7-13. https://doi.org/10.1007/s40279-015-0378-8
Effect of high-speed running on hamstring strain injury risk
Duhig, Steven, Shield, Anthony, Opar, David, Gabbett, Tim, Ferguson, Cameron and Williams, Morgan. (2016). Effect of high-speed running on hamstring strain injury risk. British Journal of Sports Medicine. 50(24). https://doi.org/10.1136/bjsports-2015-095679
Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study
Timmins, Ryan G., Bourne, Matthew N., Shield, Anthony J., Williams, Morgan, Lorenzen, Christian and Opar, David. (2016). Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study. British Journal of Sports Medicine. 50(24). https://doi.org/10.1136/bjsports-2015-095362
Architectural changes of the biceps femoris long head after concentric or eccentric training
Timmins, Ryan G., Ruddy, Joshua D., Presland, Joel, Maniar, Nirav and Williams, Morgan. (2016). Architectural changes of the biceps femoris long head after concentric or eccentric training. Medicine and Science in Sports and Exercise. 48(3), pp. 499-508. https://doi.org/10.1249/MSS.0000000000000795
Reliability of measures of quadriceps muscle function using magnetic stimulation
Tofari, Paul J., Opar, David, Kemp, Justin Guy, Billaut, Francois and Cormack, Stuart John. (2016). Reliability of measures of quadriceps muscle function using magnetic stimulation. Muscle & Nerve. https://doi.org/10.1002/mus.24926
Architectural adaptations of muscle to training and injury: A narrative review outlining the contributions by fascicle length, pennation angle and muscle thickness
Timmins, Ryan G., Shield, Anthony J., Williams, Morgan D., Lorenzen, Christian and Opar, David. (2016). Architectural adaptations of muscle to training and injury: A narrative review outlining the contributions by fascicle length, pennation angle and muscle thickness. British Journal of Sports Medicine. 50(23). https://doi.org/10.1136/bjsports-2015-094881
Comparisons of eccentric knee flexor strength and asymmetries across elite, sub-elite and school level cricket players
Chalker, Wade J., Shield, Anthony J., Opar, David and Keogh, Justin W. L.. (2016). Comparisons of eccentric knee flexor strength and asymmetries across elite, sub-elite and school level cricket players. PeerJ. 4, pp. 1 - 10. https://doi.org/10.7717/peerj.1594
What do submarines have in common with diabetes?
Rio, Ebony, Timmins, Ryan Gregory and Opar, David. (2016). What do submarines have in common with diabetes? British Journal of Sports Medicine. 50(16), pp. 955 - 956. https://doi.org/10.1136/bjsports-2016-096646
The juxtaposition of science and medicine in sport. Can we all play together nicely?
Opar, David and Rio, Ebony. (2015). The juxtaposition of science and medicine in sport. Can we all play together nicely? British Journal of Sports Medicine. 49(10), pp. 640 - 641. https://doi.org/10.1136/bjsports-2015-094819
Eccentric knee flexor strength and risk of hamstring injuries in Rugby Union: A prospective study
Bourne, Matthew, Opar, David, Williams, Morgan and Shield, Anthony. (2015). Eccentric knee flexor strength and risk of hamstring injuries in Rugby Union: A prospective study. American Journal of Sports Medicine. 43(11), pp. 2663 - 2670. https://doi.org/10.1177/0363546515599633
Acute injuries in track and field athletes : A 3-year observational study at the penn relays carnival with epidemiology and medical coverage implications
Opar, David, Drezner, Jonathan, Shield, Anthony, Williams, Morgan, Webner, David, Sennett, Brian, Kapur, Rahul, Cohen, Marc, Ulager, James, Cafengiu, Ana and Cronholm, Peter F. (2015). Acute injuries in track and field athletes : A 3-year observational study at the penn relays carnival with epidemiology and medical coverage implications. American Journal of Sports Medicine. 43(4), pp. 816 - 822. https://doi.org/10.1177/0363546514562553
Comparison of anthropometry, upper body strength and lower body power characteristics in different levels of Australian Football players
Bilsborough, Johann, Greenway, Kate, Opar, David, Livingstone, Steuart, Cordy, Justin, Bird, S. and Coutts, Aaron. (2015). Comparison of anthropometry, upper body strength and lower body power characteristics in different levels of Australian Football players. Journal of Strength and Conditioning Research. 29(3), pp. 826 - 834. https://doi.org/10.1519/JSC.0000000000000682
Eccentric hamstring strength and hamstring injury risk in Australian footballers
Opar, David A., Williams, Morgan D., Timmins, Ryan G., Duhig, Steven and Shield, Anthony J.. (2015). Eccentric hamstring strength and hamstring injury risk in Australian footballers. Medicine and Science in Sports and Exercise. 47(4). https://doi.org/10.1249/MSS.0000000000000465
The effect of previous hamstring strain injury on the change in eccentric hamstring strength during preseason training in elite Australian footballers
Opar, David A., Williams, Morgan D., Timmins, Ryan G., Hickey, Jack, Duhig, Steven J. and Shield, Anthony J.. (2015). The effect of previous hamstring strain injury on the change in eccentric hamstring strength during preseason training in elite Australian footballers. American Journal of Sports Medicine. 43(2), pp. 377-384. https://doi.org/10.1177/0363546514556638
Biceps femoris long head architecture: A reliability and retrospective injury study
Timmins, Ryan Gregory, Shield, Anthony, Williams, Morgan, Lorenzen, Christian and Opar, David. (2015). Biceps femoris long head architecture: A reliability and retrospective injury study. Medicine and Science in Sports and Exercise. 47(5), pp. 905 - 913. https://doi.org/10.1249/MSS.0000000000000507
The effect of using different regions of interest on local and mean skin temperature
Maniar, Nirav, Bach, Aaron, Stewart, Ian and Costello, Joseph. (2015). The effect of using different regions of interest on local and mean skin temperature. Journal of Thermal Biology. 49-50, pp. 33 - 38. https://doi.org/10.1016/j.jtherbio.2015.01.008
Biceps femoris long head architecture: The association with hamstring injury and response to training
Timmins, Ryan Gregory. (2015). Biceps femoris long head architecture: The association with hamstring injury and response to training [Thesis]. https://doi.org/10.4226/66/5a9cbd05b0b98
Does muscle size matter? The relationship between muscle size and strength in children with cerebral palsy
Reid, Siobhan L., Pitcher, Christian A., Williams, Sian A., Licari, Melissa K., Valentine, Jane P., Shipman, Peter J. and Elliott, Catherine M.. (2015). Does muscle size matter? The relationship between muscle size and strength in children with cerebral palsy. Disability and Rehabilitation. 37(7), pp. 579 - 584. https://doi.org/10.3109/09638288.2014.935492
Ultrasound Characterization of Medial Gastrocnemius Tissue Composition in Children with Spastic Cerebral Palsy
Pitcher, Christian A., Elliott, Catherine M., Panizzolo, Fausto A., Valentine, Jane P., Stannage, Katherine and Reid, Siobhan L.. (2015). Ultrasound Characterization of Medial Gastrocnemius Tissue Composition in Children with Spastic Cerebral Palsy. Muscle & Nerve. 52(3), pp. 397 - 403. https://doi.org/10.1002/mus.24549
Assessment of conditioning-specific movement tasks and physical fitness measures in talent identified under 16-year-old rugby union players
Parsonage, Joanna R., Williams, Rhodri S., Rainer, Paul, McKeown, Ian and Williams, Morgan D.. (2015). Assessment of conditioning-specific movement tasks and physical fitness measures in talent identified under 16-year-old rugby union players. Journal of Strength and Conditioning Research. 28(6), pp. 1497 - 1506. https://doi.org/10.1519/JSC.0000000000000298
Characteristics impacting on session rating of perceived exertion training load in Australian footballers
Gallo, Tania, Cormack, Stuart, Gabbett, Tim, Williams, Morgan and Lorenzen, Christian. (2015). Characteristics impacting on session rating of perceived exertion training load in Australian footballers. Journal of Sports Sciences. 33(5), pp. 467 - 475. https://doi.org/10.1080/02640414.2014.947311
A comparison of physical and technical match performance of a team competing in the english championship league and then the english premier league following promotion
Morgans, Ryland, Adams, David, Mullen, Richard, Sacramento, Joao, McLellan, Chris and Williams, Morgan David. (2015). A comparison of physical and technical match performance of a team competing in the english championship league and then the english premier league following promotion. International Journal of Sports Science and Coaching. 10(2-3), pp. 543 - 549. https://doi.org/10.1260/1747-9541.10.2-3.543
Reviewing current knowledge in snatch performance and technique: The need for future directions in applied research
Ho, Lester K. W., Lorenzen, Christian, Wilson, Cameron, Saunders, John and Williams, Morgan. (2014). Reviewing current knowledge in snatch performance and technique: The need for future directions in applied research. Journal of Strength and Conditioning Research. 28(2), pp. 574 - 586. https://doi.org/10.1519/JSC.0b013e31829c0bf8
Changes in physical performance variables in an English Championship League team across the competitive season: The effect of possession
Morgans, Ryland, Adams, David, Mullen, Richard and Williams, Morgan David. (2014). Changes in physical performance variables in an English Championship League team across the competitive season: The effect of possession. International Journal of Performance Analysis in Sport. 14(2), pp. 493 - 503. https://doi.org/10.1080/24748668.2014.11868738
The accuracy and precision of DXA for assessing body composition in team sport athletes
Bilsborough, Johann, Greenway, Kate, Opar, David, Livingstone, Steuart, Cordy, Justin and Coutts, Aaron. (2014). The accuracy and precision of DXA for assessing body composition in team sport athletes. Journal of Sports Sciences. 32(19), pp. 1821 - 1828. https://doi.org/10.1080/02640414.2014.926380
Assessment of conditioning-specific movement tasks and physical fitness measures in talent identified under 16-year-old rugby union players
Parsonage, Joanna, Williams, Rhodri, Rainer, Paul, McKeown, Ian and Williams, Morgan. (2014). Assessment of conditioning-specific movement tasks and physical fitness measures in talent identified under 16-year-old rugby union players. Journal of Strength and Conditioning Research. 28(6), pp. 1497 - 1506. https://doi.org/10.1519/JSC.0000000000000298
Technical and physical performance over an english championship league season
Morgans, Ryland, Adams, David, Mullen, Richard, McLellan, Chris and Williams, Morgan David. (2014). Technical and physical performance over an english championship league season. International Journal of Sports Science and Coaching. 9(5), pp. 1033 - 1042. https://doi.org/10.1260/1747-9541.9.5.1033
Is there a potential relationship between prior hamstring strain injury and increased risk for future anterior cruciate ligament injury?
Opar, David and Serpell, Benjamin. (2014). Is there a potential relationship between prior hamstring strain injury and increased risk for future anterior cruciate ligament injury? Archives of Physical Medicine and Rehabilitation. 95(2). https://doi.org/10.1016/j.apmr.2013.07.028
Reduced biceps femoris myoelectrical activity influences eccentric knee flexor weakness after repeat sprint running
Timmins, R. G., Opar, D. A., Williams, M. D., Schache, A. G., Dear, N. M. and Shield, A. J.. (2014). Reduced biceps femoris myoelectrical activity influences eccentric knee flexor weakness after repeat sprint running. Scandinavian Journal of Medicine & Science in Sports. 24(4), pp. e299-e305. https://doi.org/10.1111/sms.12171
The financial cost of hamstring strain injuries in the Australian Football League
Hickey, Jack, Shield, Anthony J., Williams, Morgan D. and Opar, David A. (2014). The financial cost of hamstring strain injuries in the Australian Football League. British Journal of Sports Medicine. 48(8), pp. 729-730. https://doi.org/10.1136/bjsports-2013-092884
Acute hamstring strain injury in track-and-field athletes: A 3-year observational study at the Penn Relay Carnival
Opar, David, Drezner, Jonathan, Shield, Anthony, Williams, Morgan, Webner, David, Sennett, Brian, Kapur, Rahul, Cohen, M., Ulager, James and Cafengiu, Ana. (2014). Acute hamstring strain injury in track-and-field athletes: A 3-year observational study at the Penn Relay Carnival. Scandinavian Journal of Medicine & Science in Sports. 24(4). https://doi.org/10.1111/sms.12159
A novel device using the Nordic hamstring exercise to assess eccentric knee flexor strength: A reliability and retrospective injury study
Opar, David, Piatowski, Timothy, Williams, Morgan and Shield, Anthony J.. (2013). A novel device using the Nordic hamstring exercise to assess eccentric knee flexor strength: A reliability and retrospective injury study. Journal of Orthopaedic and Sports Physical Therapy. 43(9), pp. 636 - 640. https://doi.org/10.2519/jospt.2013.4837
Applying decision tree induction for identification of important attributes in one-versus-one player interactions : A hockey exemplar
Morgan, Stuart, Williams, Morgan and Barnes, Chris. (2013). Applying decision tree induction for identification of important attributes in one-versus-one player interactions : A hockey exemplar. Journal of Sports Sciences. https://doi.org/10.1080/02640414.2013.770906
Endurance and sprint benefits of high-intensity and supramaximal interval training
Cicioni-Kolsky, Daniel James, Lorenzen, Christian, Williams, Morgan and Kemp, Justin. (2013). Endurance and sprint benefits of high-intensity and supramaximal interval training. European Journal of Sport Science. https://doi.org/10.1080/17461391.2011.606844
Successful short passing frequency of defenders differentiates between top and bottom four English Premier League teams
Adams, David, Morgans, Ryland, Sacramento, Joao, Morgan, Stuart and Williams, Morgan David. (2013). Successful short passing frequency of defenders differentiates between top and bottom four English Premier League teams. International Journal of Performance Analysis in Sport. 13(3), pp. 653 - 668. https://doi.org/10.1080/24748668.2013.11868678
Rate of torque and electromyographic development during anticipated eccentric contraction is lower in previously strained hamstrings
Opar, David A., Williams, Morgan D., Timmins, Ryan G. and Dear, Nuala M. (2013). Rate of torque and electromyographic development during anticipated eccentric contraction is lower in previously strained hamstrings. The American Journal of Sports Medicine. 41(1), pp. 116-125. https://doi.org/10.1177/0363546512462809
The role of neuromuscular inhibition in hamstring strain injury recurrence
Fyfe, Jackson, Opar, David, Williams, Morgan and Shield, Anthony. (2013). The role of neuromuscular inhibition in hamstring strain injury recurrence. Journal of Electromyography and Kinesiology. 23(3), pp. 523-530. https://doi.org/10.1016/j.jelekin.2012.12.006
Knee flexor strength and bicep femoris electromyographical activity is lower in previously strained hamstrings
Opar, David A., Williams, Morgan D., Timmins, Ryan G., Dear, Nuala M. and Shield, Anthony J. (2013). Knee flexor strength and bicep femoris electromyographical activity is lower in previously strained hamstrings. Journal of Electromyography and Kinesiology. 23(3), pp. 696-703. https://doi.org/10.1016/j.jelekin.2012.11.004
Outcome and process in motor performance : A comparison of jumping by typically developing children and those with low motor proficiency
Williams, Morgan, Saunders, John, Maschette, Wayne Edward and Wilson, Cameron. (2013). Outcome and process in motor performance : A comparison of jumping by typically developing children and those with low motor proficiency. Measurement in Physical Education and Exercise Science. https://doi.org/10.1080/1091367X.2013.761029
Exploring Children's Motor Development
Saunders, John, Williams, Morgan and Wilson, Cameron. (2012). Exploring Children's Motor Development. Sports Science in the heart of Europe 17th Annual Congress of the European College of Sprots Science. Germany: European College of Sport Science (ECSS). pp. 1884 - 1884
Classifying training drills based on movement demands in Australian Football
Loader, Jordan, Montgomery, Paul, Williams, Morgan, Lorenzen, Christian and Kemp, Justin. (2012). Classifying training drills based on movement demands in Australian Football. International Journal of Sports Science and Coaching. 7(1), pp. 57 - 67. https://doi.org/10.1260/1747-9541.7.1.57
Hamstring strain injuries : Factors that lead to injury and re-injury
Opar, David A., Williams, Morgan D. and Shield, Anthony J. (2012). Hamstring strain injuries : Factors that lead to injury and re-injury. Sports Medicine. 42(3), pp. 209-226. https://doi.org/10.2165/11594800-000000000-00000
Reduction of post-surgical pericardial adhesions using a pig model
Alizzi, Ali M., Summers, Phillip, Boon, Virginia H., Tantiongco, John-Paul, Thompson, Teresa, Leslie, Belinda J., Williams, David, Steele, Michael Craig, Bidstrup, Benjamin P. and Diqer, Al-Mutazz A.. (2012). Reduction of post-surgical pericardial adhesions using a pig model. Heart, Lung and Circulation. 21(1), pp. 22 - 29. https://doi.org/10.1016/j.hlc.2011.10.002
Childhood muscle morphology and strength: Alterations over six months of growth
Pitcher, Christian Andrew, Elliott, Catherine M., Williams, Sian A., Licari, Melissa K., Kuenzel, Alex, Shipman, Peter J., Valentine, Jane P. and Reid, Siobhan L.. (2012). Childhood muscle morphology and strength: Alterations over six months of growth. Muscle & Nerve. 46(3), pp. 360 - 366. https://doi.org/10.1002/mus.23326
Using three-dimensional kinematics to identify feedback for the snatch :A case study
Ho, Kuok Wai, Williams, Morgan, Wilson, Cameron and Meehan, Daniel. (2011). Using three-dimensional kinematics to identify feedback for the snatch :A case study. Journal of Strength and Conditioning Research. 25(10), pp. 2773 - 2780. https://doi.org/10.1519/JSC.0b013e31820f500e
Efficacy of a whole-body vibration intervention on functional performance of community-dwelling older adults
Furness, Trentham, Maschette, Wayne, Lorenzen, Christian, Naughton, Geraldine and Williams, Morgan. (2010). Efficacy of a whole-body vibration intervention on functional performance of community-dwelling older adults. Journal of Alternative & Complementary Medicine. 16(7), pp. 795 - 797. https://doi.org/10.1089/acm.2009.0366
Whole body vibration for preventing and treating osteoporosis (protocol)
Lorenzen, Christian, Naughton, Geraldine, Cameron, Lainie, Williams, Morgan and Greene, David. (2010). Whole body vibration for preventing and treating osteoporosis (protocol). Cochrane Database of Systematic Reviews.
Acute effects of strength training on running economy
Ho, Kuok Wai, Williams, Morgan D., Wilson, Cameron J., Lorenzen, Hans Christian, Meehan, Daniel L. and Joseph, Corey W.. (2010). Acute effects of strength training on running economy. 28th Conference of the International Society of Biomechanics in Sports. USA: International Society of Biomechanics. pp. 551 - 554
Breaking the vicious cycle of activity avoidance in an adolescent boy diagnosed with DCD and mild Asperberger's disorder
Aumand, Elizabeth, Williams, Morgan, Wilson, Cameron and Saunders, John. (2010). Breaking the vicious cycle of activity avoidance in an adolescent boy diagnosed with DCD and mild Asperberger's disorder. 4th Exercise and Sports Science Australia Conference 2010 : Research to practice : Science and nutrition in exercise and sport. Gold Coast, Queensland, Australia 09 - 11 Apr 2010 Red Hill, Queensland: Exercise and Sports Science Australia. pp. 64-64
Analysis of player workloads for defensive outlets at the Champion's Trophy International Field Hockey
Morgan, Stuart and Williams, Morgan. (2010). Analysis of player workloads for defensive outlets at the Champion's Trophy International Field Hockey. 15th Annual Congress of the ECSS (European College of Sports Science). Antalya, Turkey 23 - 26 Jun 2010
Relationship between velocity reached at VO2max and time-trial performances in elite australian rules footballers
Lorenzen, Christian Hans, Williams, Morgan D., Turk, Paul S., Meehan, Daniel Lawrence and Cicioni-Kolsky, Daniel James. (2009). Relationship between velocity reached at VO2max and time-trial performances in elite australian rules footballers. International Journal of Sports Physiology and Performance. 4(3), pp. 408 - 411. https://doi.org/10.1123/ijspp.4.3.408
Stabilising the hip and pelvis during running: Is there an explosive solution for uninjured athletes?
Meehan, Daniel Lawrence, Williams, Morgan David, Wilson, Cameron John and Bradshaw, Elizabeth Jane. (2009). Stabilising the hip and pelvis during running: Is there an explosive solution for uninjured athletes? 27th International Conference on Biomechanics; in Sports. Castleroy, Limerick, Ireland: University of Limerick. pp. 390 - 393
Reliability of the Ekblom Soccer-Specific Endurance Test
Williams, Morgan D., Wiltshire, Huw D., Lorenzen, Christian Hans, Wilson, Cameron J., Meehan, Daniel Lawrence and Cicioni-Kolsky, Daniel James. (2009). Reliability of the Ekblom Soccer-Specific Endurance Test. Journal of Strength and Conditioning Research. 23(5), pp. 1378 - 1382. https://doi.org/10.1519/JSC.0b013e31819f1e6c
Horizontal positioning error derived from stationary GPS units: A function of time and proximity to building infrastructure
Williams, Morgan and Morgan, Stuart. (2009). Horizontal positioning error derived from stationary GPS units: A function of time and proximity to building infrastructure. International Journal of Performance Analysis in Sport. 9(2), pp. 275 - 280.
Exploration of differences in vertical jump performance between typically developing children and those identified with DCD: A kinematic and kinetic analysis
Williams, Morgan. (2008). Exploration of differences in vertical jump performance between typically developing children and those identified with DCD: A kinematic and kinetic analysis [Thesis]. https://doi.org/10.4226/66/5a95e2f4c67fa
Laterality and its effect on lower extremity musculoskeletal stiffness in male soccer players and track runners
Williams, Morgan David, Bradshaw, Elizabeth Jane and Joseph, Corey W.. (2007). Laterality and its effect on lower extremity musculoskeletal stiffness in male soccer players and track runners. In Hans-Joachim Menzel and Mauro Heleno Chagas (Ed.). XXV International Symposium on Biomechanics; in Sports. Segrac,Brazil: Department of Sports, Federal University of Minas Gerais. pp. 613 - 617
Measurement agreement (repeatability) for a countermovement jump protocol using a portable forceplate
Williams, Morgan, Bradshaw, Elizabeth and Maschette, Wayne. (2007). Measurement agreement (repeatability) for a countermovement jump protocol using a portable forceplate. International Journal of Sports Physiology and Performance. 2(4), pp. 445 - 448. https://doi.org/10.1123/ijspp.2.4.445
Differences in vertical jump performance for typically developing compared to those identified with DC
Maschette, Wayne and Williams, Morgan David. (2007). Differences in vertical jump performance for typically developing compared to those identified with DC. 2nd Australian Association for Exercise and Sports Science Conference.
Evaluating strength qualities of athletes using relationships between jump protocols
Williams, Morgan David, Joseph, Corey W. and Bradshaw, Elizabeth Jane. (2007). Evaluating strength qualities of athletes using relationships between jump protocols. In Hans-Joachim Menzel and Mauro Heleno Chagas (Ed.). Federal University of the State of Minas Gerais in Belo Horizonte, Ouro Preto, Brazil. Segrac,Brazil: Department of Sports, Federal University of Minas Gerais. pp. 474 - 477
Novel insights on lower limb musculoskeletal health and performance in pre-adolescent and adolescent gymnasts
Bradshaw, Elizabeth Jane, Lorenzen, Hans Christian, Williams, Morgan David and Le Rossignol, Peter Freeman. (2006). Novel insights on lower limb musculoskeletal health and performance in pre-adolescent and adolescent gymnasts. In M Schwaneder, G Strutzenberger and Sastenbauer et al (Ed.). XXI International Conference on Biomechanics; in Sport. Salzburg, Austria: University of Salzburg. pp. 413 - 417
Timing error by children identified with DCD leads to inefficient jump performance
Williams, Morgan David, Lythgo, Noel Desmond and Maschette, Wayne Edward. (2006). Timing error by children identified with DCD leads to inefficient jump performance. In M Schwaneder, G Strutzenberger and Sastenbauer et al (Ed.). XXIV International Symposium on Biomechanics; in Sports. Salzburg, Austria: University of Salzburg. pp. 54 - 57