Associations Between Lower Extremity Myotonic Properties, Strength, and Balance in American Football Players: An...

Background/Objectives: Evidence on the role of muscle mechanical (myotonic) properties in athletic performance remains limited in young adult and sub-elite populations, particularly in American football, and sex-specific patterns of association are not well understood. This study aimed to investigate the associations between lower extremity myotonic properties and performance outcomes (strength and balance) in American football athletes, with a specific focus on sex-related differences and candidate predictors. Methods: A cross-sectional design was implemented involving 35 American football athletes (17 female, 18 male). Lower extremity muscle tone, stiffness, and elasticity were assessed using MyotonPRO. Strength parameters (lower limb, handgrip, back, and shoulder internal rotation) and balance performance (static and dynamic under eyes-open and eyes-closed conditions) were evaluated using standardized measurement protocols. Pearson correlation analysis was conducted to examine bivariate associations, followed by Least Absolute Shrinkage and Selection Operator (LASSO) regression to determine candidate predictors while addressing multicollinearity. Results: Male athletes exhibited significantly greater height, body mass, and BMI (p < 0.001), alongside elevated myotonic values compared to females. Correlation analyses indicated distinct sex-specific association patterns between myotonic properties and performance metrics. LASSO regression revealed a distinct sex-specific divergence in strength prediction: female strength was predominantly driven by proximal musculature (quadriceps and hamstring elasticity/stiffness), whereas male strength was anchored by distal musculature (gastrocnemius tone/stiffness). Furthermore, rigorous penalization shrunk nearly all balance coefficients to zero in both sexes, indicating that resting myotonic properties do not independently predict dynamic or static postural control. Conclusions: While lower extremity myotonic properties are candidate predictors of multi-regional strength via sex-specific proximal and distal strategies, they do not independently predict balance performance, suggesting postural control relies primarily on active motor recruitment rather than passive resting mechanics. Given the cross-sectional design of this study, causal inferences cannot be drawn, and these findings should be interpreted accordingly. The observed sex-specific differences may support consideration of individualized, sex-informed training strategies in American football athletes.