Changes in the medial–lateral hamstring activation ratio with foot rotation during lower limb exercise

This paper investigated whether the ratio of medial–lateral hamstring muscular activation could be altered with changes in foot rotation position (both internal and external rotation) during three standard lower limb exercises. It has been suggested that those with medial compartment knee OA activate the lateral hamstrings more than the medial to help unload the diseased compartment; therefore, preferential activation of this muscle during lower limb exercise may help to further decrease the stresses on the articular cartilage and be an effective intervention for knee OA and lateral hamstring injury. Thirteen healthy young adult subjects were tested and average medial and lateral hamstring EMG data during the full exercise, as well as the concentric and eccentric phases, were used to calculate the medial–lateral (M–L) hamstring activation ratio for each exercise and foot position. Results suggest that internal foot rotation increases the M–L hamstring activation ratio while external foot rotation decreases this ratio. Therefore, altering the position of the foot during standard lower limb exercise can help selectively activate the medial or lateral hamstring muscle groups. This selective activation may have implication in treating symptoms of knee osteoarthritis and hamstring injury; but, longitudinal intervention studies would be needed to determine clinical utility.