Movement Rate and Brain-Muscle Coupling in Male Footballers With and Without Hamstring Injury History

Background: High-speed actions constitute an important mechanism of hamstring strain injuries (HSIs) in football. These actions have a strong supraspinal base, and changes in brain activity have been noted in other musculoskeletal injuries; however, there is a lack of information about changes in brain-muscle coupling in footballers with HSI history. Therefore, this study aimed to determine whether movement speed and brain-muscle activity differ between players with and without HSI history during a high-speed knee movement task. Hypothesis: Footballers with previous HSI will show decreased knee movement rate and associated neurophysiological inhibition. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: A total of 108 male footballers (39 with HSI history) performed a maximum-speed knee flexion-extension task over eight 10-second blocks. During this task, brain and muscle activity of knee flexors and extensors were recorded using electroencephalography (EEG) and electromyography (EMG), respectively, and the movement rate was measured. Results: Footballers with HSI history moved at a higher rate in the first half of the task. This was accompanied by higher theta and decreasing alpha EEG activity, lower rectus femoris and biceps femoris activity, and less flexor-extensor co-contraction. Conversely, there were no differences in corticomuscular coherence (CMC) between groups, but the biceps femoris showed a significantly lower CMC than all other muscles. Conclusion: The task was able to differentiate players with and without HSI history; in addition, those with previous HSI showed EEG activity patterns associated with increased task load and use of attentional resources for sensorimotor integration. EMG findings indicated players with HSI history were able to perform better despite showing overall reduced activity, especially in the rectus femoris and biceps femoris. Clinical Relevance: Neurocognitive factors may be involved in HSIs and persist even after rehabilitation, suggesting the relevance of including these factors in rehabilitation.