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Competitive alpine skiing requires a high level of physical fitness to perform sport-specific manoeuvres and to minimise the risk of injury. The aim of this study was to establish reference values for the maximal anatomical cross-sectional area (ACSAmax) of the individual hamstrings (HAM) and quadriceps (QUAD) muscles as well as for the maximal voluntary torque (MVT) during knee flexion (KF) and knee extension (KE) of female and male elite competitive alpine skiers. Ultrasound and dynamometer data were obtained from a largely overlapping but not identical dataset. The ultrasound data were collected from 33 elite alpine skiers (20 women and 13 men), and the dynamometer data were collected from 35 elite alpine skiers (20 women and 15 men). Compared with female skiers, male skiers presented a significantly greater ACSAmax in the biceps femoris short head (BFsh), biceps femoris long head (BFlh), and semitendinosus (ST) muscles, as well as in the entire HAM muscle group. The ACSAmax of the semimembranosus (SM) did not differ significantly between the two sexes. Compared with female skiers, male skiers presented significantly greater ACSAmax values in the vastus lateralis (VL), rectus femoris (RF), vastus medialis (VM) and entire QUAD muscle groups. At VI, there was no significant difference in the ACSAmax between the two sexes. Compared with male skiers, female skiers had a significantly greater proportional SM ACSAmax. In terms of MVT, male skiers presented greater absolute and relative values than females did. There were no differences in the MVT/ACSAmax between the sexes. Neither the HAM/QUAD ACSAmax ratio nor the KF/KE MVT ratio differed between the sexes. The present study provides normative values for the muscle size and strength of the HAM and QUAD muscles of elite competitive alpine skiers. These values can be used as benchmarks for youth alpine skiers striving for the elite level. An interesting finding of the present study was that female skiers had a greater proportional ACSAmax of the SM, as this may be relevant in anterior cruciate ligament injury prevention given the function of tibia internal rotation.

From a preventative perspective, leg axis and core stabilization capacities are important for soccer players and alpine skiers; however, due to different sport-specific demands, the role of laterality clearly differs and may result in functional long-term adaptations. The aims of this study are 1) to determine whether there are differences in leg axis and core stability between youth soccer players and alpine skiers and 2) between dominant and non-dominant sides, and 3) to explore the outcomes of applying common sport-specific asymmetry thresholds to these two distinct cohorts. Twenty-one highly trained/national-level soccer players (16.1 years, 95% CI: 15.6, 16.5) and 61 alpine skiers (15.7 years, 95% CI: 15.6, 15.8) participated in this study. Using a marker-based 3D motion capture system, dynamic knee valgus was quantified as the medial knee displacement (MKD) during drop jump landings, and core stability was quantified as the vertical displacement during deadbug bridging exercise (DBBdisplacement). For the analysis of sports and side differences, a repeated-measures multivariate analysis of variance was used. For the interpretation of laterality, coefficients of variation (CV) and common asymmetry thresholds were applied. There were no differences in MKD or DBBdisplacement between soccer players and skiers or between the dominant and non-dominant sides, but there was an interaction effect side*sports for both variables (MKD: p = 0.040, η2p = 0.052; DBBdisplacement: p = 0.025, η2p = 0.061). On average, MKD was larger on the non-dominant side and DBBdisplacement laterality on the dominant side in soccer players, whereas this pattern was reversed in alpine skiers. Despite similar absolute values and asymmetry magnitudes of dynamic knee valgus and deadbug bridging performance in youth soccer players and alpine skiers, the effect on the direction of laterality was opposite even though much less pronounced. This may imply that sport-specific demands and potential laterality advantages should be considered when dealing with asymmetries in athletes.

Lower extremity injuries are common in competitive alpine skiers, and the knee and lower leg are often affected. The hamstring muscles, especially the biceps femoris long head (BFlh), can stabilize the knee and the hip and may counteract various adverse loading patterns during typical mechanisms leading to severe lower extremity injuries. The aim of the present study was to describe BFlh morphology in youth competitive alpine skiers in relation to sex, age and biological maturation and to investigate its association with the occurrence of traumatic lower extremity injuries in the upcoming season. 95 youth skiers underwent anthropometric measurements, maturity offset estimations and ultrasound assessment, followed by 12-months prospective injury surveillance. Unpaired t tests showed that the two sexes did not differ in BFlh morphology, including fascicle length (Lf), pennation angle (PA), muscle thickness (MT) and average anatomical cross-sectional area (ACSAavg). In contrast, U16 skiers had longer fascicles than U15 skiers (9.5 ± 1.3 cm vs 8.9 ± 1.3 cm, p < 0.05). Linear regression analyses revealed that maturity offset was associated with Lf (R2 = 0.129, p < 0.001), MT (R2 = 0.244, p < 0.001) and ACSAavg (R2 = 0.065, p = 0.007). No association was found between maturity offset and PA (p = 0.524). According to a binary logistic regression analysis, ACSAavg was significantly associated with the occurrence of traumatic lower extremity injuries (Chi-square = 4.627, p = 0.031, RNagelkerke2 = 0.064, Cohen f = 0.07). The present study showed that BFlh morphology is age- and biological maturation-dependent and that BFlh ACSAavg can be considered a relevant modifiable variable associated with lower extremity injuries in youth competitive alpine skiers.

High end ultrasonography devices lack in portability and are expensive. We investigated the agreement and reliability of a handheld and portable ultrasound system for human lower limb muscle architecture measurements. We captured ultrasound images of the rectus femoris (RF), vastus lateralis (VL) and gastrocnemius medialis (GM) in 36 active healthy participants (15 female, 21 male) at 50% of muscle length using the handheld Lumify (L12-4, linear-array 37 mm, Philips Healthcare, Amsterdam, Netherlands) and a high-end laboratory device (ACUSON Juniper, linear-array 54 mm, 12L3, SIEMENS Healthineers, Erlangen, Germany). We compared measurements of muscle fascicle length, pennation angle and thickness. To assess inter-session reliability of the Lumify system, participants were measured twice within 1 week. Comparing RF architecture measurements of both devices resulted in intra-class correlations (ICCs) ranging from 0.46–0.82 and standardized mean difference (SMDs) ranging from −0.45–0.05. For VL, ICCs ranged from 0.60–0.89 and SMDs ranged from −0.11–0.13. ICCs and SMDs for the GM ranged from 0.82–0.86 and −0.07–0.07. Calculating inter-session reliability for RF resulted in ICCs ranging from 0.44–0.76 and SMDs ranging from −0.38–0.15. For VL, ICCs and SMDs ranged from 0.57–0.75 and −0.13–0.02. ICCs for GM ranged from 0.75–0.92 and SMDs ranged from −0.15–0.16. Measurement of muscle thickness demonstrated the highest agreement (ICC ≥0.82) and reliability (ICC ≥0.75) across all muscles. The Lumify system was comparable to a high-end device and reliable for GM measurements. However, agreement and reliability were lower for the RF and VL. Of all evaluated architectural parameters, muscle thickness exhibited highest agreement and reliability.

PurposeTo investigate the time-course of changes in knee-extensors muscle mass, architecture and function in response to plyometric training (PLT) performed on a novel training device, the Tramp-Trainer. This machine consists in a trampoline connected to an inclined sledge which allows the performance of repeated jumps while the subject is sitting on a chair.MethodsEight healthy males (173.6 ± 4.7 cm, 69.7 ± 13.5 kg, 25.3 ± 4.6 years) underwent 6 weeks of bilateral PLT on the tramp-trainer machine. Training was performed three times per week (between 120 and 150 bounces per session). Knee-extensor maximum voluntary torque (MVT) and power, quadriceps femoris (QF) volume (VOL), cross-sectional area from the 20% to the 60% of femur length and CSAmean, together with vastus lateralis (VL) architecture (fascicle length, Lf, and pennation angle, PA) were assessed after 2, 4, and 6 weeks of PLT.ResultsAll results are presented as changes versus baseline values. MVT increased by 17.8% (week 2, p < 0.001) and 22.2% (week 4, p < 0.01), respectively, and declined to 13.3% (p < 0.05) at week 6 of PLT. Power increased by 18.2% (week 4, p < 0.05) and 19.7% (week 6, p < 0.05). QF VOL increased by 4.7% (week 4, p < 0.05) and 5.8% (week 6, p < 0.01); VL VOL increased by 5.2%, (p < 0.05), 8.2%, (p < 0.01), and 9.6% (p < 0.05) at weeks 2, 4, and 6, respectively. An increase in Lf was detected already at wk 2 (2.2%, p < 0.05), with further increase at 4 and 6 weeks of PLT (4 and 4.4%, respectively, p < 0.01). PA increased by 5.8% (p < 0.05) at week 6. Significant positive correlations were found between CSAmean and Power (R2 = 0.46, p < 0.001) and between QF VOL and Power (R2 = 0.44, p < 0.024).ConclusionsPLT induced rapid increases in muscle volume, fascicle length, pennation angle, torque and power in healthy younger adults. Notably, changes in VL VOL and Lf were detectable already after 2 weeks, followed by increases in knee extensors VOL and power from week 4 of PLT. Since the increase in CSAmean and QF VOL cannot fully explain the increment in muscle power, it is likely that other factors (such as adaptations in neural drive or tendon mechanical properties) may have contributed to such fucntional changes.

IntroductionGene polymorphisms are associated with athletic phenotypes relying on maximal or continued power production and affect the specialization of skeletal muscle composition with endurance or strength training of untrained subjects. We tested whether prominent polymorphisms in genes for angiotensin converting enzyme (ACE), tenascin-C (TNC), and actinin-3 (ACTN3) are associated with the differentiation of cellular hallmarks of muscle metabolism and contraction in high level athletes.MethodsMuscle biopsies were collected from m. vastus lateralis of three distinct phenotypes; endurance athletes (n = 29), power athletes (n = 17), and untrained non-athletes (n = 63). Metabolism-, and contraction-related cellular parameters (such as capillary-to-fiber ratio, capillary length density, volume densities of mitochondria and intramyocellular lipid, fiber mean cross sectional area (MCSA) and volume densities of myofibrils) and the volume densities of sarcoplasma were analyzed by quantitative electron microscopy of the biopsies. Gene polymorphisms of ACE (I/D (insertion/deletion), rs1799752), TNC (A/T, rs2104772), and ACTN3 (C/T, rs1815739) were determined using high-resolution melting polymerase chain reaction (HRM-PCR). Genotype distribution was assessed using Chi2 tests. Genotype and phenotype effects were analyzed by univariate or multivariate analysis of variance and post hoc test of Fisher. P-values below 0.05 were considered statistically significant.ResultsThe athletes demonstrated the specialization of metabolism- and contraction-related cellular parameters. Differences in cellular parameters could be identified for genotypes rs1799752 and rs2104772, and localized post hoc when taking the interaction with the phenotype into account. Between endurance and power athletes these concerned effects on capillary length density for rs1799752 and rs2104772, fiber type distribution and volume densities of myofibrils (rs1799752), and MSCA (rs2104772). Endurance athletes carrying the I-allele of rs1799752 demonstrated 50%-higher volume densities of mitochondria and sarcoplasma, when power athletes that carried only the D-allele showed the highest fiber MCSAs and a lower percentage of slow type muscle fibers.DiscussionACE and tenascin-C gene polymorphisms are associated with differences in cellular aspects of muscle metabolism and contraction in specifically-trained high level athletes. Quantitative differences in muscle fiber type distribution and composition, and capillarization in knee extensor muscle explain, in part, identified associations of the insertion/deletion genotypes of ACE (rs1799752) with endurance- and power-type Sports.

The preservation of muscle power is crucial in aging for maintaining mobility and performing daily tasks. Resistance training involving high movement velocities represents a valid strategy to slow down the rate of sarcopenia, counteracting the loss of muscle mass and muscle power. Plyometric exercise may represent an effective training modality for increasing muscle power; however, its application in older populations has been sparingly investigated, as the high impact actions involved may reduce its feasibility for older individuals. By adopting a safer modality of plyometric training, we investigated if a 6-week plyometric training intervention could increase knee extensor muscle size, architecture, force and power in 14 young (YM, age = 25.4 ± 3.5 y; means ± SD) and nine older males (OM, age = 69.7 ± 3.4 y). Volunteers trained 3 times/week using a device similar to a leg press machine where the user was required to bounce against his body mass on a trampoline. Pre-to-post training changes in isometric maximum voluntary torque (MVT), leg extension power and vastus lateralis (VL) architecture were assessed. Muscle power increased in both groups (+27% OM -P < 0.001, 20% YM -P < 0.001), although the total external work performed during the training period was significantly lower for OM (i.e., ~-47%). Both groups showed significant increases in muscle thickness (MT) (+5.8 OM -P < 0.01 vs. +3.8% YM -P < 0.01), fascicle length (Lf) (+8% OM -P < 0.001 vs. +6% YM -P < 0.001), and pennation angle (PA) (+7.5% OM -P < 0.001 vs. +4.1% YM -P < 0.001). The current study shows that trampoline-based plyometric training is an effective intervention producing a rapid increase in muscle mass and power in both young and older individuals. The training modality used in this study seems to particularly benefit the older population, targeting the morphological and functional effects of sarcopenia in human muscle.

Competitive alpine skiers are subject to substantial risks of injury, especially concerning the anterior cruciate ligament (ACL). During “landing back weighted” episodes, hamstrings may partially counteract the anterior shear force acting on the tibia by eccentrically resisting the boot-induced drawer of the tibia relative to the femur. The aim of the present study was to provide novel descriptive data and sport-specific reference values on maximal eccentric hamstrings strength (MEHS) in competitive alpine skiers from youth to elite level, and to explore potential relationships with sex, age and biological maturation. 170 competitive alpine skiers were investigated: 139 youth athletes (51 females, 88 males; age: 13.8 ± 0.59 years) and 31 elite athletes (19 females, 12 males; age: 21.7 ± 2.8 years). MEHS was assessed by the (Vald Performance, Newstead, Australia). U15 female skiers presented lower MEHS compared to female elite skiers for both limbs (R = 210 ± 44 N vs. 340 ± 48 N, respectively, p < 0.001, and L = 207 ± 46 N vs. 303 ± 35 N, respectively, p < 0.001). Similarly, lower MEHS was observed in U15 male skiers compared to male elite skiers for both limbs (R = 259 ± 51 N vs. 486 ± 62 N, respectively, p < 0.001, and L = 258 ± 57 N vs. 427 ± 54 N, respectively, p < 0.001). Correlations between MEHS and chronological age were modestly significant only for the U15 group (r = 0.37 and p < 0.001). When the correlations for the U15 group were performed between MHES and maturity offset (obtained from the calculation of biological age, i.e., age at peak height velocity), statistical significance was reached by all the correlations run for 3 variables (Males < 0: r = 0.59, p < 0.0001; Males > 0: r = 0.70, p < 0.0001; and Females > 0: r = 0.46, p < 0.0001, start of maturity offset = 0). This cross-sectional description of MEHS in alpine skiers from youth to elite level highlights the importance of biological maturation for MEHS values in youth athletes and presents novel data that may offer insights into new approaches for injury prevention.

We investigated molecular and cellular parameters which set metabolic and mechanical functioning of knee extensor muscles in the operated and contralateral control leg of 9 patients with a chronically insufficient anterior cruciate ligament (ACL; 26.6 ± 8.3 years, 8 males, 1 female) after open reconstructive surgery (week 0), after ambulant physiotherapy under cast immobilization (week 9), succeeding rehabilitation training (up to week 26), and subsequent voluntary physical activity (week 260). Clinical indices of knee function in the operated leg were improved at 52 weeks and remained at a comparable level at week 260. CSA of the quadriceps (-18%), MCSA of muscle fibers (-24%), and capillary-to-fiber ratio (-24%) in m. vastus lateralis from the ACL insufficient leg were lower at week 0 than reference values in the contralateral leg at week 260. Slow type fiber percentage (-35%) and mitochondrial volume density (-39%) were reduced in m. vastus lateralis from the operated leg at weeks 9 and 26. Composition alterations in the operated leg exceeded those in the contralateral leg and, with the exception of the volume density of subsarcolemmal mitochondria, returned to the reference levels at week 260. Leg-specific deterioration of metabolic characteristics in the vasti from the operated leg was reflected by the down-regulation of mitochondrial respiration complex I-III markers (-41–57%) at week 9. After rehabilitation training at week 26, the specific Y397 phosphorylation of focal adhesion kinase (FAK), which is a proxy for mechano-regulation, was elevated by 71% in the operated leg but not in the contralateral leg, which had performed strengthening type exercise during ambulant physiotherapy. Total FAK protein and Y397 phosphorylation levels were lowered in both legs at week 26 resulting in positive correlations with mitochondrial volume densities and mitochondrial protein levels. The findings emphasize that a loss of mechanical and metabolic characteristics in knee extensor muscle remains detectable years after untreated ACL rupture, which may be aggravated in the post-operative phase by the deterioration of slow-oxidative characteristics after reconstruction due to insufficient load-bearing muscle activity. The reestablishment of muscle composition subsequent to years of voluntary physical activity reinforces that slow-to-fast fiber transformation is reversible in humans.

Skeletal muscle contracts either by shortening or lengthening (concentrically or eccentrically, respectively); however, the two contractions substantially differ from one another in terms of mechanisms of force generation, maximum force production and energy cost. It is generally known that eccentric actions generate greater force than isometric and concentric contractions and at a lower metabolic cost. Hence, by virtue of the greater mechanical loading involved in active lengthening, eccentric resistance training (ECC RT) is assumed to produce greater hypertrophy than concentric resistance training (CON RT). Nonetheless, prevalence of either ECC RT or CON RT in inducing gains in muscle mass is still an open issue, with some studies reporting greater hypertrophy with eccentric, some with concentric and some with similar hypertrophy within both training modes. Recent observations suggest that such hypertrophic responses to lengthening vs. shortening contractions are achieved by different adaptations in muscle architecture. Whilst the changes in muscle protein synthesis in response to acute and chronic concentric and eccentric exercise bouts seem very similar, the molecular mechanisms regulating the myogenic adaptations to the two distinct loading stimuli are still incompletely understood.Thus, the present review aims to, (a) critically discuss the literature on the contribution of eccentric vs. concentric loading to muscular hypertrophy and structural remodeling, and, (b) clarify the molecular mechanisms that may regulate such adaptations.We conclude that, when matched for either maximum load or work, similar increase in muscle size is found between ECC and CON RT. However, such hypertrophic changes appear to be achieved through distinct structural adaptations, which may be regulated by different myogenic and molecular responses observed between lengthening and shortening contractions.

The purpose of the present study was to elucidate how plyometric training improves stretch-shortening cycle (SSC) exercise performance in terms of muscle strength, tendon stiffness, and muscle-tendon behavior during SSC exercise. Eleven men were assigned to a training group and ten to a control group. Subjects in the training group performed depth jumps (DJ) using only the ankle joint for 12 weeks. Before and after the period, we observed reaction forces at foot, muscle-tendon behavior of the gastrocnemius, and electromyographic activities of the triceps surae and tibialis anterior during DJ. Maximal static plantar flexion strength and Achilles tendon stiffness were also determined. In the training group, maximal strength remained unchanged while tendon stiffness increased. The force impulse of DJ increased, with a shorter contact time and larger reaction force over the latter half of braking and initial half of propulsion phases. In the latter half of braking phase, the average electromyographic activity (mEMG) increased in the triceps surae and decreased in tibialis anterior, while fascicle behavior of the gastrocnemius remained unchanged. In the initial half of propulsion, mEMG of triceps surae and shortening velocity of gastrocnemius fascicle decreased, while shortening velocity of the tendon increased. These results suggest that the following mechanisms play an important role in improving SSC exercise performance through plyometric training: (1) optimization of muscle-tendon behavior of the agonists, associated with alteration in the neuromuscular activity during SSC exercise and increase in tendon stiffness and (2) decrease in the neuromuscular activity of antagonists during a counter movement. [ABSTRACT FROM AUTHOR]