Latest research in football - week 48 - 2020

#1 Concussion in soccer: a comprehensive review of the literature
Reference: Concussion. 2020 Jul 1;5(3):CNC76. doi: 10.2217/cnc-2020-0004.
Authors: James Mooney, Mitchell Self, Karim ReFaey, Galal Elsayed, Gustavo Chagoya, Joshua D Bernstock, James M Johnston
Summary: Sports-related concussion has been examined extensively in collision sports such as football and hockey. However, historically, lower-risk contact sports such as soccer have only more recently garnered increased attention. Here, we review articles examining the epidemiology, injury mechanisms, sex differences, as well as the neurochemical, neurostructural and neurocognitive changes associated with soccer-related concussion. From 436 titles and abstracts, 121 full texts were reviewed with a total of 64 articles identified for inclusion. Concussion rates are higher during competitions and in female athletes with purposeful heading rarely resulting in concussion. Given a lack of high-level studies examining sports-related concussion in soccer, clinicians and scientists must focus research efforts on large-scale data gathering and development of improved technologies to better detect and understand concussion.


#2 The Effects of Long-Term Magnesium Creatine Chelate Supplementation on Repeated Sprint Ability (RAST) in Elite Soccer Players
Reference: Nutrients. 2020 Sep 28;12(10):E2961. doi: 10.3390/nu12102961.
Authors: Adam Zajac, Artur Golas, Jakub Chycki, Mateusz Halz, Małgorzata Magdalena Michalczyk
Download link: https://www.mdpi.com/2072-6643/12/10/2961/pdf
Summary: The aim of the study was to evaluate the effects of 16 weeks of a low dose of magnesium creatine chelate supplementation on repeated sprint ability test (RAST) results in elite soccer players. Twenty well-trained soccer players participated in the study. The players were divided randomly into two groups: the supplemented group (SG = 10) and placebo group (PG = 10). Out of the 20 subjects selected for the study, 16 (SG = 8, PG = 8) completed the entire experiment. The SG ingested a single dose of 5500 mg of magnesium creatine chelate (MgCr-C), in 4 capsules per day, which was 0.07 g/kg/d. The PG received an identical 4 capsules containing corn starch. Before and after the study, the RAST was performed. In the RAST, total time (TT), first and sixth 35 m sprint length (s), average power (AP) and max power (MP) were measured. Additionally, before and after the test, lactate LA (mmol/L) and acid-base equilibrium pH (-log(H+)), bicarbonates HCO3- (mmol/L) were evaluated. Also, in serum at rest, creatinine (mg/dL) concentration was measured. After the study, significantly better results in TT, AP and MP were observed in the SG. No significant changes in the RAST results were observed in the PG. After the study, significant changes in the first 35 m sprint, as well as the sixth 35 m sprint results were registered in the SG, while insignificant changes occurred in the PG. A significantly higher creatinine concentration was observed. Also, a higher post-RAST concentration of LA, HCO3- and lower values of pH were observed in April, May and June compared with baseline values. The long timeframe, i.e., 16 weeks, of the low dose of magnesium creatine chelate supplementation improved the RAST results in the SG. Despite the long period of MgCr-C supplementation, in the end of the study, the creatinine level in the SG reached higher but still reference values.


#3 Is It High Time to Increase Elite Soccer Substitutions Permanently?
Reference: Int J Environ Res Public Health. 2020 Sep 25;17(19):E7008. doi: 10.3390/ijerph17197008.
Authors: Gustavo R Mota, Izabela Aparecida Dos Santos, Rhaí André Arriel, Moacir Marocolo
Download link: https://www.mdpi.com/1660-4601/17/19/7008/pdf
Summary: Rules determine how team sport matches occur. Match-induced fatigue is specific to each sport, and may be associated with injury incidence. For example, the injury rate in soccer is distinctly higher during matches than in training sessions. Understanding the differences between team sports rules might be useful for enhancing rules (e.g., safer sport). Therefore, this study aimed to evaluate the impact of the rule-induced physical demands between soccer, futsal, basketball, and handball, focusing on substitution rules. Data from the elite team sports' rules (e.g., absolute and relative court dimensions; the number of players, substitutions allowed, total game time, time-outs) were collected, including the changes due to the coronavirus disease (COVID-19) pandemic in soccer substitutions, and comparisons were performed. The data showed that soccer has higher rule-induced physical demands: e.g., substantially lower substitution rate, higher dimensions in absolute (eight to fifteen times), and relative (four to eight times) values. Simulations also showed that soccer has extremely large differences, even considering COVID-19 substitution changes (from three to up to five). We conclude that elite soccer has remarkably higher overall rule-induced physical demands than elite futsal, basketball and handball, and increasing soccer substitutions permanently (e.g., unlimited) might mitigate overall soccer demands.


#4 Diagnostic performance of the Strength and Pain Assessment (SPA) score for non-contact muscle injury screening in male soccer players
Reference: Phys Sportsmed. 2020 Sep 29;1-7. doi: 10.1080/00913847.2020.1824986. Online ahead of print.
Authors: Luca Semperboni, Chiara Vignati, Maria Giulia Ballatore, Anita Tabacco, Chiara Busso, Marco A Minetto
Summary: The aims of this study were to develop a clinical-feature based scoring system for muscle injury screening and to assess its diagnostic accuracy when large number of injuries are suspected. A prospective diagnostic accuracy study was performed according to the Standards for Reporting of Diagnostic Accuracy (STARD) criteria. The diagnostic accuracy of the Strength and Pain Assessment (SPA) score (index test) was assessed in relation to muscle ultrasonography (reference standard). A large (n = 175) number of male soccer players met the inclusion/exclusion criteria: clinical assessment (i.e., evaluation of pain onset modality, location, distribution, impact on performance, and manual muscle strength testing) and ultrasonography were performed in all players after 48 hours from the sudden or progressive onset of muscle pain during or after a soccer competition. 91 of 175 cases (52%) were classified as functional muscle disorders, while signs of muscle tear were observed in the remaining 84 of 175 (48%) cases that were classified as structural muscle injuries. The median (1st - 3rd quartile) value of the SPA score was significantly (P < 0.001) lower in the functional disorder group [9 (9-10)] compared to the structural injury group [12 (12-13)]. The area under the Receiver Operating Characteristic curve for different cutoff points of the SPA score was 0.977 (95% confidence intervals: 0.957-0.998) and the optimal cutoff value of the SPA score providing the greatest sensitivity and specificity (respectively, 99% and 89%) was 11. This study found that the SPA score has high diagnostic accuracy for structural muscle injuries and could be used as a valid screening tool in soccer players presenting with sudden or progressive onset of muscle pain during or after a competition.


#5 Effects of Field Position on Fluid Balance and Electrolyte Losses in Collegiate Women's Soccer Players
Reference: Medicina (Kaunas). 2020 Sep 24;56(10):E502. doi: 10.3390/medicina56100502.
Authors: Haoyan Wang, Kate S Early, Bailey M Theall, Adam C Lowe, Nathan P Lemoine Jr, Jack Marucci, Shelly Mullenix, Neil M Johannsen
Download link: https://www.mdpi.com/1010-660X/56/10/502/pdf
Summary: Research investigating hydration strategies specialized for women's soccer players is limited, despite the growth in the sport. The purpose of this study was to determine the effects of fluid balance and electrolyte losses in collegiate women's soccer players. Eighteen NCAA Division I women's soccer players were recruited (age: 19.2 ± 1.0 yr; weight: 68.5 ± 9.0 kg, and height: 168.4 ± 6.7 cm; mean ± SD), including: 3 forwards (FW), 7 mid-fielders (MD), 5 defenders (DF), and 3 goalkeepers (GK). Players practiced outdoor during spring off-season training camp for a total 14 practices (WBGT: 18.3 ± 3.1 °C). The main outcome measures included body mass change (BMC), sweat rate, urine and sweat electrolyte concentrations, and fluid intake. Results were analyzed for comparison between low (LOW; 16.2 ± 2.6° C, n = 7) and moderate risk environments for hyperthermia (MOD; 20.5 ± 1.5 °C, n = 7) as well as by field position. The majority (54%) of players were in a hypohydrated state prior to practice. Overall, 26.7% of players had a %BMC greater than 0%, 71.4% of players had a %BMC less than -2%, and 1.9% of players had a %BMC greater than -2% (all MD position). Mean %BMC and sweat rate in all environmental conditions were -0.4 ± 0.4 kg (-0.5 ± 0.6% body mass) and 1.03 ± 0.21 mg·cm-2·min-1, respectively. In the MOD environment, players exhibited a greater sweat rate (1.07 ± 0.22 mg·cm-2·min-1) compared to LOW (0.99 ± 0.22 mg·cm-2·min-1; p = 0.02). By position, DF had a greater total fluid intake and a lower %BMC compared to FW, MD, and GK (all p < 0.001). FW had a greater sweat sodium (Na+) (51.4 ± 9.8 mmol·L-1), whereas GK had the lowest sweat sodium (Na+) (30.9 ± 3.9 mmol·L-1). Hydration strategies should target pre-practice to ensure players are adequately hydrated. Environments deemed to be of moderate risk of hyperthermia significantly elevated the sweat rate but did not influence fluid intake and hydration status compared to low-risk environments. Given the differences in fluid balance and sweat responses, recommendations should be issued relative to soccer position.


#6 Use of Numerically Blinded Ratings of Perceived Exertion in Soccer: Assessing Concurrent and Construct Validity
Reference: Int J Sports Physiol Perform. 2020 Sep 28;1-7. doi: 10.1123/ijspp.2019-0740. Online ahead of print.
Authors: Ric Lovell, Sam Halley, Jason Siegler, Tony Wignell, Aaron J Coutts, Tim Massard
Summary: The purpose was to examine the concurrent and construct validity of numerically blinded ratings of perceived exertion (RPEs). A total of 30 elite male youth soccer players (age 16.7 [0.5] y) were monitored during training and matches over a 17-wk in-season period. The players' external loads were determined via raw 10-Hz global positioning system. Heart rate (HR) was collected continuously and expressed as Bannister and Edwards training impulses, and minutes >80% of the players predetermined the maximum HR by the Yo-Yo Intermittent Recovery Test Level 1. RPE was collected confidentially 10 to 15 min after training/matches using 2 methods: (1) a traditional verbal response to the 0 to 100 category-ratio "centiMax" scale (RPE) and (2) numerically blinded RPE centiMax scale (RPEblind) with the response selected manually via a 5 × 7-in tablet "slider." The RPE and RPEblind were divided by 10 and multiplied by the duration to derive the sessional RPE. Linear mixed models compared ratings, and within-subject repeated-measures correlations assessed the sessional RPE versus HR and external load associations. There were no differences between the RPE and RPEblind (0.19; 95% confidence intervals, -0.59 to 0.20 au, P = .326) or their session values (13.5; 95% confidence intervals, -17.0 to 44.0 au, P = .386), and the ratings were nearly perfectly correlated (r = .96). The associations between the sessional RPE versus HR and external load metrics were large to very large (r = .65-.81), with no differences between the RPE methods (P ≥ .50). The RPEblind also reduced verbal anchor clustering and integer bias by 11% and 50%, respectively. RPEblind demonstrated concurrent and construct validity versus the traditional method, and may be used in situations where practitioners have concerns regarding the authenticity of athlete ratings.


#7 Profiling the Post-match Top-up Conditioning Practices of Professional Soccer Substitutes: An Analysis of Contextual Influences
Reference: J Strength Cond Res. 2020 Oct;34(10):2805-2814. doi: 10.1519/JSC.0000000000003721.
Authors: Samuel P Hills, Stephen Barrett, Matt Busby, Liam P Kilduff, Martin J Barwood, Jon N Radcliffe, Carlton B Cooke, Mark Russell
Summary: Soccer practitioners implement "top-up" conditioning sessions to compensate for substitutes' limited match-play exposure. Although perceived to be valuable for reducing injury risk and augmenting positive physical adaptations, little research has considered the demands of post-match top-up training. To quantify post-match top-up responses, 31 professional soccer players wore 10 Hz microelectromechanical systems after 37 matches whereby they were selected in the match-day squad as substitutes (184 observations; 6 ± 5 observations·player). Linear mixed models and effect sizes (ES) assessed the influence of contextual factors on 23 physical performance variables. Top-ups lasted 17.13 ± 7.44 minutes, eliciting total and high-speed distances of 1.7 ± 6.2 km and 0.4 ± 1.7 km, respectively. Each contextual factor (i.e., position, substitution timing, match location, result, time of day, stage of the season, and fixture density) influenced at least 4 of the dependent variables profiled (p ≤ 0.05). Top-up duration; total, moderate-speed, and low-speed distance; and the number of repeated high-intensity efforts were greater for unused vs. used substitutes (ES: 0.38-0.73, small to moderate). Relative to away matches, home top-ups elicited heightened total, low-speed, and high-speed distances, alongside more moderate-speed accelerations and decelerations, and repeated high-intensity efforts (ES: 0.25-0.89, small to moderate). Although absolute and relative running distances were generally the highest when the fixture density was low, the greatest acceleration and deceleration demands were observed during the most congested fixture periods. Late-season top-ups typically elicited lower absolute physical responses than early and mid-season sessions. These data provide important information for practitioners when considering the aims and design of substitute top-up conditioning sessions, particularly with reference to contextual influences.


#8 Effects of Maturation on Physical Fitness Adaptations to Plyometric Drop Jump Training in Male Youth Soccer Players
Reference: J Strength Cond Res. 2020 Oct;34(10):2760-2768. doi: 10.1519/JSC.0000000000003151.
Authors: Tiago Vera-Assaoka, Rodrigo Ramirez-Campillo, Cristian Alvarez, Felipe Garcia-Pinillos, Jason Moran, Paulo Gentil, David Behm
Summary: Effects of maturation on physical fitness adaptations to plyometric drop jump training in male youth soccer players. J Strength Cond Res 34(10): 2760-2768, 2020-The objective of this study was to compare the effects of maturation on physical fitness adaptations to a twice weekly, 7-week plyometric drop jump training program. Seventy-six young male soccer players (aged 10-16 years) participated in this randomized controlled trial. Before and after the intervention, a physical fitness test battery was applied (countermovement jump; drop jump from 20 to 40 cm; 5 multiple bounds test; 20-m sprint time; change of direction speed; 2.4-km running time-trial; 5 repetition maximum [RM] squat; and maximal kicking distance). Participants were randomly divided into an active soccer-control group (CG) with Tanner stage maturation of 1-3 (CG-early; n = 16) or Tanner stage 4-5 (CG-late; n = 22), and to plyometric drop jump training groups with Tanner stage 1-3 (plyometric jump training [PJT]-early; n = 16) or 4-5 (PJT-late; n = 22). The analysis of variance and effect size (ES) measures revealed that when compared with their age-matched controls, the PJT-early (ES = 0.39-1.58) and PJT-late (ES = 0.21-0.65) groups showed greater improvements (p < 0.05) in sprint time, 2.4-km running time-trial, change of direction speed, 5RM squat, jumping, and kicking distance. The PJT-early exceeded the PJT-late group with greater (p < 0.05) improvements in drop jump from 20 cm (ES = 1.58 vs. 0.51) and 40 cm (ES = 0.71 vs. 0.4) and kicking distance (ES = 0.95 vs. 0.65). Therefore, a 7-week plyometric drop jump training program was effective in improving physical fitness traits in both younger and older male youth soccer players, with greater jumping and kicking adaptations in the less-mature athletes.


#9 Does an Optimal Relationship Between Injury Risk and Workload Represented by the "Sweet Spot" Really Exist? An Example From Elite French Soccer Players and Pentathletes
Reference: Front Physiol. 2020 Aug 28;11:1034. doi: 10.3389/fphys.2020.01034. eCollection 2020.
Authors: Adrien Sedeaud, Quentin De Larochelambert, Issa Moussa, Didier Brasse , Jean-Maxence Berrou, Stephanie Duncombe, Juliana Antero, Emmanuel Orhant, Christopher Carling, Jean-Francois Toussaint
Download link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7485291/pdf/fphys-11-01034.pdf
Summary: The aim was to examine the relationships between the occurrence and severity of injuries using three workload ratios (ACWR, EWMA, REDI) in elite female soccer players and international male and female pentathletes. Female soccer players in the U16 to U18 national French teams (n = 24) and international athletes (n = 12, 4 women and 8 men) in the French modern pentathlon team were monitored throughout an entire season. The Acute Chronic Workload Ratio (ACWR), the Exponentially Weighted Moving Averages (EWMA), and the Robust Exponential Decreasing Index (REDI) were calculated for internal load by the ROE method in soccer and external load in pentathlon. The occurrence and severity of injuries (determined according to time-loss) were quantified in the sweet spot zone [0.8; 1.3] and compared to the other zones of load variation: [0; 0.8], [1.3; 1.5], [1.5; +8], using the three ratios. Over the study period, a total of sixty-six injuries (2.75 per athlete) were reported in the soccer players and twelve in pentathletes (1 per athlete). The cumulative severity of all injuries was 788 days lost in soccer and 36 in pentathlon: respectively, 11.9 days lost per injury in soccer player and 3.0 per pentathlete. The mean values across the three methods in soccer showed a higher number of injuries detected in the [0; 0.8] workload ratio zone: 22.3 ± 6.4. They were 17.3 ± 3.5 in the sweet spot ([0.8-1.3] zone) and 17.6 ± 5.5 in the [1.5; +8] zone. In comparison to the [1.5; +8] zone, soccer players reported a higher number of days lost to injuries in the presumed sweet spot and in the [0-0.8] zone: 204.7 ± 28.7 and 275.0 ± 120.7 days, respectively. In pentathletes, ten of the twelve injuries (83.3%) occurred in the presumed sweet spot. REDI was the only method capable of tracking workloads over all-time series. In the present cohort of elite soccer players and pentathletes, acute chronic workload calculations showed an association with injury occurrence and severity but did not provide evidence supporting existence of a sweet spot diminishing injury risk.


#10 Factors Associated with Ball Velocity and Low Back Pain During Kicking in Adolescent Soccer Players
Reference: Open Access J Sports Med. 2020 Sep 7;11:133-143. doi: 10.2147/OAJSM.S262990. eCollection 2020.
Authors: Michio Tojima, Seira Takei , Suguru Torii
Download link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7490067/pdf/oajsm-11-133.pdf
Summary: The factors associated with low back pain (LBP) and the relationship between LBP and ball velocity during kicking motion of adolescent soccer players remain largely unknown. This study aims to clarify the relationship between increasing ball velocity and LBP in adolescent soccer players. Adolescent soccer players were divided into two groups according to the presence and absence of LBP (LBP group, n=38 and NBP (no back pain) group, n=29, respectively). Real-time kick motion was measured using a three-dimensional motion analysis system and the angle of the lumbar spine, hip, and center of mass (COM) were calculated. Regression analysis was used to identify factors associated with ball velocity and LBP. In addition, Pearson's correlation coefficients were determined between the angle of the lumbar spine and hip, and ball velocity and position of COM in the extracted phase from regression analysis. The major factor associated with increasing ball velocity was the rotation angle of both hips (Adjusted R2=0.244) and vertical position of COM during kicking (Adjusted R2=0.262). Furthermore, the factors associated with LBP were the flexion angle of kick-side hip (OR=1.126) and abduction angle of both hips (kick-side OR=1.124; support-side OR=0.872). The factors for ball velocity and LBP were related to the maximum hip extension phase. In the hip extension phase of kicking, compared with the NBP group, the LBP group showed lesser extension and external rotation of the kick-side hip angle. In the hip flexion phase of kicking, the ball velocity was correlated with vertical (r=0.56)/anterior (r=0.46) position of COM in the NBP group. To compensate for this restricted hip motion, the LBP group could extend and rotate their lumbar spine, which may likely cause stress to this region.


#11 Impact of football matches on number of visits to an emergency department

Reference: Emergencias. 2020 Sep;32(5):345-348.
Authors: Sendoa Ballesteros Peña, Irrintzi Fernández Aedo, Gorka Vallejo de la Hoz
Summary: The purpose was to analyze the impact of a local football team's matches on patient demand for hospital emergency department care in Bilbao, in the Spanish province of Biscay. We retrieved the number of patients coming to the emergency department on the days and hours of matches played by Bilbao's Athletic Club during the 2017-2019 and 2018-2019 seasons and compared the caseloads with those on the same days of the weeks before and after the matches (control days). Ninety-five match days were studied. Nineteen of the matches were considered key events. Visits by adults to the emergency department fell by a statistically significant 7.5% (95% CI, 4.6%-11.6%) when matches were being played in Bilbao. The decrease was 8.4% (95% CI, 5.3%-12.6%) when matches were played away. The decrease in pediatric emergencies was 32.7% (95% CI, 7.4%-68.3%) in the hours while important matches were played outside the city. The impact of football on the number of visits to our hospital emergency department was modest, except during important away matches.


#12 Kinematic Analysis of the Postural Demands in Professional Soccer Match Play Using Inertial Measurement Units
Reference: Sensors (Basel). 2020 Oct 22;20(21):E5971. doi: 10.3390/s20215971.
Authors: José M Oliva-Lozano, Elisa F Maraver, Víctor Fortes, José M Muyor
Download link: https://www.mdpi.com/1424-8220/20/21/5971/htm
Summary: The development of wearable sensors has allowed the analysis of trunk kinematics in match play, which is necessary for a better understanding of the postural demands of the players. The aims of this study were to analyze the postural demands of professional soccer players by playing position. A longitudinal study for 13 consecutive microcycles, which included one match per microcycle, was conducted. Wearable sensors with inertial measurement units were used to collect the percentage (%) of playing time spent and G-forces experienced in different trunk inclinations and the inclination required for different speeds thresholds. The inclination zone had a significant effect on the time percentage spent on each zone (p < 0.001, partial eta-squared (ηp2 = 0.85) and the G-forces experienced by the players (p < 0.001, ηp2 = 0.24). Additionally, a significant effect of the speed variable on the trunk inclination zones was found, since trunk flexion increased with greater speeds (p < 0.001; ηp2 = 0.73), except for midfielders. The players spent most of the time in trunk flexion between 20° and 40°; the greatest G-forces were observed in trunk extension zones between 0° and 30°, and a linear relationship between trunk inclination and speed was found. This study presents a new approach for the analysis of players' performance. Given the large volumes of trunk flexion and the interaction of playing position, coaches are recommended to incorporate position-specific training drills aimed to properly prepare the players for the perception-action demands (i.e., visual exploration and decision-making) of the match, as well as trunk strength exercises and other compensatory strategies before and after the match.


#13 Long-term influence of technical, physical performance indicators and situational variables on match outcome in male professional Chinese soccer
Reference: J Sports Sci. 2020 Oct 27;1-11. doi: 10.1080/02640414.2020.1836793. Online ahead of print.
Authors: Changjing Zhou, Alberto Lorenzo Calvo, Sam Robertson, Miguel-Ángel Gómez
Summary: This study aimed to determine whether the role of technical, physical performance indicators and situational variables in determining match outcome has varied from a long-term analysis (seasons 2012 to 2017) of the Chinese Soccer Super League (CSL). The sample included 1,429 matches where 17 technical performance-related indicators, 11 physical performance-related indicators and two situational variables (match location and quality of opposition) were analysed. Three binary logistic regression models (inclusion of different variables) were used to measure the level of association between factors and match outcome over the six seasons studied. Results of models 1 and 2 revealed that shots on target, possession, total distance in ball possession, total distance out of ball possession, and match location exerted a decreased influence on winning the matches from 2012 to 2014 seasons. However, these indicators play a more important role in winning matches from 2014 to 2017 seasons. Additionally, the quality of opposition has a continuously increased negative effect on the match outcome. In model 3, more variables, such as high-speed distance, high-speed out of ball possession, had a meaningful influence on winning the match. These results provide valuable information about performance indicators and situational variables on winning the matches from a long-term approach.


#14 Electromyographic Comparison of Flywheel Inertial Leg Curl and Nordic Hamstring Exercise Among Soccer Players
Reference: Int J Sports Physiol Perform. 2020 Oct 28;1-6. doi: 10.1123/ijspp.2019-0921. Online ahead of print.
Authors: Helene Pedersen, Atle Hole Saeterbakken, Markus Vagle, Marius Steiro Fimland, Vidar Andersen
Summary: The Nordic hamstring exercise (NHE) has been shown to considerably reduce hamstring injuries among soccer players. However, as the load in the NHE is the person's own bodyweight, it is a very heavy exercise and difficult to individualize. The flywheel inertial leg curl (FLC) could be an alternative since the eccentric overload is based on the amount of work produced in the concentric movement. Therefore, the primary aim of this study was to compare the activation in the hamstrings at long muscle lengths in the NHE and the FLC in amateur soccer players. Fifteen male amateur soccer players performed 5 repetitions in each exercise in a randomized and counterbalanced order. The concentric and eccentric movements were divided into lower and upper phases. Surface EMG was measured distally, proximally, and in the middle, at both muscles. In the lower phase in the eccentric movement, there were no significant differences between the 2 exercises (P = .101-.826). In the lower concentric movement, the FLC led to higher activation in all parts of both the biceps femoris (31%-52%, P < .001) and the semitendinosus (20%-35%, P = .001-.023). Both exercises activated the hamstrings similarly at long muscle lengths during eccentric contractions (Nordic hamstring, nonsignificantly higher). However, when performing concentric contractions, the FLC induced higher activations. Therefore, the FLC could be a useful alternative to the NHE and particularly suitable for weaker athletes before progressing to NHE.