Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 5/2007

01-05-2007 | Knee

Submaximal fatigue of the hamstrings impairs specific reflex components and knee stability

Authors: Mark Melnyk, Albert Gollhofer

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 5/2007

Login to get access

Abstract

Rupture of the anterior cruciate ligament (ACL) is one of the most serious sports-related injuries and requires long recovery time. The quadriceps and hamstring muscles are functionally important to control stability of the knee joint complex. Fatigue, however, is an important factor that may influence stabilizing control and thus cause ACL injuries. The objective of this study was therefore to assess how submaximal fatigue exercises of the hamstring muscles affect anterior tibial translation as a direct measure of knee joint stability. While 15 test participants were standing upright with the knees in 30° of flexion, anterior tibial translation was induced by a force of 315 N. Two linear potentiometers placed on the tibial tuberosity and the patella recorded tibial motion relative to the femur. Reflex latencies and neuromuscular hamstring activity were determined using surface electromyography (EMG). Muscle fatigue produced a significant longer latency for the monosynaptic reflex latencies, whereas no differences in the latencies of the medium latency component were found. Fatigue significantly reduced EMG amplitudes of the short and medium latency components. These alterations were in line with significantly increased anterior tibial translation. Our results suggest that hamstring fatigue is effectively associated with mechanical loss of knee stability. This decrease in joint stability may at least in part explain higher risk of ACL injury, especially in fatigued muscles. Furthermore, we discuss why the present findings indicate that reduced motor activity rather than the extended latency of the first hamstring response is the reason for possible failure.
Literature
1.
Avela J, Komi PV (1998) Reduced stretch reflex sensitivity and muscle stiffness after long-lasting stretch-shortening cycle exercise in humans. Eur J Appl Physiol Occup Physiol 78:403–410PubMedCrossRef
2.
Avela J, Kyrolainen H, Komi PV, Rama D (1999) Reduced reflex sensitivity persists several days after long-lasting stretch-shortening cycle exercise. J Appl Physiol 86:1292–1300PubMedCrossRef
3.
Beard DJ, Kyberd PJ, Ferguson CM, Dodd CA (1993) Proprioception after rupture of the anterior cruciate ligament. An objective indication of the need for surgery? J Bone Joint Surg 75:311–315
4.
Beard DJ, Kyberd PJ, O’Connor JJ, Ferguson CM, Dodd CA (1994) Reflex hamstring contraction latency in anterior cruciate ligament deficiency. J Orthop Res 12:219–228PubMedCrossRef
5.
Bigland-Ritchie BR, Furbush F, Woods JJ (1986) Fatigue of intermittent submaximal voluntary contractions: central and peripheral factors. J Appl Physiol 61:421–429PubMed
6.
Bongiovanni LG, Hagbarth K-E (1990) Tonic vibration reflexes elicited during fatigue from maximal voluntary contractions in man. J Physiol 423:1–14PubMed
7.
Bruhn S (1999) Functional knee stability. PhD Thesis, University of Stuttgart
8.
Dhaher YY, Tsoumains AD, Houle TT, Rymer WZ (2005) Neuromuscular reflexes contribute to knee stiffness during valgus loading. J Neurophysiol 93:2698–2709PubMedCrossRef
9.
Dolmage T, Cafarelli E (1991) Role of fatigue during repeated submaximal contractions of human quadriceps muscle. Can J Physiol Pharmacol 69:1410–1415PubMed
10.
Duchateau J, Hainaut K (1993) Behaviour of short and long latency reflexes in fatigued human muscles. J Physiol 471:787–799PubMed
11.
Dyrhe-Poulsen P, Krogsgaard MR (2000) Muscular reflexes elicited by electrical stimulation of the anterior cruciate ligament in humans. J Appl Physiol 98:2191–2195
12.
Freeman MA, Wyke B (1967) The innervation of the knee joint. An anatomical study and histological study in the cat. J Anat 101:505–532PubMed
13.
Friemert B, Faist M, Spengler C, Gerngross H, Claes L, Melnyk M (2005) Intraoperative direct mechanical stimulation of the anterior cruciate ligament elicits short and medium latency hamstring reflexes. J Neurophysiol 94:3996–4001PubMedCrossRef
14.
Friemert B, Bumann-Melnyk M, Faist M, Schwarz W, Gerngross H, Claes L (2005) Differentiation of hamstring short latency and medium latency response of the hamstring after tibia translation. Exp Brain Res 160:1–9PubMedCrossRef
15.
Grana WA, Muse G (1988) The effect of exercise on laxity in the anterior cruciate ligament deficient knee. Am J Sports Med 16:586–588PubMed
16.
Grey MJ, Ladouceur M, Andersen JB, Nielsen JB, Sinkjaer T (2001) Group II muscle afferents probably contribute to the medium latency soleus stretch reflex during walking in humans. J Physiol 534:925–933PubMedCrossRef
17.
18.
Hawkins RD, Fuller CW (1998) An examination of the frequency and severity of injuries and incidents at three levels of professional football. Br J Sports Med 32:326–332PubMedCrossRef
19.
Hiemstra LA, Lo IK, Fowler PJ (2001) Effect of fatigue on knee proprioception: implications for dynamic stabilization. J Orthop Sports Phys Ther 31:598–605PubMed
20.
Jerosch J, Prymka M (1996) Proprioception and joint stability. Knee Surg Sports Traumatol Arthrosc 4:171–179PubMedCrossRef
21.
Johansson H, Sjölander P, Sojka P (1990) Activity in receptors afferents from the anterior cruciate ligament evokes reflex effects on fusimotor neurones. Neurosci Res 8:54–59PubMedCrossRef
22.
Johansson H, Sjölander P, Sojka P (1991) A sensory role for the cruciate ligaments. Clin Orthop 268:161–178PubMed
23.
Jones LA (1995) The senses of effort and force during fatiguing contractions. Adv Exp Med Biol 384:305–313PubMed
24.
Kuitunen S, Avela J, Kyrölainen H, Nicol C, Komi PV (2002) Acute and prolonged reduction in joint stiffness in humans after exhausting stretch-shortening cycle exercise. Eur J Appl Physiol 88:107–116PubMedCrossRef
25.
Kuitunen S, Komi PV, Kyrolainen H (2002) Knee and ankle joint stiffness in sprint running. Med Sci Sports Exerc 34:166–173PubMedCrossRef
26.
Lattanzio PJ, Petrella RJ, Sproule JR, Fowler PJ (1997) Effects of fatigue on knee proprioception. Clin J Sport Med 7:22–27PubMedCrossRef
27.
Markolf KL, Graff-Radford A, Amstutz HC (1978) In vivo knee stability. A quantitative assessment using an instrumented clinical testing apparatus. J Bone J Surg 60A:664–674
28.
McCloskey DI (1978) Kinesthetic sensibility. Physiol Rev 58:763–820PubMed
29.
More RC, Karras BT, Neiman R, Fritschy D, Woo SL, Daniel DM (1993) Hamstrings—an anterior cruciate ligament protagonist. An in vitro study. Am J Sports Med 21:231–237PubMed
30.
Mrachacz-Kersting N, Sinkjaer T (2003) Reflex and non-reflex torque responses to stretch of the human knee extensors. Exp Brain Res 151:72–81PubMedCrossRef
31.
Nelson DL, Hutton RS (1985) Dynamic and static stretch responses in muscle spindle receptors in fatigued muscle. Med Sci Sports Exerc 17:445–450PubMedCrossRef
32.
Nicol C, Komi PV, Horita T, Kyrolainen H, Takala TE (1996) Reduced stretch-reflex sensitivity after exhausting stretch-shortening cycle exercise. Eur J Appl Physiol Occup Physiol 72:401–409PubMedCrossRef
33.
Nyland JA, Caborn DN, Shapiro R, Johnson DL (1997) Fatigue after eccentric quadriceps femoris work produces earlier gastrocnemius and delayed quadriceps femoris activation during crossover cutting among normal athletic women. Knee Surg Sports Traumatol Arthrosc 5:162–7PubMedCrossRef
34.
Nyland JA, Shapiro R, Stine RL, Horn TS, Ireland ML (1994) Relationship of fatigued run and rapid stop to ground reaction forces, lower extremities kinematics, and muscle activation. J Orthop Sports Phys Ther 20:132–137PubMed
35.
Shultz SJ, Carcia CR, Perrin DH (2004) Knee joint laxity affects muscle activation patterns in the healthy knee. J Electromyogr Kinesiol 14:475–483PubMedCrossRef
36.
Sjolander P, Johansson H, Sojka P, Rehnholm A (1989) Sensory nerve endings in the cat cruciate ligaments: a morphological investigation. Neurosc Lett 102:33–38CrossRef
37.
Skinner HB, Wyatt MP, Hodgon JA, Conard DW, Barrack RL (1986) Effect of fatigue on joint position sense of the knee. J Orthop Res 4:112–118PubMedCrossRef
38.
Solomonow M, Krogsgaard M (2001) Sensorimotor control of knee stability. A review. Scand J Med Sci Sports 11:64–80PubMedCrossRef
39.
Solomonow M, Baretta R, Zhou BH, Shoji H, Bose B, Beck C, D’Ambrosia R (1987) The synergistic action of the anterior cruciate ligament and thigh muscle in maintaining joint stability. Am J Sports Med 15:207–231PubMed
40.
Steiner ME, Grana WA, Chillag K, Schelberg-Karnes E (1986) The effect of exercise on anterior–posterior knee laxity 14:24–29
41.
Stoller DW, Markolf KL, Zager SA, Shoemaker SC (1983) The effects of exercise, ice and ultrasonography on torsional laxity of the knee. Clin Orthop 174:172–180PubMed
42.
Tsepis E, Vagenas G, Giakas G, Georgoulis A (2004) Hamstring weakness as an indicator of poor knee function in ACL-deficient patients. Knee Surg Sports Traumatol Arthrosc 12:22–29PubMedCrossRef
43.
Tsuda E, Ishibashi Y, Okamura Y, Toh S (2003) Restoration of anterior cruciate ligament-hamstring reflex arc after anterior cruciate ligament reconstruction. Knee Surg Sports Traumtol Arthosc 11:63–67
44.
Wojtys EM, Wylie BB, Huston LJ (1996) The effects of muscle fatigue on neuromuscular function and anterior tibial translation in healthy knees. Am J Sports Med 24:615–621PubMed
45.
Wojtys EM, Huston LJ (1994) Neuromuscular performance in normal and anterior cruciate ligament-deficient lower extremities. Am J Sports Med 22:89–104PubMed
46.
Wikstrom EA, Powers M, Tillman MD (2004) Dynamic stabilization time after isokinetic and functional fatigue. J Athl Train 39:247–253PubMed
47.
Woo SL, Hollis JM, Adams DJ, Lyon RM, Takai S (1991) Tensile properties of the human femur-anterior cruciate ligament-tibia complex. The effects of specimen age and orientation. Am J Sports Med 19:217–225PubMed
48.
Zhang LQ, Rymer WZ (2001) Reflex and intrinsic changes induced by fatigue of human elbow extensor muscle. J Neurophysiol 86:1086–1094PubMed
49.
Zhang LQ, Nuber G, Butler J, Bowen M, Rymer WZ (1998) In vivo human knee joint dynamic properties as functions of muscle contraction and joint position. J Biomech 31:71–76PubMedCrossRef
50.
Zimny ML, Schutte M, Dabezies E (1986) Mechanoreceptors in the human anterior cruciate ligament. Anat Rec 214:204–209PubMedCrossRef
Metadata
Title
Submaximal fatigue of the hamstrings impairs specific reflex components and knee stability
Authors
Mark Melnyk
Albert Gollhofer
Publication date
01-05-2007
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 5/2007
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-006-0226-3

Other articles of this Issue 5/2007

Knee Surgery, Sports Traumatology, Arthroscopy 5/2007 Go to the issue

Shoulder

The value of ultrasonography in the preoperative diagnostic evaluation of patients with recurrent anterior shoulder dislocation: a prospective study of 44 patients

Knee

Double-bundle versus single-bundle anterior cruciate ligament reconstruction: a prospective, randomize clinical study

Knee

Intra-articular hyaluronic acid after knee arthroscopy: a two-year study

Letter to the Editor

A European ACL register

Sports Medicine

Treatment of Jumper’s knee: promising short-term results in a pilot study using a new arthroscopic approach based on imaging findings

Knee

Clinical, radiologic and arthroscopic assessment and treatment of bilateral discoid lateral meniscus