The effects of eccentric training on lower limb flexibility: A systematic review

British Journal of Sports Medicine

Volumn 46, Issue 12, 2012, Pages 838-845

  O'Sullivan, Kieran ^a   McAuliffe, Sean ^a   DeBurca, Neasa ^a  

^a UNIVERSITY OF LIMERICK   (Ireland)

Author keywords

[No Author keywords available]

Indexed keywords

EXERCISE; HUMAN; INJURY; JOINT CHARACTERISTICS AND FUNCTIONS; LEG; METHODOLOGY; PHYSIOLOGY; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; SPORT INJURY; STRETCHING EXERCISE;

ATHLETIC INJURIES; EXERCISE; HUMANS; LOWER EXTREMITY; MUSCLE STRETCHING EXERCISES; RANDOMIZED CONTROLLED TRIALS AS TOPIC; RANGE OF MOTION, ARTICULAR;

EID: 84866610220     PISSN: 03063674     EISSN: 14730480     Source Type: Journal    
DOI: 10.1136/bjsports-2011-090835     Document Type: Review

References (77)

1. Orchard J, Seward H. Epidemiology of injuries in the Australian Football League, seasons 1997-2000. Br J Sports Med 2002;36:39-44. (Pubitemid 34165276)
2. Le Gall F, Carling C, Reilly T, et al. Incidence of injuries in elite French youth soccer players: a 10-season study. Am J Sports Med 2006;34:928-38. (Pubitemid 43725759)
3. Yeung EW, Yeung SS. A systematic review of interventions to prevent lower limb soft tissue running injuries. Br J Sports Med 2001;35:383-9. (Pubitemid 34025285)
4. Mason D, Dickens V, Vail A. Rehabilitation for hamstring injuries. Cochrane Database Syst Rev 2007;1:CD004575.
5. Goldman E, Jones D. Interventions for preventing hamstring injuries. Cochrane Database Syst Rev 2010;2:CD006782.
6. Verrall GM, Slavotinek J P, Barnes PG, et al. Clinical risk factors for hamstring muscle strain injury: a prospective study with correlation of injury by magnetic resonance imaging. Br J Sports Med 2001;35:435-9; discussion 440. (Pubitemid 34025295)
7. Knapik JJ, Sharp MA, Canham-Chervak M, et al. Risk factors for training-related injuries among men and women in basic combat training. Med Sci Sports Exerc 2001;33:946-54. (Pubitemid 32524709)
8. Bennell K, Wajswelner H, Lew P, et al. Isokinetic strength testing does not predict hamstring injury in Australian Rules footballers. Br J Sports Med 1998;32:309-14. (Pubitemid 28534877)
9. Gilchrist J, Mandelbaum BR, Melancon H, et al. A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players. Am J Sports Med 2008;36:1476-83. (Pubitemid 352019487)
10. Mahieu NN, Witvrouw E, Stevens V, et al. Intrinsic risk factors for the development of achilles tendon overuse injury: a prospective study. Am J Sports Med 2006;34:226-35. (Pubitemid 43152959)
11. Arnason A, Andersen TE, Holme I, et al. Prevention of hamstring strains in elite soccer: an intervention study. Scand J Med Sci Sports 2008;18:40-8.
12. Brockett CL, Morgan DL, Proske U. Predicting hamstring strain injury in elite athletes. Med Sci Sports Exerc 2004;36:379-87. (Pubitemid 38298688)
13. Mackey C, O'Sullivan K, O'Connor A, et al. Altered hamstring strength profile in Gaelic footballers with a previous hamstring injury. Isokinet Exerc Sci 2011;19:47-54.
14. Murphy DF, Connolly DA, Beynnon BD. Risk factors for lower extremity injury: a review of the literature. Br J Sports Med 2003;37:13-29. (Pubitemid 36152798)
15. Malliaropoulos N, Papalexandris S, Papalada A, et al. The role of stretching in rehabilitation of hamstring injuries: 80 athletes follow-up. Med Sci Sports Exerc 2004;36:756-9. (Pubitemid 38596377)
16. Harvey L, Herbert R, Crosbie J. Does stretching induce lasting increases in joint ROM? A systematic review. Physiother Res Int 2002;7:1-13.
17. Thacker SB, Gilchrist J, Stroup D F, et al. The impact of stretching on sports injury risk: a systematic review of the literature. Med Sci Sports Exerc 2004;36:371-8. (Pubitemid 38298687)
18. Pope RP, Herbert RD, Kirwan JD, et al. A randomized trial of preexercise stretching for prevention of lower-limb injury. Med Sci Sports Exerc 2000;32:271-7. (Pubitemid 30108103)
19. van Mechelen W, Hlobil H, Kemper HC, et al. Prevention of running injuries by warm-up, cool-down, and stretching exercises. Am J Sports Med 1993;21:711-19. (Pubitemid 23276795)
20. Pope R, Herbert R, Kirwan J. Effects of ankle dorsiflexion range and pre-exercise calf muscle stretching on injury risk in Army recruits. Aust J Physiother 1998;44:165-72. (Pubitemid 28438765)
21. Parkkari J, Kujala UM, Kannus P. Is it possible to prevent sports injuries? Review of controlled clinical trials and recommendations for future work. Sports Med 2001;31:985-95. (Pubitemid 33095990)
22. Weldon SM, Hill RH. The efficacy of stretching for prevention of exercise-related injury: a systematic review of the literature. Man Ther 2003;8:141-50. (Pubitemid 37010283)
23. Aaltonen S, Karjalainen H, Heinonen A, et al. Prevention of sports injuries: systematic review of randomized controlled trials. Arch Intern Med 2007;167:1585-92. (Pubitemid 47280338)
24. Herbert RD, Gabriel M. Effects of stretching before and after exercising on muscle soreness and risk of injury: systematic review. BMJ 2002;325:468.
25. Herbert RD, de Noronha M, Kamper SJ. Stretching to prevent or reduce muscle soreness after exercise. Cochrane Database Syst Rev 2011;7:CD004577.
26. Rubini EC, Costa AL, Gomes PS. The effects of stretching on strength performance. Sports Med 2007;37:213-24. (Pubitemid 46376774)
27. Shrier I. Does stretching improve performance? A systematic and critical review of the literature. Clin J Sport Med 2004;14:267-73. (Pubitemid 39313481)
28. de Weijer VC, Gorniak GC, Shamus E. The effect of static stretch and warm-up exercise on hamstring length over the course of 24 hours. J Orthop Sports Phys Ther 2003;33:727-33. (Pubitemid 38018377)
29. O'Sullivan K, Murray E, Sainsbury D. The effect of warm-up, static stretching and dynamic stretching on hamstring flexibility in previously injured subjects. BMC Musculoskelet Disord 2009;10:37.
30. Spernoga SG, Uhl TL, Arnold BL, et al. Duration of maintained hamstring flexibility after a one-time, modified hold-relax stretching protocol. J Athl Train 2001;36:44-8. (Pubitemid 33691199)
31. Ford P, McChesney J. Duration of maintained hamstring ROM following termination of three stretching protocols. J Sport Rehabil 2007;16:18-27.
32. Davis DS, Ashby PE, McCale KL, et al. The effectiveness of 3 stretching techniques on hamstring flexibility using consistent stretching parameters. J Strength Cond Res 2005;19:27-32. (Pubitemid 40417250)
33. Chan SP, Hong Y, Robinson PD. Flexibility and passive resistance of the hamstrings of young adults using two different static stretching protocols. Scand J Med Sci Sports 2001;11:81-6. (Pubitemid 33644824)
34. Bandy WD, Irion JM, Briggler M. The effect of static stretch and dynamic range of motion training on the flexibility of the hamstring muscles. J Orthop Sports Phys Ther 1998;27:295-300. (Pubitemid 28145357)
35. Reid DA, McNair PJ. Passive force, angle, and stiffness changes after stretching of hamstring muscles. Med Sci Sports Exerc 2004;36:1944-8. (Pubitemid 39473514)
36. Worrell TW, Perrin DH, Gansneder BM, et al. Comparison of isokinetic strength and flexibility measures between hamstring injured and noninjured athletes. J Orthop Sports Phys Ther 1991;13:118-25.
37. Gabbe BJ, Bennell KL, Finch C F, et al. Predictors of hamstring injury at the elite level of Australian football. Scand J Med Sci Sports 2006;16:7-13. (Pubitemid 43433299)
38. Alonso J, McHugh M P, Mullaney MJ, et al. Effect of hamstring flexibility on isometric knee flexion angle-torque relationship. Scand J Med Sci Sports 2009;19:252-6.
39. Lynn R, Morgan DL. Decline running produces more sarcomeres in rat vastus intermedius muscle fibers than does incline running. J Appl Physiol 1994;77:1439-44. (Pubitemid 24299401)
40. Kilgallon M, Donnelly AE, Shafat A. Progressive resistance training temporarily alters hamstring torque-angle relationship. Scand J Med Sci Sports 2007;17:18-24.
41. Morgan DL. New insights into the behavior of muscle during active lengthening. Biophys J 1990;57:209-21. (Pubitemid 20058256)
42. Proske U, Morgan DL. Muscle damage from eccentric exercise: mechanism, mechanical signs, adaptation and clinical applications. J Physiol (Lond) 2001;537:333-45. (Pubitemid 33130492)
43. Wedderkopp N, Kaltoft M, Lundgaard B, et al. Prevention of injuries in young female players in European team handball. A prospective intervention study. Scand J Med Sci Sports 1999;9:41-7.
44. Lynn R, Talbot JA, Morgan DL. Differences in rat skeletal muscles after incline and decline running. J Appl Physiol 1998;85:98-104. (Pubitemid 28334911)
45. Askling C, Karlsson J, Thorstensson A. Hamstring injury occurrence in elite soccer players after preseason strength training with eccentric overload. Scand J Med Sci Sports 2003;13:244-50. (Pubitemid 37463796)
46. Mjølsnes R, Arnason A, Østhagen T, et al. A 10-week randomized trial comparing eccentric vs. concentric hamstring strength training in well-trained soccer players. Scand J Med Sci Sports 2004;14:311-17. (Pubitemid 39360656)
47. Blazevich AJ, Gill ND, Zhou S. Intra-and intermuscular variation in human quadriceps femoris architecture assessed in vivo. J Anat 2006;209:289-310. (Pubitemid 44269820)
48. Prospero. 2012 [updated 2012 24/10/2011; cited 24/10/2011]; Available from: (accessed 2 April 2012).
49. Moher D, Liberati A, Tetzlaff J, et al.; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097.
50. Maher CG, Sherrington C, Herbert RD, et al. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther 2003;83:713-21. (Pubitemid 37238882)
51. de Morton NA. The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust J Physiother 2009;55:129-33.
52. Ye L, Kalichman L, Spittle A, et al. Effects of rehabilitative interventions on pain, function and physical impairments in people with hand osteoarthritis: a systematic review. Arthritis Res Ther 2011;13:R28.
53. Silbernagel KG, Thomeé R, Thomeé P, et al. Eccentric overload training for patients with chronic Achilles tendon pain-a randomised controlled study with reliability testing of the evaluation methods. Scand J Med Sci Sports 2001;11:197-206. (Pubitemid 33643506)
54. Blazevich AJ, Cannavan D, Coleman DR, et al. Influence of concentric and eccentric resistance training on architectural adaptation in human quadriceps muscles. J Appl Physiol 2007;103:1565-75. (Pubitemid 350033839)
55. Duclay J, Martin A, Duclay A, et al. Behavior of fascicles and the myotendinous junction of human medial gastrocnemius following eccentric strength training. Muscle Nerve 2009;39:819-27.
56. Mahieu NN, McNair P, Cools A, et al. Effect of eccentric training on the plantar flexor muscle-tendon tissue properties. Med Sci Sports Exerc 2008;40:117-23.
57. Nelson RT, Bandy WD. Eccentric training and static stretching improve hamstring flexibility of high school males. J Athl Train 2004;39:254-8. (Pubitemid 39318949)
58. Potier TG, Alexander CM, Seynnes OR. Effects of eccentric strength training on biceps femoris muscle architecture and knee joint range of movement. Eur J Appl Physiol 2009;105:939-44.
59. Reeves ND, Maganaris CN, Longo S, et al. Differential adaptations to eccentric versus conventional resistance training in older humans. Exp Physiol 2009;94:825-33.
60. Aquino CF, Fonseca ST, Gonçalves GG, et al. Stretching versus strength training in lengthened position in subjects with tight hamstring muscles: a randomized controlled trial. Man Ther 2010;15:26-31.
61. Fredriksen H, Dagfinrud H, Jacobsen V, et al. Passive knee extension test to measure hamstring muscle tightness. Scand J Med Sci Sports 1997;7:279-82. (Pubitemid 127524363)
62. Noorkoiv M, Nosaka K, Blazevich AJ. Assessment of quadriceps muscle crosssectional area by ultrasound extended-field-of-view imaging. Eur J Appl Physiol 2010;109:631-9.
63. Brockett CL, Morgan DL, Proske U. Human hamstring muscles adapt to eccentric exercise by changing optimum length. Med Sci Sports Exerc 2001;33:783-90. (Pubitemid 32336640)
64. Decoster LC, Cleland J, Altieri C, et al. The effects of hamstring stretching on range of motion: a systematic literature review. J Orthop Sports Phys Ther 2005;35:377-87. (Pubitemid 40770933)
65. Radford JA, Burns J, Buchbinder R, et al. Does stretching increase ankle dorsiflexion range of motion? A systematic review. Br J Sports Med 2006;40:870-5; discussion 875. (Pubitemid 44526061)
66. Bandy WD, Irion JM, Briggler M. The effect of time and frequency of static stretching on flexibility of the hamstring muscles. Phys Ther 1997;77:1090-6. (Pubitemid 27419473)
67. Clark R, Bryant A, Culgan J-P, et al. The effects of eccentric hamstring strength training on dynamic jumping performance and isokinetic strength parameters: a pilot study on the implications for the prevention of hamstring injuries. Phys Ther Sport 2005;6:67-73. (Pubitemid 40637288)
68. Petersen J, Hölmich P. Evidence based prevention of hamstring injuries in sport. Br J Sports Med 2005;39:319-23. (Pubitemid 40780612)
69. Kingma JJ, de Knikker R, Wittink HM, et al. Eccentric overload training in patients with chronic Achilles tendinopathy: a systematic review. Br J Sports Med 2007;41:e3.
70. Wasielewski NJ, Kotsko KM. Does eccentric exercise reduce pain and improve strength in physically active adults with symptomatic lower extremity tendinosis? A systematic review. J Athl Train 2007;42:409-21. (Pubitemid 47535687)
71. Petersen J, Thorborg K, Nielsen MB, et al. Preventive effect of eccentric training on acute hamstring injuries in men's soccer: a cluster-randomized controlled trial. Am J Sports Med 2011;39:2296-303.
72. Young MA, Cook JL, Purdam CR, et al. Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players. Br J Sports Med 2005;39:102-5. (Pubitemid 40179549)
73. Mueller M, Breil FA, Vogt M, et al. Different response to eccentric and concentric training in older men and women. Eur J Appl Physiol 2009;107:145-53.
74. Higbie EJ, Cureton KJ, Warren GL 3rd, et al. Effects of concentric and eccentric training on muscle strength, cross-sectional area, and neural activation. J Appl Physiol 1996;81:2173-81. (Pubitemid 26384547)
75. Pettitt RW, Symons DJ, Eisenman PA, et al. Eccentric strain at long muscle length evokes the repeated bout effect. J Strength Cond Res 2005;19:918-24. (Pubitemid 41784053)
76. Brughelli M, Cronin J. Altering the length-tension relationship with eccentric exercise: implications for performance and injury. Sports Med 2007;37:807-26. (Pubitemid 47347393)
77. Gabbe BJ, Branson R, Bennell KL. A pilot randomised controlled trial of eccentric exercise to prevent hamstring injuries in community-level Australian Football. J Sci Med Sport 2006;9:103-9.