Hamstring and Quadriceps Muscle Strength in Youth to Senior Elite Soccer: A Cross-Sectional Study Including 125 Players

in International Journal of Sports Physiology and Performance
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Purpose: Increasing age, high quadriceps strength, and low hamstring muscle strength are associated with hamstring strain injury in soccer. The authors investigated the age-related variation in maximal hamstring and quadriceps strength in male elite soccer players from under-13 (U-13) to the senior level. Methods: A total of 125 elite soccer players were included from a Danish professional soccer club and associated youth academy (first tier; U-13, n = 19; U-14, n = 16; U-15, n = 19; U-17, n = 24; U-19, n = 17; and senior, n = 30). Maximal voluntary isometric force was assessed for the hamstrings at 15° knee joint angle and for the quadriceps at 60° knee joint angle (0° = full extension) using an external-fixated handheld dynamometer. Hamstring-to-quadriceps strength (H:Q) ratio and hamstring and quadriceps maximal voluntary isometric force levels were compared across age groups (U-13 to senior). Results: Senior players showed 18% to 26% lower H:Q ratio compared with all younger age groups (P ≤ .026). Specific H:Q ratios (mean [95% confidence interval]) were as follows: senior, 0.45 (0.42–0.48); U-19, 0.61 (0.55–0.66); U-17, 0.56 (0.51–0.60); U-15, 0.59 (0.54–0.64); U-14, 0.54 (0.50–0.59); and U-13, 0.57 (0.51–0.62). Hamstring strength increased from U-13 to U-19 with a significant drop from U-19 to the senior level (P = .048), whereas quadriceps strength increased gradually from U-13 to senior level. Conclusion: Elite senior soccer players demonstrate lower H:Q ratio compared with youth players, which is driven by lower hamstring strength at the senior level compared with the U-19 level combined with a higher quadriceps strength. This discrepancy in hamstring and quadriceps strength capacity may place senior-level players at increased risk of hamstring muscle strain injuries.

Ishøi, Krommes, Nielsen, Thornton, Hölmich, Penalver, and Thorborg are with the Dept of Orthopedic Surgery, Sports Orthopedic Research Center—Copenhagen (SORC-C), Copenhagen University Hospital, Amager-Hvidovre, Denmark; Thorborg is also with Physical Medicine & Rehabilitation Research—Copenhagen (PMR-C) at the hospital. Aagaard is with the Dept of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.

Ishøi (lasse.ishoei@regionh.dk) is corresponding author.

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  • 1.

    Ueblacker P, Muller-Wohlfahrt HW, Ekstrand J. Epidemiological and clinical outcome comparison of indirect (‘strain’) versus direct (‘contusion’) anterior and posterior thigh muscle injuries in male elite football players: UEFA Elite League study of 2287 thigh injuries (2001–2013). Br J Sports Med. 2015;49(22):14611465.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Timmins RG, Bourne MN, Shield AJ, Williams MD, Lorenzen C, Opar DA. Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study. Br J Sports Med. 2016;50(24):15241535. PubMed ID: 26675089

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Raya-Gonzalez J, Suarez-Arrones L, Navandar A, Balsalobre-Fernandez C, Saez de Villarreal E. Injury profile of elite male young soccer players in a Spanish professional soccer club: a prospective study during 4 consecutive seasons. J Sport Rehabil. 2019;29(6):801–807. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Ekstrand J, Hagglund M, Walden M. Epidemiology of muscle injuries in professional football (soccer). Am J Sports Med. 2011;39(6):12261232. PubMed ID: 21335353

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Buchheit M, Mendez-Villanueva A, Simpson BM, Bourdon PC. Match running performance and fitness in youth soccer. Int J Sports Med. 2010;31(11):818825. PubMed ID: 20703978

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Houtmeyers K, Jaspers A, Brink M, Vanrenterghem J, Varley M, Helsen W. External load differences between elite youth and professional football players: ready for take-off? Sci Med Football. 2021;5(1):1–5. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Haugen TA, Tonnessen E, Seiler S. Anaerobic performance testing of professional soccer players 1995–2010. Int J Sports Physiol Perform. 2013;8(2):148156. doi: PubMed ID: 22868347

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Schache AG, Blanch PD, Dorn TW, Brown NA, Rosemond D, Pandy MG. Effect of running speed on lower limb joint kinetics. Med Sci Sports Exerc. 2011;43(7):12601271. PubMed ID: 21131859

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Ishoi L, Aagaard P, Nielsen MF, et al. The influence of hamstring muscle peak torque and rate of torque development for sprinting performance in football players: a cross-sectional study. Int J Sports Physiol Perform. 2019;14(5):665673. doi: PubMed ID: 30427242

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Forbes H, Bullers A, Lovell A, McNaughton LR, Polman RC, Siegler JC. Relative torque profiles of elite male youth footballers: effects of age and pubertal development. Int J Sports Med. 2009;30(8):592597. PubMed ID: 19468968

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Peek K, Gatherer D, Bennett KJM, Fransen J, Watsford M. Muscle strength characteristics of the hamstrings and quadriceps in players from a high-level youth football (soccer) academy. Res Sports Med. 2018;26(3):276288. PubMed ID: 29506423

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Freckleton G, Pizzari T. Risk factors for hamstring muscle strain injury in sport: a systematic review and meta-analysis. Br J Sports Med. 2013;47(6):351358. PubMed ID: 22763118

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Vandenbroucke JP, von Elm E, Altman DG, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Epidemiology. 2007;18(6):805835. PubMed ID: 18049195

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Maniar N, Shield AJ, Williams MD, Timmins RG, Opar DA. Hamstring strength and flexibility after hamstring strain injury: a systematic review and meta-analysis. Br J Sports Med. 2016;50(15):909920. PubMed ID: 27075962

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Rabano-Munoz A, Asian-Clemente J, Saez de Villarreal E, Nayler J, Requena B. Age-related differences in the physical and physiological demands during small-sided games with floaters. Sports. 2019;7(4):79.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Thorborg K, Bandholm T, Holmich P. Hip- and knee-strength assessments using a hand-held dynamometer with external belt-fixation are inter-tester reliable. Knee Surg Sports Traumatol Arthrosc. 2013;21(3):550555. PubMed ID: 22773065

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Mentiplay BF, Perraton LG, Bower KJ, et al. Assessment of lower limb muscle strength and power using hand-held and fixed dynamometry: a reliability and validity study. PLoS One. 2015;10(10):e0140822. PubMed ID: 26509265

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Cohen J. A power primer. Psychol Bull. 1992;112(1):155159. PubMed ID: 19565683

  • 19.

    Forbes H, Sutcliffe S, Lovell A, McNaughton LR, Siegler JC. Isokinetic thigh muscle ratios in youth football: effect of age and dominance. Int J Sports Med. 2009;30(8):602606. PubMed ID: 19301218

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Risberg MA, Steffen K, Nilstad A, et al Normative quadriceps and hamstring muscle strength values for female, healthy, elite handball and football players. J Strength Cond Res. 2018;32(8):23142323. PubMed ID: 29794892

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Markovic G, Sarabon N, Boban F, et al. Nordic hamstring strength of highly trained youth football players and its relation to sprint performance. J Strength Cond Res. 2020; 34(3):800807. PubMed ID: 30239451 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Roe M, Malone S, Delahunt E, et al. Eccentric knee flexor strength profiles of 341 elite male academy and senior Gaelic football players: do body mass and previous hamstring injury impact performance? Phys Ther Sport. 2018;31:6874. PubMed ID: 29503012

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Chalker WJ, Shield AJ, Opar DA, Keogh JW. Comparisons of eccentric knee flexor strength and asymmetries across elite, sub-elite and school level cricket players. PeerJ. 2016;4:e1594. PubMed ID: 26925310

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Bourne MN, Opar DA, Williams MD, Shield AJ. Eccentric knee flexor strength and risk of hamstring injuries in rugby union: a prospective study. Am J Sports Med. 2015;43(11):26632670. PubMed ID: 26337245

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Fiorentino NM, Rehorn MR, Chumanov ES, Thelen DG, Blemker SS. Computational models predict larger muscle tissue strains at faster sprinting speeds. Med Sci Sports Exerc. 2014;46(4):776786. PubMed ID: 24145724

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Wollin M, Thorborg K, Drew M, Pizzari T. A novel hamstring strain injury prevention system: post-match strength testing for secondary prevention in football. Br J Sports Med. 2020;54(9):498499. PubMed ID: 31630091 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Ishoi L, Krommes K, Husted RS, Juhl CB, Thorborg K. Diagnosis, prevention and treatment of common lower extremity muscle injuries in sport—grading the evidence: a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF). Br J Sports Med. 2020;54(9):528537. PubMed ID: 31937579 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Dowson MN, Nevill ME, Lakomy HK, Nevill AM, Hazeldine RJ. Modelling the relationship between isokinetic muscle strength and sprint running performance. J Sports Sci. 1998;16(3):257265. PubMed ID: 9596360

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Fritsch CG, Dornelles MP, Oliveira GDS, Baroni BM. Poor hamstrings-to-quadriceps torque ratios in male soccer players: weak hamstrings, strong quadriceps, or both? Sports Biomech. Published online June 8, 2020. doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Morgan DL. New insights into the behavior of muscle during active lengthening. Biophys J. 1990;57(2):209221. PubMed ID: 2317547

  • 31.

    Small K, McNaughton L, Greig M, Lovell R. The effects of multidirectional soccer-specific fatigue on markers of hamstring injury risk. J Sci Med Sport. 2010;13(1):120125. PubMed ID: 18976956

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Lovell R, Whalan M, Marshall PWM, Sampson JA, Siegler JC, Buchheit M. Scheduling of eccentric lower limb injury prevention exercises during the soccer micro-cycle: which day of the week? Scand J Med Sci Sports. 2018;28(10):22162225. PubMed ID: 29797592

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Sangnier S, Tourny-Chollet C. Comparison of the decrease in strength between hamstrings and quadriceps during isokinetic fatigue testing in semiprofessional soccer players. Int J Sports Med. 2007;28(11):952957. PubMed ID: 17497573

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Jimenez-Rubio S, Navandar A, Rivilla-Garcia J, Paredes-Hernandez V, Gomez-Ruano MA. Improvements in match-related physical performance of professional soccer players after the application of an on-field training program for hamstring injury rehabilitation. J Sport Rehabil. 2019;29(8):1145–1150. doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Cunha GDS, Vaz MA, Herzog W, Geremia JM, Leites GT, Reischak-Oliveira A. Maturity status effects on torque and muscle architecture of young soccer players. J Sports Sci. 2020;38(11–12):12861295. PubMed ID: 30896284

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Lee JWY, Mok KM, Chan HCK, Yung PSH, Chan KM. Eccentric hamstring strength deficit and poor hamstring-to-quadriceps ratio are risk factors for hamstring strain injury in football: a prospective study of 146 professional players. J Sci Med Sport. 2018;21(8):789793. PubMed ID: 29233665

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Vicens-Bordas J, Esteve E, Fort-Vanmeerhaeghe A, Clausen MB, Bandholm T, Opar D, Shield A, Thorborg K. Eccentric hamstring strength is associated with age and duration of previous season hamstring injury in male soccer players. Int J Sports Phys Ther. 2020;15(2):246253. PubMed ID: 32269858

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Vicens-Bordas J, Esteve E, Fort-Vanmeerhaeghe A, et al. Performance changes during the off-season period in football players—effects of age and previous hamstring injury. J Sports Sci. 2020;38(21):2489–2499. doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Owen A, Dunlop G, Rouissi M, et al. The relationship between lower-limb strength and match-related muscle damage in elite level professional European soccer players. J Sports Sci. 2015;33(20):21002105. PubMed ID: 26158195

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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