Neuromuscular Inhibition, Hamstring Strain Injury, and Rehabilitation: A Review

JOURNAL TITLE: Journal of Postgraduate Medicine, Education and Research

1. Robert G Crowther
2. Gregory A Lovell
3. Karthik Badrinath
Publishing Year
Author Affiliations
    1. Sportsmed, Stepney Branch, Australia
    1. UniSA: Allied Health and Human Performance, University of South Australia, Adelaide, South Australia; Alliance for Research in Exercise, Nutrition & Activity (ARENA), University of South Australia, Adelaide, South Australia
    1. University of Canberra Research Institute for Sport and Exercise, Canberra, Australia
  • Article keywords
    Hamstring, Inhibition, Muscle injury, Neuromuscular, Strain injury, Surface electromyography


    Objective: The purpose of this review was to summarize the neuromuscular inhibition of the hamstring and lumbopelvic musculature following a hamstring strain injury (HSI) and its subsequent implications on the rehabilitation of the injury. Design: Narrative review. Results: A search of electronic databases and references within the articles found 18 articles suitable for review. A critical review of the literature revealed that despite returning to the sport, athletes demonstrated an impairment in the myoelectric activity in the hamstring muscle group, particularly the biceps femoris (BF). Additionally, altered activation patterns in the lumbopelvic musculature (gluteus medius and maximus, external and internal oblique, thoracic and lumbar erector trunci) of healthy athletes were also associated with increased HSI risk. Conclusion: Despite athletes completing evidence-based rehabilitation programs, there is persistent neuromuscular inhibition present in the hamstring and lumbopelvic musculature on return to sport. Clinicians should be aware of this phenomenon as a return of athletes to sport with neuromuscular inhibition may increase their risk of hamstring strain re-injury. Measures such as surface electromyography (EMG) may be a useful tool to detect neuromuscular changes following HSI and help guide clinicians in the return to play process following an HSI.

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