The development of a HAMstring InjuRy (HAMIR) index to mitigate injury risk through innovative imaging, biomechanics, and data analytics : Protocol for an observational cohort study

Journal article

Heiderscheit, Bryan C., Blemker, Silvia S., Opar, David, Stiffler-Joachim, Mikel R., Bedi, Asheesh, Hart, Joseph, Mortensen, Brett, Kliethermes, Stephanie A., Baer, Geoffrey, Buckley, Craig, Costigan, Kyle, Drew, Shauna, Eberhardt, Duffy, Fabian, Kurrel, Feller, Herman, Hammer, Erin, Heidt, Danielle, Lee, Kenneth, Lund, Brian, ... Sund, Sarah. (2022). The development of a HAMstring InjuRy (HAMIR) index to mitigate injury risk through innovative imaging, biomechanics, and data analytics : Protocol for an observational cohort study. BMC Sports Science, Medicine and Rehabilitation. 14(1), p. Article 128. https://doi.org/10.1186/s13102-022-00520-3
AuthorsHeiderscheit, Bryan C., Blemker, Silvia S., Opar, David, Stiffler-Joachim, Mikel R., Bedi, Asheesh, Hart, Joseph, Mortensen, Brett, Kliethermes, Stephanie A., Baer, Geoffrey, Buckley, Craig, Costigan, Kyle, Drew, Shauna, Eberhardt, Duffy, Fabian, Kurrel, Feller, Herman, Hammer, Erin, Heidt, Danielle, Lee, Kenneth, Lund, Brian, Martin, Jack, Moll, Michael, Sanfilippo, Jennifer, Snee, Shaun, Tanaka, Claire, Taylor, Ty, Wilson, John, Woodhouse, Devin, Lin, Yi-Chung, Hickey, Jack, Maniar, Nirav, Taylor, Frances, Timmins, Ryan, Cousins, Matthew, DuCharme, Olivia, Feng, Xue, Magargee, Scott, Meyer, Craig, Nguyen, Anthony, Riem, Lara, West, Robin, Allen, Steven, Allred, Dain, Beutler, Anthony, Bruening, Dustin, Campbell, Darren, Johnson, A. Wayne, Nguyen, Camille, Remington, Emma, Smedley, Annie A., Sponbeck, Joshua K., Berkoff, David, Berkowitz, Josh, Birchmeier, Thomas, Blackburn, Troy, Choudhari, Malvika, Ciocca, Mario, Lennon, Alessa, Lisee, Caroline, McCoy, Noah, Mincberg, David, Oliaro, Scott, Pietrosimone, Brian, Ross, Luke, Titter, Julie and Sund, Sarah
Abstract

Background
The etiology of hamstring strain injury (HSI) in American football is multi-factorial and understanding these risk factors is paramount to developing predictive models and guiding prevention and rehabilitation strategies. Many player-games are lost due to the lack of a clear understanding of risk factors and the absence of effective methods to minimize re-injury. This paper describes the protocol that will be followed to develop the HAMstring InjuRy (HAMIR) index risk prediction models for HSI and re-injury based on morphological, architectural, biomechanical and clinical factors in National Collegiate Athletic Association Division I collegiate football players.

Methods
A 3-year, prospective study will be conducted involving collegiate football student-athletes at four institutions. Enrolled participants will complete preseason assessments of eccentric hamstring strength, on-field sprinting biomechanics and muscle–tendon volumes using magnetic-resonance imaging (MRI). Athletic trainers will monitor injuries and exposure for the duration of the study. Participants who sustain an HSI will undergo a clinical assessment at the time of injury along with MRI examinations. Following completion of structured rehabilitation and return to unrestricted sport participation, clinical assessments, MRI examinations and sprinting biomechanics will be repeated. Injury recurrence will be monitored through a 6-month follow-up period. HAMIR index prediction models for index HSI injury and re-injury will be constructed.

Discussion
The most appropriate strategies for reducing risk of HSI are likely multi-factorial and depend on risk factors unique to each athlete. This study will be the largest-of-its-kind (1200 player-years) to gather detailed information on index and recurrent HSI, and will be the first study to simultaneously investigate the effect of morphological, biomechanical and clinical variables on risk of HSI in collegiate football athletes. The quantitative HAMIR index will be formulated to identify an athlete’s propensity for HSI, and more importantly, identify targets for injury mitigation, thereby reducing the global burden of HSI in high-level American football players.

Trial Registration The trial is prospectively registered on ClinicalTrials.gov (NCT05343052; April 22, 2022).

Keywordsmuscle injury; risk prediction model; sprint running; muscle volume; eccentric strength
Year2022
JournalBMC Sports Science, Medicine and Rehabilitation
Journal citation14 (1), p. Article 128
PublisherBioMed Central
ISSN2052-1847
Digital Object Identifier (DOI)https://doi.org/10.1186/s13102-022-00520-3
PubMed ID35841053
Scopus EID2-s2.0-85134300210
PubMed Central IDPMC9288010
Open accessPublished as ‘gold’ (paid) open access
Page range1-9
FunderNational Football League (NFL)
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online15 Jul 2022
Publication process dates
Accepted06 Jul 2022
Deposited23 May 2023
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Hamstrings biomechanics related to running
Maniar, Nirav, Schache, Anthony, Heiderscheit, Bryan and Opar, David. (2020). Hamstrings biomechanics related to running. In In Thorborg, Kristian, Opar, David and Shield, Anthony (Ed.). Prevention and rehabilitation of hamstring injuries pp. 65-81 Springer Nature Switzerland AG. https://doi.org/10.1007/978-3-030-31638-9_3
Pain-free versus pain-threshold rehabilitation following acute hamstring strain injury : A randomized controlled trial
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
Performance changes during the off-season period in football players–Effects of age and previous hamstring injury
Vicens-Bordas, Jordi, Esteve, Ernest, Fort-Vanmeerhaeghe, Azahara, Casals, Martí, Bandholm, Thomas, Ishøi, Lasse, Opar, David, Shield, Anthony and Thorborg, Kristian. (2020). Performance changes during the off-season period in football players–Effects of age and previous hamstring injury. Journal of Sports Sciences. 38(21), pp. 2489-2499. https://doi.org/10.1080/02640414.2020.1792160
Muscle contributions to tibiofemoral shear forces and valgus and rotational joint moments during single leg drop landing
Maniar, Nirav, Schache, Anthony G., Pizzolato, Claudio and Opar, David A.. (2020). Muscle contributions to tibiofemoral shear forces and valgus and rotational joint moments during single leg drop landing. Scandinavian Journal of Medicine & Science in Sports. 30(9), pp. 1664-1674. https://doi.org/10.1111/sms.13711
Muscle contributions to medial and lateral tibiofemoral compressive loads during sidestep cutting
Maniar, Nirav, Bryant, Adam L., Sritharan, Prasanna, Schache, Anthony G. and Opar, David A.. (2020). Muscle contributions to medial and lateral tibiofemoral compressive loads during sidestep cutting. Journal of Biomechanics. 101, p. 109641. https://doi.org/10.1016/j.jbiomech.2020.109641
Preseason hip/groin strength and HAGOS scores are associated with subsequent injury in professional male soccer players
Bourne, Matthew N., Williams, Morgan, Jackson, Jeremy, Williams, Kate L., Timmins, Ryan G. and Pizzari, Tania. (2020). Preseason hip/groin strength and HAGOS scores are associated with subsequent injury in professional male soccer players. Journal of Orthopaedic and Sports Physical Therapy. 50(5), pp. 234-242. https://doi.org/10.2519/jospt.2020.9022
Hamstring strength and architectural adaptations following inertial flywheel resistance training
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
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.
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
Lower-limb muscle function during gait in varus mal-aligned osteoarthritis patients
Sritharan, Prasanna, Lin, Yi-Chung, Richardson, Sara E., Crossley, Kay M., Birmingham, Trevor B. and Pandy, Marcus G.. (2018). Lower-limb muscle function during gait in varus mal-aligned osteoarthritis patients. Journal of Orthopaedic Research. 36(8), pp. 2157-2166. https://doi.org/10.1002/jor.23883
Is running better than walking for reducing hip joint loads?
Schache, Anthony G., Lin, Yi-Chung, Crossley, Kay M. and Pandy, Marcus G.. (2018). Is running better than walking for reducing hip joint loads? Medicine and Science in Sports and Exercise. 50(11), pp. 2301-2310. https://doi.org/10.1249/MSS.0000000000001689
Predictive simulations of neuromuscular coordination and joint-contact loading in human gait
Lin, Yi-Chung, Walter, Jonathan P. and Pandy, Marcus G.. (2018). Predictive simulations of neuromuscular coordination and joint-contact loading in human gait. Annals of Biomedical Engineering. 46(8), pp. 1216-1227. https://doi.org/10.1007/s10439-018-2026-6
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
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
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
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
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
Three-dimensional data-tracking dynamic optimization simulations of human locomotion generated by direct collocation
Lin, Yi-Chung and Pandy, Marcus. (2017). Three-dimensional data-tracking dynamic optimization simulations of human locomotion generated by direct collocation. Journal of Biomechanics. 59, pp. 1-8. https://doi.org/10.1016/j.jbiomech.2017.04.038
Effects of step length and step frequency on lower-limb muscle function in human gait
Lim, Yoong Ping, Lin, Yi-Chung and Pandy, Marcus G.. (2017). Effects of step length and step frequency on lower-limb muscle function in human gait. Journal of Biomechanics. 57, pp. 1-7. https://doi.org/10.1016/j.jbiomech.2017.03.004
Musculoskeletal loading in the symptomatic and asymptomatic knees of middle-aged osteoarthritis patients
Sritharan, Prasanna, Lin, Yi-Chung, Richardson, Sara E., Crossley, Kay M., Birmingham, Trevor B. and Pandy, Marcus G.. (2017). Musculoskeletal loading in the symptomatic and asymptomatic knees of middle-aged osteoarthritis patients. Journal of Orthopaedic Research. 35(2), pp. 321-330. https://doi.org/10.1002/jor.23264
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
Direct methods for predicting movement biomechanics based upon optimal control theory with implementation in OpenSim
Porsa, Sina, Lin, Yi-Chung and Pandy, Marcus. (2016). Direct methods for predicting movement biomechanics based upon optimal control theory with implementation in OpenSim. Annals of Biomedical Engineering. 44(8), pp. 2542-2557. https://doi.org/10.1007/s10439-015-1538-6
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
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
In vivo behavior of the human soleus muscle with increasing walking and running speeds
Lai, Adrian K. M., Lichtwark, Glen A., Schache, Anthony, Lin, Yi-Chung, Brown, Nicholas A. T. and Pandy, Marcus. (2015). In vivo behavior of the human soleus muscle with increasing walking and running speeds. Journal of Applied Physiology. 118(10), pp. 1266-1275. https://doi.org/10.1152/japplphysiol.00128.2015
Muscle coordination of support, progression and balance during stair ambulation
Lin, Yi-Chung, Fok, Laurence, Schache, Anthony and Pandy, Marcus. (2015). Muscle coordination of support, progression and balance during stair ambulation. Journal of Biomechanics. 48(2), pp. 340-347. https://doi.org/10.1016/j.jbiomech.2014.11.019
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
Tendon elastic strain energy in the human ankle plantar-flexors and its role with increased running speed
Lai, Adrian K. M., Schache, Anthony, Lin, Yi-Chung and Pandy, Marcus. (2014). Tendon elastic strain energy in the human ankle plantar-flexors and its role with increased running speed. The Journal of Experimental Biology. 217(17), pp. 3159-3168. https://doi.org/10.1242/jeb.100826
Quantitative evaluation of the major determinants of human gait
Lin, Yi-Chung, Gfoehler, Margit and Pandy, Marcus. (2014). Quantitative evaluation of the major determinants of human gait. Journal of Biomechanics. 47(6), pp. 1324-1331. https://doi.org/10.1016/j.jbiomech.2014.02.002
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
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
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
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