ArticleInternational journal of sports physical therapy2021
Medio-Lateral Hamstring Muscle Activity in Unilateral vs. Bilateral Strength Exercises in Female Team Handball Players - A Cross-Sectional Study.
Article in International journal of sports physical therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Injury Prevalence of the Lower Limbs in Handball Players: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Rehabilitative and Conditioning Exercises That Selectively Activate Individual Lower Extremity Muscles: A Systematic Review.Sports health · 2026Review
- No Alterations in ACL Injury Risk Factors in Preadolescent Elite Female Handball Players Following an Eight-Week Targeted Training Intervention: A Randomised Controlled Trial.Translational sports medicine · 2026Article
- Effects of Kettlebell Swing Style and Mass on Female Hip Joint Kinetics.International journal of sports physical therapy · 2025Article
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundReduced activation of the hamstring muscles and specifically the medial semitendinosus muscle (ST) has been shown to be a risk factor for non-contact anterior cruciate ligament (ACL) injury. Specific hamstring strength exercises may show high ST activity, however the effect of unilateral vs. bilateral exercise execution on ST activation remains unknown. PURPOSE: To investigate selected lower limb strengthening exercises performed either unilaterally or bilaterally to identify 1) which exercise elicited the highest hamstring activation, 2) which exercise elicited the highest ST activation, and 3) to examine if unilateral exercise execution altered the medio-lateral hamstring activation pattern. Furthermore, the kinematic characteristics of each specific exercise and execution modality were determined to reveal possible causes for differences in medio-lateral hamstring activation between the different exercise conditions. STUDY
designCross-sectional study.
methodsSingle-session repeated measures were obtained in a randomized manner. Twenty-three female elite team handball players were recruited. Hamstring electromyographic (EMG) activity and 3D kinematics were obtained during selected lower limb exercises (hip thrust, kettlebell swing, Romanian deadlift). Hamstring EMG activity, normalized to maximal voluntary contraction (MVC) (nEMG), and inter-muscular activation difference between the ST and lateral hamstring biceps femoris (BF) were compared across exercises using two-way repeated measures ANOVA.
resultsBilateral hip thrust demonstrated highest overall hamstring activity (68.9±16.6 %). Kettlebell swing (Δ13%-point, p<0.01) and Romanian deadlift (Δ20-24%-point, p<0.01) demonstrated greater ST-BF activation differences (Δ=ST-BF) in favor of ST compared to hip thrust (Δ2-7%). Positive correlations were observed between knee joint angle and ST activity in kettlebell swing and deadlift.
conclusionKettlebell swing, deadlift and hip thrust all produced high activation of the hamstring muscles. Kettlebell swing and both deadlift exercises were superior in activating ST over BF, favoring these exercises in the prevention of non-contact ACL injury in female athletes, which should be evaluated in future intervention studies. LEVEL OF EVIDENCE: 3.
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