©Journal of Sports Science and Medicine (2022) 21, 43-48

http://www.jssm.org DOI: https://doi.org/10.52082/jssm.2022.43

` Research article

The Effect of Ankle Position on Peak Eccentric Force during The Nordic
Hamstring Exercise

Satoru Nishida 1, Wataru Ito 2,3

, Taisuke Ohishi 4, Riku Yoshida 2, Shigeru Sato 2
and Masatoshi
Nakamura 2,3
1
Faculty of Sports and Health Science, Fukuoka University, Fukuoka, Japan; 2 Institute for Human Movement and Med-
ical Sciences, Niigata University of Health and Welfare, Niigata, Japan; 3 Department of Physical Therapy, Niigata Uni-
versity of Health and Welfare, Niigata, Japan; 4 Niigata Rehabilitation Hospital, Japan

(60°/s), although this contribution is relatively small (effect

Abstract size = 0.2) (Green et al., 2018). Thus, the authors suggest
Peak eccentric force during the Nordic hamstring exercise (NHE) using alternative strength tests to assess eccentric ham-
is recognized as a predictive factor for hamstring strain injury string force-generating capacity to predict the risk of HSI
(HSI). During the NHE, the knee flexor muscles are eccentrically more accurately. The Nordic hamstring exercise (NHE) is
contracting to resist the knee joint extension. Therefore, it is a typical eccentric hamstring exercise to reduce HSI
thought that the action of the gastrocnemius muscle, and thus the
ankle position, influences peak eccentric force during the NHE.
(Bourne et al., 2018; van Dyk et al., 2019). Recently, ec-
However, the effect of ankle position on peak eccentric force dur- centric force during the NHE has been recognized as an
ing the NHE remains unclear. Therefore, we investigated the ef- indicator of eccentric hamstring strength. Previous studies
fect of ankle position on peak eccentric force during the NHE in have investigated the relationship between the peak eccen-
a cohort of 50 healthy young male rugby players (mean age, 18.7 tric force during the NHE and the risk of HSI (Opar et al.,
± 1.2 years; mean body mass, 81.7 ± 15.2 kg; height, 1.72 ± 0.06 2015; Timmins et al., 2016) and reported that athletes with
m) with no history of HSI. Each participant performed NHE peak eccentric force, reported relative to body mass (N/kg),
strength testing with the ankle dorsiflexed or plantarflexed posi- of less than 4.35 N/kg were at a 2.5-fold greater risk of sub-
tion and was instructed to fall forward as far as possible within 3 sequent HSI than stronger players (Timmins et al., 2016).
s. Peak eccentric force, reported relative to body mass (N/kg), of
both legs was recorded, and the mean values of both legs were
Thus, testing of eccentric force during the NHE has re-
compared in both ankle positions. The mean peak eccentric force placed isokinetic strength assessment as a predictive factor
was significantly greater with the ankle plantarflexed position for HSI.
than the dorsiflexed position (3.8 ± 1.1 vs. 3.5 ± 1.1 N/kg, respec- Hamstring strength may be affected by ankle posi-
tively, p = 0.049). These results indicate that ankle position tion, as a previous study reported that isometric knee flex-
should be carefully considered when measuring peak eccentric ion torque was 14-22% greater with the ankle dorsiflexed
force during the NHE and performing NHE training. position than the plantarflexed position (Ogborn et al.,
2021; Marchetti et al., 2019). Similarly, concentric knee
Key words: Eccentric exercise, hamstring strain injury, risk flexion torque (angular velocity of 60°/s) was 7-13%
screening, injury prevention
greater with the ankle dorsiflexed position than the plantar-
flexed position (Miller et al., 1996; Croce and Miller,
Introduction 2000). However, a previous study found the ankle position
had no impact on the electromyography activity of the
Hamstring strain injury (HSI) is among the most frequent hamstring and gastrocnemius, and suggested that by
sports injuries, as the hamstring is especially susceptible to stretching the gastrocnemius due to ankle dorsiflexion, the
strain injury during high-speed running due to eccentric gastrocnemius muscle length was extended to a sufficient
contractions to absorb knee extension moment to deceler- position in the length-tension relationship, allowing more
ate lower limb momentum during the late swing phase of force to be produced during knee flexion (Croce et al.,
sprinting (Woods et al., 2004; Brooks et al., 2006; Chu- 2000). It is also generally believed that the ankle position
manov et al., 2012; Schache et al., 2012). Therefore, ec- affects knee flexion training and strength (Kim et al.,
centric hamstring strength is considered important to pre- 2016). Kim et al. (Kim et al., 2016) reported that the max-
vent HSI (van Dyk et al., 2016; Lee et al., 2018). Although imal concentric knee flexion torque (angular velocity of
many previous studies have investigated the mechanism, 60°/s) was 29-59% greater after four weeks of isokinetic
risk factors, and strategies for the prevention of HSI, the knee flexion training with the ankle dorsiflexed position
incidence has not changed over the past decade than training with the ankle plantarflexed position. These
(Buckthorpe et al., 2019; Green et al., 2020). results suggest that performing NHE strength testing with
Eccentric hamstring strength is commonly meas- the ankle dorsiflexed position could produce a greater ec-
ured using an isokinetic dynamometer. However, a review centric force. Similar to the knee flexion testing, no differ-
article pointed out that the role of isokinetic strength as- ence was observed in electromyography activity of the
sessment in detecting future risk of HSI is limited only in hamstring and gastrocnemius during NHE between ankle
eccentric knee flexor torque at a lower angular velocity dorsiflexed position and plantarflexed position (Comfort et

Received: 15 September 2021 / Accepted: 27 October 2021 / Published (online): 15 February 2022
44 Nordic hamstring and ankle position

al., 2017). However, no study has yet to investigate the re- Statistical analyses
lationship between peak eccentric force during the NHE The intraclass correlation coefficient (ICC), coefficient of
and ankle position. Elucidation of the relationship between variation (CV) and their 95% confident intervals (95% CIs)
peak eccentric force during the NHE and ankle position were calculated to assess relative reliability between the
could help to select the optimal ankle joint position for two trials. An ICC values were based on the lower bound
NHE strength testing and efficient NHE training. 95% CI, and ICC of ≥ 0.9 was regarded as excellent, 0.75-
Therefore, the aim of the present study was to ex- 0.9 as good,0.5-0.75 as moderate, and ≤ 0.5 as poor (Koo
amine the effect of ankle position during NHE strength and Li, 2016), while a and CV of ≤ 10% was considered
testing on peak eccentric force. The hypothesis of this reliable (William, 2005) The Shapiro-Wilk test was used to
study is that peak eccentric force during the NHE is greater assess the normality of the data. The Wilcoxon signed-rank
with the ankle dorsiflexed position than the planter flexion test was used to compare the mean peak eccentric force of
position. the right and left legs during NHE between the two ankle
positions. Effect size (ES) describing the magnitude of the
Methods differences in peak eccentric force between ankle positions
were examined by calculating r using the following equa-
Study approval tion: r = Z/√n (Mizumoto and Takeuchi, 2008). Cohen et
The study protocol was approved by the Ethics Committees al.(Cohen, 1988) described r of 0.1-0.3 as representing a
of Fukuoka University (Fukuoka, Japan) and was con- small, 0.3-0.5 as a moderate, and ≥ 0.5 as a large magnitude
ducted in accordance with the ethical principles for medi- of change. In addition, Spearman's rank-order correlation
cal research involving human subjects described in the was used to examine the relationship between the ankle po-
Declaration of Helsinki. The study procedures and poten- sition and the mean peak eccentric force, and 95% CIs of
tial risks were explained to all participants prior to provid- correlation coefficient was calculated. Thresholds of 0.1-
ing written informed consent for study participation. 0.3, 0.3-0.5, 0.5-0.7, 0.7-0.9, and ≥ 0.9 for small, moderate,
large, very large, and extremely large correlation coeffi-
Participants cients were used (Hopkins et al., 2009). A probability (p)
The study cohort consisted of 50 healthy young male rugby value of < 0.05 was considered statistically significant. All
players with a mean ± standard deviation (range) age, body statistical analyses were performed using IBM SPSS Sta-
mass, and height of 18.7 ± 1.24 (16-20) years, 81.7 ± 15.2 tistics for Windows, version 27.0. (IBM Corporation, Ar-
(55.4-128.2) kg, and 1.72 ± 6 (1.6-1.88) m, respectively. monk, NY, USA).
Participants habitually performed resistance training, in-
cluding knee flexors 2-3 times per week, and had experi-
ence with continuous NHE training. None of the partici-
pants had a history of HSI.

NHE strength testing

For evaluation of peak eccentric force during the NHE,
each participant was in a kneeling position on a custom-
made NHE device with each ankle secured above the lat-
eral malleolus with an ankle brace that was attached to a
load cell sensor (Figure 1). The force against the ankle
brace in the vertical direction was quantified with the load
cell sensor. Force data were synchronized and transferred
at 1000 Hz from a PowerLab16/35 data acquisition and Figure 1. Setup for measurement of NH force.
analysis system (AD Instruments, Bella Vista, NSW, Aus-
tralia) to a personal computer (VersaPro; NEC Corpora- Results
tion, Tokyo, Japan). Each participant was instructed to
gradually lean forward from the initial kneeling position at The relative reliability of the mean peak eccentric force of
90° knee flexion to a prone position within 3 s with the the right and left legs was good to excellent with the ankle
arms crossed at the chest and the hip joints fully extended. dorsiflexed position (ICC = 0.88; 95% CI 0.81 to 0.93, CV
Before testing, the participants practiced the NHE strength = 7.8%; 95% CI 2.6 to 14.1) and ankle plantarflexed posi-
testing 2-3 times. The NHE strength testing was conducted tion (ICC = 0.91; 95% CI 0.85 to 0.95, CV = 6.8%; 95%
twice with the ankle dorsiflexed or plantarflexed position CI 3.3 to 10.1). As shown in Figure 2, the mean peak ec-
in random order. The ankle position was passively secured centric force of the right and left legs was significantly
by the examiner. To standardize the velocity of the move- greater with the ankle plantarflexed position than the dor-
ment, the participants were instructed to lean forward at a siflexed position (p = 0.049). Effect size (r) was small (r =
constant angular velocity as indicated by a metronome. 0.28). Significant correlations in the mean peak eccentric
Peak eccentric force, reported relative to body mass (N/kg), force of the right and left legs were evident with the ankle
of both legs was recorded, and the difference in the mean dorsiflexed and plantarflexed positions (r = 0.72; 95% CI
peak eccentric force between the right and left legs was 0.55 to 0.83, p < 0.01) (Figure 3).
used for further analyses.
Nishida et al. 45

was suitable for exerting greater peak eccentric force than

p = 0.049
8 the plantarflexed position; but, our results differed from the
Peak Eccentric Force (N/kg)

hypothesis. Ankle plantarflexion slackens the gastrocnem-

ius, possibly resulting in decreased activity of the ham-
6
string as well as the gastrocnemius. However, Comfort et
al. (2017) reported that ankle position did not influence the
4 activity of the hamstring and gastrocnemius during NHE.
In addition, recent studies have shown that peak eccentric
force during the NHE was not related to isometric and iso-
2 kinetic knee flexion strength (Moreno-Pérez et al., 2020;
van Dyk et al., 2018) These results suggest that differences
0 in ankle position might influence peak eccentric force dur-
ing the NHE by affecting factors other than knee flexion
Dorsiflexed Plantarflexed torque and muscle activity acting on knee flexion. Notably,
Position Position NHE was performed without securing the hip joint and
Figure 2. Comparison of the mean peak eccentric force values trunk; thus, the hip and trunk muscles were likely to be
of the right and left legs with the ankle plantarflexed and dor- used during the NHE strength testing. In fact, Sarabon et
siflexed positions. al. (2019) reported that during NHE, the torque exerted by
the hip joint was about half of that of the knee joint (150
vs. 300 Nm, respectively). Moreover, Narouei et al.
in Ankle Plantarflexed Position (N/kg)

(Narouei et al., 2018) reported that muscle activity of the

8 internal and external obliques or erector spine was ob-
served during NHE. Accordingly, in the present study,
Peak Eccentric Force

6 changes to the hip and trunk muscle activities with the an-
kle plantarflexed position might exert a larger peak eccen-
tric force during the NHE. It appears that further studies are
4
required to clarify the effects of ankle position on the me-
r = 0.72
chanical properties of hip and trunk muscles during NHE.
2 To the best of our knowledge, this is the first study
p < 0.01
to examine the relationship between ankle position and
0 peak eccentric force during the NHE. Previous studies re-
0 2 4 6 8 vealed that a greater peak eccentric force during the NHE
decreases future risks of HSI (Opar et al., 2015; Timmins
Peak Eccentric Force et al., 2016) and that a peak eccentric force, reported rela-
in Ankle Dorsiflexed Position (N/kg) tive to body mass (N/kg), of less than 4.35 N/kg was asso-
ciated with a 2.5-fold greater risk of a subsequent HSI
Figure 3. Correlations between the mean peak eccentric force
(Timmins et al., 2016). The results of the present study
values of the right and left legs with the ankle plantarflexed
and dorsiflexed positions. showed that peak eccentric force during the NHE was sig-
nificantly greater with the ankle plantarflexed position than
Discussion the dorsiflexed position, suggesting the importance of con-
sidering ankle position for measurement of peak eccentric
The present study investigated the effect of ankle position force during the NHE. However, no previous studies that
during NHE on peak eccentric force in well-trained young examined the relationship between peak eccentric force
rugby players. The most important finding was that the during the NHE and the incidence of HSI took into account
mean peak eccentric force during the NHE of the right and the position of the ankle during NHE. Hence, further stud-
left legs was significantly greater with the ankle plantar- ies are needed to confirm the optimal ankle position for
flexed position than the dorsiflexed position. However, this prediction of the risk of HSI by peak eccentric force during
result did not support the hypothesis that peak eccentric the NHE. On the other hand, it has been reported that NHE
force during the NHE is greater with the ankle dorsiflexed training improves peak eccentric force during the NHE and
position than the planterflexed position. several variables related to HSI, such as sprint performance
Previous studies have reported that isometric and and hamstring fascicle length (Bourne et al., 2017; Bautista
concentric knee flexion torque was significantly greater et al., 2021). The effect of ankle position on the efficacy of
with the ankle dorsiflexed position than the plantarflexed NHE training is an interesting matter from the viewpoint
position (Ogborn et al., 2021; Marchetti et al., 2019; Miller of HSI prevention.
et al., 1996; Croce et al., 2000). Since the gastrocnemius is Of note, a very large positive correlation (r = 0.72)
a biarticular muscle, it is thought that ankle dorsiflexion was observed in the present study between peak eccentric
stretches the gastrocnemius and brings it closer to its opti- force during the NHE with the ankle in both the plantar-
mal length, which contributes to knee flexion strength and flexed and dorsiflexed positions. This result indicates that
knee joint stability, thereby enabling greater muscle force athletes who exerted greater peak eccentric force on the an-
(Miller et al., 1996; Croce et al., 2000) In NHE strength kle plantarflexed position also exerted a larger peak eccen-
testing, it was thought that the ankle dorsiflexed position tric force on the ankle dorsiflexed position, suggesting that
46 Nordic hamstring and ankle position

there is no net difference in peak eccentric force during the 43. https://doi.org/10.1016/j.clinbiomech.2018.07.009
Bourne, M.N., Duhig, S.J., Timmins, R.G., Williams, M.D., Opar, D.A.,
NHE on the ankle planterflexed position vs. the dorsiflexed
Al Najjar, A., Graham, K.K. and Shield, A.J. (2017) Impact of
position. On the other hand, the eccentric force was signif- the Nordic hamstring and hip extension exercises on hamstring
icantly greater with the ankle plantarflexed position than architecture and morphology: implications for injury prevention.
the dorsiflexed position, but the effect size (r) was small (r British Journal of Sports Medicine 51(5), 469-477.
https://doi.org/10.1136/bjsports-2016-096130
= 0.28) in the present study. In addition, fifteen participants
Bourne, M.N., Timmins, R.G., Opar, D.A., Pizzari, T., Ruddy, J. D., Sims,
exerted a peak eccentric force during the NHE greater than C, Morgan, D.W. and Shield, A.J. (2018) An Evidence-Based
4.35 N/kg, which is a critical cut off value of the future risk Framework for Strengthening Exercises to Prevent Hamstring
of HSI(Timmins et al., 2016); however, peak eccentric Injury Key Points. Sports Medicine 48, 251-267.
https://doi.org/10.1007/s40279-017-0796-x
force was less than 4.35 N/kg with the ankle plantarflexed
Brooks, J.H.M., Fuller, C.W., Kemp, S.P.T., and Reddin, D.B. (2006).
position for several participants (n = 2), whereas the peak Incidence, Risk, and Prevention of Hamstring Muscle Injuries in
eccentric force with the ankle dorsiflexed positions was Professional Rugby Union. The American Journal of Sports
greater than 4.35 N. These results suggest that the ankle Medicine 34(8), 1297-1306.
https://doi.org/10.1177/0363546505286022
plantarflexed position is not necessarily suitable for global
Buckthorpe, M., Wright, S., Bruce-Low, S., Nanni, G., Sturdy, T., Gross,
evaluation of peak eccentric force during the NHE. During A.S., Bowen, L., Styles, B., Della Villa, S., Davison, M. and
the late swing to contact phase of sprinting, which is con- Gimpel, M. (2019) Recommendations for hamstring injury
sidered to be a high risk for HSI, ankle dorsiflexion move- prevention in elite football: Translating research into practice.
British Journal of Sports Medicine 53(7), 449-456.
ment and preactivation of ankle dorsiflexor and plantar-
https://doi.org/10.1136/bjsports-2018-099616
flexor will increase the stiffness of those muscle-tendon Chumanov E.S., Schache A.G., Heiderscheit B.C., Thelen D.G. (2021)
units to tolerate and absorb high impact loads at the begin- Hamstrings are most susceptible to injury during the late swing
ning of the ground contact (Kyröläinen et al., 1999; phase of sprinting. British Journal of Sports Medicine 46(2), 90.
https://doi.org/10.1136/bjsports-2011-090176
Kuitunen et al., 2002). The importance of peak eccentric
Cohen, J. (1988) Statistical Power Analysis for the Behavioral Sciences
force during the NHE evaluation with the ankle dorsiflexed (2nd ed.) Hillsdale (NJ): Lawrence Erlbaum Associates.
position can be seen from the mechanical characteristics in Comfort, P., Regan, A., Herrington, L., Thomas, C., McMahon, J. and
this phase, during which HSI is more likely to occur. Jones, P. (2017) Lack of Effect of Ankle Position During the
Nordic Curl on Muscle Activity of the Biceps Femoris and
Therefore, the choice of the ankle position during NHE
Medial Gastrocnemius. Journal of Sport Rehabilitation 26(3),
should be carefully considered for each participant. 202-207. https://doi.org/10.1123/jsr.2015-0130
It should be noted that NHE was performed within Croce, R., Miller, J. and Pierre, P.S. (2000) Effect of ankle position
3 s in the present study, a longer duration of NHE (e.g., 5 fixation on peak torque and electromyographic activity of the
knee flexors and extensors. Electromyography and Clinical
or 6 s) was provided in previous studies (Blandford et al.,
Neurophysiology 40(6), 365-373.
2018; Hegyi et al., 2019). Moreover, the duration of NHE Green, B., Bourne, M.N. and Pizzari, T. (2018) Isokinetic strength
was controlled by metronome in this study, but the exact assessment offers limited predictive validity for detecting risk of
duration was not measured. Duration of NHE may affect future hamstring strain in sport: a systematic review and meta-
analysis. British Journal of Sports Medicine 52(5), 329-336.
the difference of ankle position in eccentric force during
https://doi.org/10.1136/bjsports-2017-098101
NHE; therefore, future study should be required to examine Green, B., Bourne, M.N., van Dyk, N. and Pizzari, T. (2020)
the difference of ankle position in eccentric force during Recalibrating the risk of hamstring strain injury (HSI) - A 2020
NHE within the variable duration. systematic review and meta-analysis of risk factors for index and
recurrent HSI in sport. British Journal of Sports Medicine
54(18),1081-1088.
Conclusion https://doi.org/10.1136/bjsports-2019-100983
Hegyi, A., Lahti, J., Giacomo, J.P., Gerus, P., Cronin, N.J. and Morin, J.B.
(2019) Impact of Hip Flexion Angle on Unilateral and Bilateral
The results of the present study revealed that peak eccentric
Nordic Hamstring Exercise Torque and High-Density
force during the NHE was significantly greater with the an- Electromyography Activity. Journal of Orthopaedic & Sports
kle plantarflexed position than the dorsiflexed position. Physical Therapy 49(8), 584-592.
The position of the ankle should be carefully considered https://doi.org/10.2519/jospt.2019.8801
Hopkins, W., Marshall, S., Batterham, A. and Hanin, J. (2009)
when measuring peak eccentric force during the NHE.
Progressive statistics for studies in sports medicine and exercise
science. Medicine and Science in Sports and Exercise 41(1), 312.
Acknowledgements https://doi.org/10.1249/MSS.0b013e31818cb278
The experiments comply with the current laws of the country in which Kim, K., Cha, Y. and Fell, D.W. (2016) Differential effects of ankle
they were performed. The authors have no conflict of interest to declare. position on isokinetic knee extensor and flexor strength gains
The datasets generated during and/or analyzed during the current study during strength training. Isokinetics and Exercise Science 24(3),
are not publicly available, but are available from the corresponding author 195-199. https://doi.org/10.3233/IES-160617
who was an organizer of the study. Koo, T. and Li, M. (2016) A Guideline of Selecting and Reporting
Intraclass Correlation Coefficients for Reliability Research.
References Journal of Chiropractic Medicine 15(2), 155-163.
https://doi.org/10.1016/j.jcm.2016.02.012
Bautista, I., Vicente-Mampel, J., Baraja-Vegas, L., Segarra, V., Martín, Kuitunen, S., Komi, P.V. and Kyröläinen, H. (2002) Knee and ankle joint
F. and Van Hooren, B. (2021) The effects of the Nordic stiffness in sprint running. Medicine and Science in Sports and
hamstring exercise on sprint performance and eccentric knee Exercise 34(1), 166-173.
flexor strength: A systematic review and meta-analysis of https://doi.org/10.1097/00005768-200201000-00025
intervention studies among team sport players. Journal of Kyröläinen, H., Komi, P.V. and Belli, A. (1999) Changes in muscle
Science and Medicine in Sport 24(9), 931-938. activity patterns and kinetics with increasing running speed.
https://doi.org/10.1016/j.jsams.2021.03.009 Journal of Strength and Conditioning Research 13(4), 400-406.
Blandford, L., Theis, N., Charvet, I. and Mahaffey, R. (2018) Is https://doi.org/10.1519/00124278-199911000-00017
neuromuscular inhibition detectable in elite footballers during Lee, J.W.Y., Mok, K.-M., Chan, H.C.K., Yung, P.S.H., and Chan, K.-M.
the Nordic hamstring exercise? Clinical Biomechanics 58, 39- (2018). Eccentric hamstring strength deficit and poor hamstring-
Nishida et al. 47

to-quadriceps ratio are risk factors for hamstring strain injury in

football: A prospective study of 146 professional players. Jour- Key points
nal of Science and Medicine in Sport 21(8), 789-793.
https://doi.org/10.1016/J.JSAMS.2017.11.017  We examine the relationship between ankle position and
Marchetti, P.H., Magalhaes, R.A., Gomes, W.A., da Silva, J.J., Stecyk, peak eccentric force during the Nordic hamstring exercise.
S.D. and Whiting, W.C. (2019) Different knee and ankle  Peak eccentric force was significantly greater with the ankle
positions affect force and muscle activation during prone leg curl
in trained subjects. Journal of Strength and Conditioning
plantarflexed position than the dorsiflexed position
Research. https://doi.org/10.1519/JSC.0000000000003333  Significant positive correlation was observed between peak
Miller, J.P., Catlaw, K. and Angelopoulas, C. (1996) Effect of ankle eccentric force with the ankle in both the plantarflexed and
position on knee flexor and extensor torque. Isokinetics and dorsiflexed positions.
Exercise Science, 6(2), 153-155. https://doi.org/10.3233/IES-  These results suggest that the position of the ankle should
1996-6212 be carefully considered when measuring peak eccentric
Mizumoto, A. and Takeuchi, O. (2008) Basics and considerations for
force during the Nordic hamstring exercise.
reporting effect sizes in research papers. Studies in English
Language Teaching, 57-66.
Moreno-Pérez, V., Méndez-Villanueva, A., Soler, A., Del Coso, J. and AUTHOR BIOGRAPHY
Courel-Ibáñez, J. (2020) No relationship between the nordic Satoru NISHIDA
hamstring and two different isometric strength tests to assess
Employment
hamstring muscle strength in professional soccer players.
Physical Therapy in Sport 46, 97-103.
Faculty of Sports and Health Science, Fu-
https://doi.org/10.1016/j.ptsp.2020.08.009 kuoka University, Fukuoka, Japan
Narouei, S., Imai, A., Akuzawa, H., Hasebe, K., Kaneoka, K., Narouei, Degree
S., Imai, A., Akuzawa, H., Hasebe, K. and Kaneoka, K. (2018) PhD
Hip and trunk muscles activity during nordic hamstring exercise. Research interests
Journal of Exercise Rehabilitation 14(2), 231-238. Injury prevention, hamstring strain in-
https://doi.org/10.12965//jer.1835200.600 jury, athletic training, exercise physiol-
Ogborn, D.I., Bellemare, A., Bruinooge, B., Brown, H., McRae, S. and ogy, eccentric exercise
Leiter, J. (2021) Comparison of common methodologies for the
determination of knee flexor muscle strength. International
E-mail: atoru.nishida5521@gmail.com
Journal of Sports Physical Therapy 16(2), 350-359. Wataru ITO
https://doi.org/10.26603/001c.21311 Employment
Opar, D.A., Williams, M.D., Timmins, R.G., Hickey, J., Duhig, S.J. and Lecture, Institute for Human Movement
Shield, A.J. (2015) Eccentric hamstring strength and hamstring and Medical Sciences, Niigata Univ. of
injury risk in Australian footballers. Medicine and Science in Health and Welfare, Niigata, Japan
Sports and Exercise 47(4), 857-865. Degree
https://doi.org/10.1249/MSS.0000000000000465
PhD
Šarabon, N., Marušič, J., Marković, G. and Kozinc, Ž. (2019) Kinematic
and electromyographic analysis of variations in Nordic Research interests
hamstring exercise. Plos One 14(10), e0223437. Physical therapy, sports medicine, sports
https://doi.org/10.1371/journal.pone.0223437 science, biomechanics
Schache A.G., Dorn T.W., Blanch P.D., Brown N.A.T., Pandy M.G. E-mail: wataru-ito@nuhw.ac.jp
(2012) Mechanics of the human hamstring muscles during Taisuke OHISHI
sprinting. Medicine and Science in Sports and Exercise 44(4), Employment
647-658. https://doi.org/10.1249/MSS.0b013e318236a3d2 Niigata Rehabilitation Hospital, Niigata,
Timmins, R.G., Bourne, M.N., Shield, A.J., Williams, M.D., Lorenzen,
C. and Opar, D.A. (2016) Short biceps femoris fascicles and
Japan
eccentric knee flexor weakness increase the risk of hamstring Degree
injury in elite football (soccer): a prospective cohort study. RPT, JSPO-AT, NSCA-CSCS
British Journal of Sports Medicine 50(24), 1524-1535. Research interests
https://doi.org/10.1136/bjsports-2015-095362 Physical therapy, injury prevention
William J.V. (2005) Statistics in Kinesiology. 3rd edition. Human E-mail:masatoshi-nakaura@nuhw.ac.jp
Kinetics, champaign, IL. Riku YOSHIDA
Woods, C., Hawkins, R.D., Maltby, S., Hulse, M., Thomas, A., and Hod-
Employment
son, A. (2004). The Football Association Medical Research Pro-
gramme: an audit of injuries in professional football--analysis of Institute for Human Movement and Med-
hamstring injuries. British Journal of Sports Medicine 38(1), 36- ical Sciences, Niigata University of
41. https://doi.org/10.1136/bjsm.2002.002352 Health and Welfare, Niigata, Japan
van Dyk, N., Bahr, R., Whiteley, R., Tol, J.L., Kumar, B.D., Hamilton, Degree
B., Farooq, A., Witvrouw, E. (2016) Hamstring and Quadriceps BSc, MSc student
Isokinetic Strength Deficits Are Weak Risk Factors for Ham- Research interests
string Strain Injuries. The American Journal of Sports Medicine Physical therapy, resistance training,
44(7), 1789–1795.
cross-education
https://doi.org/10.1177/0363546516632526
Van Dyk, N., Witvrouw, E. and Bahr, R. (2018) Interseason variability in E-mail: hpm21017@nuhw.ac.jp
isokinetic strength and poor correlation with Nordic hamstring Shigeru SATO
eccentric strength in football players. Scandinavian Journal of Employment
Medicine and Science in Sports 28(8), 1878-1887. Institute for Human Movement and Med-
https://doi.org/10.1111/sms.13201 ical Sciences, Niigata University of
Van Dyk, N., Behan, F.P. and Whiteley, R. (2019) Including the Nordic Health and Welfare, Niigata, Japan
hamstring exercise in injury prevention programmes halves the Degree
rate of hamstring injuries: A systematic review and meta-
analysis of 8459 athletes. British Journal of Sports Medicine
MSc, PhD student
53(21), 1362-1370. https://doi.org/10.1136/bjsports-2018- Research interests
100045 Physical therapy, stretching, flexibility,
resistance training
E-mail: hpm19006@nuhw.ac.jp
48 Nordic hamstring and ankle position

Masatoshi NAKAMURA
Employment
Lecture, Institute for Human Movement
and Medical Sciences, Niigata University
of Health and Welfare, Niigata, Japan
Degree
PhD
Research interests
Physical therapy, stretching, exercise
physiology, flexibility
E-mail:
masatoshi-nakmura@nuhw.ac.jp

 Satoru Nishida, PhD, JSPO-AT

Faculty of Sports and Health Science, Fukuoka University 8-19-
1, Nanakuma, Jonan-ku, Fukuoka, Fukuoka 814-0180, Japan