Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
Androit-APP Journal of Sports Science and Medicine
©Journal of Sports Science and Medicine (2024) 23, 436 - 444   DOI:

Research article
Thoracolumbar Fascia and Lumbar Muscle Stiffness in Athletes with A History of Hamstring Injury
Eleftherios Kellis1, , Afxentios Kekelekis1, Eleni E. Drakonaki2
Author Information
1 Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
2 Department of Anatomy, Medical School, University of Crete, Heraklion Crete, Greece

Eleftherios Kellis
✉ Ph.D. Laboratory of Neuromechanics, Aristotle University of Thessaloniki, TEFAA Serres, 62100 Greece
Publish Date
Received: 21-04-2024
Accepted: 09-05-2024
Published (online): 01-06-2024

The purpose of this study was to examine the differences in thoracolumbar fascia (TLF) and lumbar muscle modulus in individuals with and without hamstring injury using shear wave elastography (SWE). Thirteen male soccer players without a previous hamstring injury and eleven players with a history of hamstring injury performed passive and active (submaximal) knee flexion efforts from 0°, 45° and 90° angle of knee flexion as well as an active prone trunk extension test. The elastic modulus of the TLF, the erector spinae (ES) and the multifidus (MF) was measured using ultrasound SWE simultaneously with the surface electromyography (EMG) signal of the ES and MF. The TLF SWE modulus was significantly (p < 0.05) higher in the injured group (range: 29.86 ± 8.58 to 66.57 ± 11.71 kPa) than in the uninjured group (range: 17.47 ± 9.37 to 47.03 ± 16.04 kPa). The ES and MF modulus ranged from 14.97 ± 4.10 to 66.57 ± 11.71 kPa in the injured group and it was significantly (p < .05) greater compared to the uninjured group (range: 11.65 ± 5.99 to 40.49 ± 12.35 kPa). TLF modulus was greater than ES and MF modulus (p < 0.05). Active modulus was greater during the prone trunk extension test compared to the knee flexion tests and it was greater in the knee flexion test at 0° than at 90° (p < 0.05). The muscle EMG was greater in the injured compared to the uninjured group in the passive tests only (p < 0.05). SWE modulus of the TLF and ES and MF was greater in soccer players with previous hamstring injury than uninjured players. Further research could establish whether exercises that target the paraspinal muscles and the lumbar fascia can assist in preventing individuals with a history of hamstring injury from sustaining a new injury.

Key words: Biceps femoris strain, Spine, myofascial, injured hamstring

           Key Points
  • Athletes with a history of a recent hamstring injury show a greater shear-wave elastic modulus of the thoracolumbar fascia compared to uninjured athletes when performing passive and active knee flexion tests and active trunk extensions.
  • Shear-wave elastic modulus and passive activation of the lumbar spine muscles was greater in athletes with a recent hamstring injury compared to uninjured athletes.
  • Management of athletes with a previous hamstring injury could include exercises or interventions that alter stiffness of the lumbo-pelvic fascia and musculature.
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