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Updated: Sep 22, 2025

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Muscle Imbalances: Testing and Training Functional Eccentric Hamstring Strength in Athletic Populations
Published on: May 1, 2018
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The hamstrings to quadriceps functional ratio expressed over the full angle-angular velocity range using a limited
Dimitrios Voukelatos1, Pavlos E Evangelidis2, Matthew T G Pain1
1School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK.
Royal Society Open Science
|May 23, 2022
Summary
The traditional hamstring to quadriceps (H:Q) strength ratio may not accurately predict hamstring injuries. A new 3D model offers a more comprehensive assessment of knee muscle balance for injury screening.
Area of Science:
- Biomechanics
- Sports Medicine
- Musculoskeletal Research
Background:
- The hamstring to quadriceps (H:Q) strength ratio is a common metric for assessing hamstring strain injury risk.
- Current H:Q ratio calculations are limited, often providing only 1D or 2D representations and neglecting crucial muscle mechanics.
Purpose of the Study:
- To develop and validate a novel 3D functional H:Q ratio model.
- To improve the accuracy and comprehensiveness of H:Q ratio assessment for injury risk identification.
Main Methods:
- Collected isokinetic torque data for knee flexors and extensors (0-400° s⁻¹) in 25 physically active males.
- Derived a model equation to create a 3D H:Q functional ratio profile.
- Tested model robustness with varying data points (8, 11, 14, 17) and joint angle perturbations (5°).
Main Results:
- The 3D H:Q functional ratio model demonstrated robustness and consistency across tested conditions, performing well with as few as 11 data points.
- The model accurately described the H:Q functional ratio even at unassessed angles and velocities.
- Model performance was slightly reduced with only 8 data points (R² = 0.84-0.96; RMSE = 0.14-0.25; NRMSE = 0.12-0.27).
Conclusions:
- The developed 3D H:Q functional ratio model provides a fast, accurate, and comprehensive assessment of knee joint muscle strength balance.
- This model has the potential to serve as an easily implementable screening tool for identifying individuals at risk of hamstring strain injuries.

