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Purpose: Knee flexor electromechanical delay (EMD) has been proposed as a contributing factor to non-contact anterior cruciate ligament (ACL) injury risk and the semitendinosus (ST) autograft technique has been shown to impair knee flexor torque at large angles of knee flexion. The purpose of this study was to analyse the effects of ACL reconstruction (ACLR) using the ST tendon autograft technique on knee flexor EMD across the knee flexion range of motion, in athletes who had returned to competition., Methods: Athletes with ACLR (n = 8 females, n = 3 males, 1.7 ± 0.5 years post-surgery) and non-injured control athletes (n = 6 females, n = 4 males) performed rapid maximal voluntary contractions of isometric knee flexion and extension at 30°, 50°, 70°, 90°,and 105° of knee flexion. Electrical activity of the ST, biceps femoris (BF), vastus lateralis, and vastus medialis was recorded using surface electromyography., Results: No change in EMD for the knee flexors or extensors was observed across joint angles. Greater EMD was found only for the BF in the ACLR limb of injured athletes compared to the contralateral limb (P < 0.05). In post-hoc analysis, evidence of ST tendon regrowth was noted for only 2/11 athletes., Conclusion: While the EMD-joint angle relationship appeared to be unaffected by ST tendon harvest for ACLR, the absence of ST tendon regrowth should be considered. Despite return to competition, greater BF EMD was found, which may impair knee joint stabilization capacity by delaying the transfer time of muscle tension to the tibia after ST autograft.

Purpose: To assess the stiffness of hamstring muscles during isometric contractions in healthy individuals, using ultrasound-based shear wave elastography to (1) determine the intra- and inter-day assessment repeatability, (2) characterize the stiffness of semitendinosus (ST) and biceps femoris long head (BFlh) along the contraction intensity, and (3) characterize stiffness distribution among the hamstring muscles and inter-limb symmetry., Methods: Two experiments were conducted. In experiment I (n = 12), the intra-day repeatability in assessing the BFlh and ST stiffness were determined at intensities between 10-60% of maximal voluntary isometric contraction (MVIC) in a single session. In experiment II (n = 11), the stiffness of the hamstring muscles of both thighs was assessed at 20% of MVIC in the first session; and retested (for one randomly chosen thigh) in a second session. Isometric contraction of knee flexors was performed with the knee flexed at 30° and with the hip in a neutral position., Results: Moderate-to-very-high intra- and inter-day repeatability was found (ICC = 0.69-0.93). The BFlh/ST stiffness ratio increased with contraction intensity. At 20% of MVIC, the ST showed the highest stiffness among the hamstring muscles (p < 0.02), with no differences between the remaining hamstring muscles (p > 0.474). No differences were found between limbs (p = 0.12)., Conclusions: The stiffness distribution among the hamstring muscles during submaximal isometric contractions is heterogeneous, but symmetric between limbs, and changes depending on the contraction intensity. Shear wave elastography is a reliable tool to assess the stiffness of hamstring muscles during contraction.