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A New Concept For Isokinetic Hamstring: Quadriceps Muscle Strength Ratio

Per Aagaard, Erik B. Simonsen, S. Peter Magnusson, Benny Larsson and Poul Dyhre-Poulsen
Am J Sports Med 1998 26: 231

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0363-5465/98/2626-0231$02.00/0
THE AMERICAN JOURNAL OF SPORTS MEDICINE, Vol. 26, No. 2
© 1998 American Orthopaedic Society for Sports Medicine
A New Concept For Isokinetic Hamstring:
Quadriceps Muscle Strength Ratio
Per Aagaard,*† MSc, Erik B. Simonsen,‡ PhD, S. Peter Magnusson,§ PT,
Benny Larsson,§ MSc, and Poul Dyhre-Poulsen,* MD
From the *Department of Neurophysiology, Institute of Medical Physiology,
‡Anatomical Institute C, Panum Institute, and §Team Danmark Test Centre, Rigshospitalet,
University of Copenhagen, Copenhagen, Denmark
ABSTRACT
Conventionally, the hamstring:quadriceps strength ra-
tio is calculated by dividing the maximal knee flexor
(hamstring) moment by the maximal knee extensor
(quadriceps) moment measured at identical angular
velocity and contraction mode. The agonist-antagonist
strength relationship for knee extension and flexion
may, however, be better described by the more func-
tional ratios of eccentric hamstring to concentric quad-
riceps moments (extension), and concentric hamstring
to eccentric quadriceps moments (flexion). We com-
pared functional and conventional isokinetic hamstring:
quadriceps strength ratios and examined their relation
to knee joint angle and joint angular velocity. Peak and
angle-specific (50°, 40°, and 30° of knee flexion) mo-
ments were determined during maximal concentric and
eccentric muscle contractions (10° to 90° of motion; 30
and 240 deg/sec). Across movement speeds and con-
traction modes the functional ratios for different mo-
ments varied between 0.3 and 1.0 (peak and 50°), 0.4
and 1.1 (40°), and 0.4 and 1.4 (30°). In contrast, con-
ventional hamstring:quadriceps ratios were 0.5 to 0.6
based on peak and 50° moments, 0.6 to 0.7 based on
40° moment, and 0.6 to 0.8 based on 30° moment. The
functional hamstring:quadriceps ratio for fast knee ex-
tension yielded a 1:1 relationship, which increased with
extended knee joint position, indicating a significant
capacity of the hamstring muscles to provide dynamic
knee joint stability in these conditions. The evaluation
of knee joint function by use of isokinetic dynamometry
should comprise data on functional and conventional
hamstring:quadriceps ratios as well as data on abso-
lute muscle strength.
† Address correspondence and reprint requests to Per Aagaard, MSc,
Department of Neurophysiology 16.5.5, MFI, Panum Institute, Blegdamsvej 3,
DK-2200 Copenhagen N, Denmark.
No author or related institution has received any financial benefit from
research in this study. See “Acknowledgments” for funding information.
231
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The ratio of maximal isokinetic hamstring muscle
strength relative to maximal isokinetic quadriceps muscle
strength (H:Q ratio) is a parameter commonly used to
describe the muscle strength properties about the knee
joint.3, 12, 19 The H:Q ratio has conventionally been calcu-
lated as maximal knee flexion strength divided by maxi-
mal knee extension strength obtained at a given knee
angular velocity and contraction mode (isometric, concen-
tric, eccentric). For example, the conventional concentric
H:Q strength ratio is calculated by dividing maximal con-
centric knee flexor (hamstring) moment by the maximal
concentric knee extensor (quadriceps) moment obtained at
a given joint angular velocity. It has recently been sug-
gested that the agonist-antagonist strength relationship
for knee extension and flexion may be better described by
a functional H:Q ratio of eccentric hamstring to concentric
quadriceps muscle strength (Hecc:Qcon, representative of
knee extension) or concentric hamstring to eccentric quad-
riceps muscle strength (Hcon:Qecc, representative of knee
flexion).2 As an example, the functional H:Q ratio for knee
extension is calculated by expressing maximal eccentric
hamstring moment relative to maximal concentric quad-
riceps moment obtained at given angular velocity.
In conceptual terms, the conventional H:Q ratio implies
that concentric (or eccentric) contraction would take place
for the knee extensors and flexors simultaneously. How-
ever, true knee joint movement only allows eccentric ham-
string muscle contraction to be combined with concentric
quadriceps muscle contraction (during extension) or vice
versa (during flexion). As such, the conventional H:Q ratio
has been suggested to merely indicate whether a qualita-
tive similarity exists between the moment-velocity pat-
terns of the hamstring and quadriceps muscles, as sug-
gested by a constancy in conventional H:Q ratios across
contraction modes and speeds.2
While addressing the use of isokinetic dynamometry in
the assessment of human muscle function, several authors
have focused on the aspect of conventional isokinetic H:Q
strength ratios.3, 7, 12, 19 Various terms have been used for
232 Aagaard et al.
this H:Q ratio: reciprocal muscle group ratio,3, 12 agonist:
antagonist muscle ratio,19 and torque ratio.7 The rele-
vance of this strength variable has appeared just as di-
verse. One review reported it to be arguably more
important than the maximal moment for the assessment
of human muscle function,3 whereas another review con-
cluded the H:Q strength ratio to be an idiosyncratic pa-
rameter when used as a measure for successful rehabili-
tation in individual subjects.12
Even though the presence of nonoptimal (i.e., lowered)
H:Q strength ratios has been suggested to be associated
with an increased risk of musculoskeletal injury, such a
relationship has not yet actually been demonstrated.8
Active quadriceps muscle contraction may create signif-
icant anterior tibial translation or shear, particularly at
high contraction forces and with the knee toward full
extension.5, 10, 15, 17, 18, 26 It may also produce substantial
internal rotation of the tibia relative to the femur.10, 17 In
addition to ligamentous constraints (the ACL), the
amount of active co-activation of the hamstring muscles
will significantly contribute to counterbalance this tibial
shear4, 6, 17, 27 or rotation.17
The functional Hecc:Qcon ratio introduced earlier may be
used to indicate the extent to which the hamstring mus-
cles are capable of counteracting the anterior tibial shear
induced by maximal quadriceps muscle contraction.2 Val-
ues for conventional H:Q strength ratios of 0.40 to 0.50
have been reported based on peak moments, independent
of contraction mode and velocity.2, 24 In contrast, a func-
tional Hecc:Qcon ratio of about 1.00 was found for fast
isokinetic knee extension, indicating a significant capacity
of the hamstring muscles to provide dynamic joint stabi-
lization during active knee extension.2 This capacity for
dynamic joint stabilization was enhanced after high-resis-
tance strength training but unchanged after fast low-
resistance types of strength training.1 Low values (0.30)
have been reported for functional H:Q ratios representa-
tive of fast isokinetic knee flexion (Hcon:Qecc),1, 2 which
suggests that the hamstring muscles have a reduced ca-
pacity for dynamic knee joint stabilization during forceful
knee flexion movements with simultaneous eccentric
quadriceps muscle contraction.
Recent studies have proposed that combining data on
conventional H:Q ratios with data on functional H:Q ra-
tios and values of absolute strength will result in a more
thorough description of the muscular strength properties
at the knee joint than that revealed by the conventional
H:Q ratio alone.1, 2 More information may thereby be
gained on the evaluation of eccentric hamstring muscle
function, including its potential for providing dynamic
knee joint stability during fast forceful knee extension
movements and its possible enhancement in response to
specific types of physical training.
The purpose of the present study was to examine and
compare the conventional and functional H:Q strength
ratios obtained during concentric and eccentric muscle
contraction in maximal isokinetic knee extension and flex-
ion movements. This comprised an analysis of the influ-
ence from movement velocity as well as knee joint position
on the calculation of the different H:Q strength ratios.
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American Journal of Sports Medicine
MATERIALS AND METHODS
Subjects
Nine track and field athletes (pole vault, long jump, and
high jump) were examined. All subjects (four women and
five men) gave their informed consent to the conditions of
the study.
Isokinetic Strength Measurements
Maximal concentric and eccentric quadriceps and ham-
string muscle strength was obtained by measuring maxi-
mal force moments (torque) during isokinetic knee exten-
sion and flexion movements. A Kin-Com dynamometer
(Chattecx Corp., Chattanooga, Tennessee) was used for
the measurements. Subjects were seated and reclined 10°.
Their hips and thighs were firmly strapped to the seat of
the dynamometer. The axis of rotation of the dynamome-
ter lever arm was visually aligned with the lateral femoral
condyle, and the lower leg was attached to the lever arm of
the dynamometer at the level of the lateral malleolus.
Efforts for measurement were preceded by 15 minutes
of warmup and preconditioning to the testing device. For
each specific velocity and contraction mode, trials were
performed until the subject was unable to increase the
peak moment any further. The interval of rest between
trials was 45 to 90 seconds. All recorded moment signals
were corrected for the gravitational pull on the segment
masses located distal to the knee joint.2 Peak moment and
angle-specific moments at 50°, 40°, and 30° knee flexion
angles were identified during slow (angular velocity, 30
deg/sec) as well as fast (240 deg/sec) knee joint move-
ments. Range of motion was 10° to 90° (0° indicating full
extension).
For the isokinetic measurements obtained at the 30°
knee angle, concentric hamstring muscle strength and
eccentric quadriceps muscle strength at the higher veloc-
ity (240 deg/sec) may have been slightly underestimated
because they were obtained very early (about 100 ms)
after the onset of contraction. Thus the contractile compo-
nent had probably not reached its full active state. In
support for this, at the 30° knee angle somewhat low
concentric hamstring muscle strength and conventional
H:Q ratios were observed at 240 deg/sec joint angular
velocity. The problem could have been reduced by using a
90° to 0° range of motion instead of 90° to 10° or by
allowing substantial buildup of muscle force before the
onset of movement. However, because of safety precau-
tions the 10° to 0° range of excursion (full extension) was
avoided as on some occasions this could be expected to
result in a potentially hazardous combination of high mus-
cle forces and tibial rotation, the latter associated with the
lock-unlock (screw home) mechanism of the knee joint at
full extension.
Isokinetic H:Q Strength Ratio
Hamstring:quadriceps muscle strength ratios were calcu-
lated separately based on peak moment and angle-specific
Vol. 26, No. 2, 1998 Isokinetic Hamstring:Quadriceps Muscle Strength Ratio 233

moments obtained at 50°, 40°, and 30° knee joint angles.

The conventional H:Q ratio, determined as maximal ham-
string moment divided by maximal quadriceps moment,
was calculated separately for each velocity and contrac-
tion mode. The functional H:Q ratio representative for
knee extension (Hecc:Qcon) was determined as maximal
eccentric hamstring moment divided by maximal concen-
tric quadriceps moment and was calculated separately at
each of the respective joint angular velocities. The func-
tional H:Q ratio representative for knee flexion (Hcon:Qecc)
was determined as maximal concentric hamstring mo-
ment divided by maximal eccentric quadriceps moment. It
should be noted that the maximal eccentric hamstring and
concentric quadriceps moments were determined in sepa-
rate knee extension trials. In the trials of concentric quad-
riceps muscle contraction, a knee extension moment was
generated that assisted the motor-driven movement of the
dynamometer lever arm. In the trials of eccentric ham-
string muscle contraction, the hamstring-gastrocnemius
muscles generated a flexion moment trying to resist the
knee extension movement forced by the moving lever arm.

Statistics

The changes in H:Q ratio with variation in knee angle and

knee angular velocity were evaluated with the Friedman
two-way analysis of variance by ranks for repeated meas-
ures of related samples. The level of significance was 0.05.

RESULTS
Maximal concentric and eccentric peak moments and an-
gle-specific moments obtained during isokinetic knee ex-
tension and flexion are shown in Figure 1. Figure 2 dis-
plays the conventional and functional H:Q strength ratios
calculated from the data in Figure 1. Specific values
(⫾SD) are given in Tables 1 and 2.
Absolute Strength Levels
Maximal eccentric strength was greater than maximal
concentric strength for both the quadriceps and hamstring
muscles (P ⬍ 0.01) (Fig. 1). Furthermore, maximal quad-
riceps muscle strength was elevated when obtained at
gradually more flexed knee joint positions (i.e.,
50°⬎40°⬎30°) (P ⬍ 0.05). Conversely, maximal hamstring
muscle strength was greater when obtained at gradually
more extended positions (i.e., 30°⬎40°⬎50°) (P ⬍ 0.05)
except for concentric hamstring muscle strength at 240
deg/sec, where the values obtained at 30° and 50° knee
flexion angles were similar.
Figure 1. Maximal quadriceps (A) and hamstring (B) muscle
strength obtained as peak moment and constant-angle mo-
ments at 50°, 40°, 30° knee joint angles during slow (30
deg/sec) and fast (240 deg/sec) isokinetic knee joint move-
ments. Positive and negative velocities denote concentric
and eccentric muscle contraction, respectively. Error bars
show standard error of the mean (SEM); SEM is shown for
the top and bottom curves only. The SEMs not shown were
similar to those displayed at respective velocities and con-
traction modes.
240 deg/sec, where the H:Q ratio at the 40° knee angle was
similar to that measured at the 30° knee flexion angle.
Functional H:Q Ratio

Conventional H:Q Ratio
The conventional H:Q ratios were 0.5 to 0.6 based on peak
and 50° moments, 0.6 to 0.7 based on 40° moments, and
0.6 to 0.8 based on 30° moments (Fig. 2 and Table 1). The
conventional H:Q ratio increased with more extended
knee joint positions (P ⬍ 0.001) (Table 1). An exception to
this pattern was observed for the concentric H:Q ratio at
The functional H:Q ratios for fast knee extension were 1.0,
1.1, and 1.4 based on 50°, 40°, and 30° moments, respec-
tively (Fig. 2 and Table 2). The corresponding values for
slow knee extension were 0.6, 0.8, and 1.0. The functional
H:Q ratio increased with extended knee joint positions
(P ⬍ 0.001) (Table 2), except for fast knee flexion (240
deg/sec) where the functional H:Q ratios based on 30° and
40° of knee flexion were similar.

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234 Aagaard et al.
Figure 2. Isokinetic H:Q strength ratios calculated from
peak moment and angle-specific moments at 50°, 40°, 30°
knee joint angles obtained during slow (30 deg/sec) and fast
(240 deg/sec) isokinetic knee joint movements. For clarifica-
tion SEM is displayed only for the top and bottom curves. A,
conventional H:Q ratio. Positive velocities denote concentric
contractions, negative velocities, eccentric contractions.
Specific values (⫾SD) are given in Table 1. B, functional H:Q
ratios: Hecc:Qcon (knee extension, positive velocities) and
Hcon:Qecc (knee flexion, negative velocities). Specific values
(⫾SD) are given in Table 2.
The functional H:Q ratio representative for knee exten-
sion (Hecc:Qcon) increased with increases in extension ve-
locity, whereas the functional H:Q ratio representative for
knee flexion (Hcon:Qecc) decreased with increases in flex-
ion velocity (P ⬍ 0.001) (Fig. 2).
DISCUSSION
In the present study, a functional H:Q strength ratio
was calculated by expressing eccentric hamstring
muscle strength relative to concentric quadriceps muscle
strength (Hecc:Qcon) and concentric hamstring muscle
strength relative to eccentric quadriceps muscle strength
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American Journal of Sports Medicine
(Hcon:Qecc). A major finding of the present study was that
the functional H:Q ratio for fast knee extension was al-
ways 1.0 or greater, or approximately double that of the
conventional H:Q ratio. In other words, the functional H:Q
ratio yielded a 1:1 hamstring to quadriceps strength rela-
tionship for fast knee extension, which increased well
above 1.0 at the most extended knee joint positions.
It has recently been suggested that the functional H:Q
ratio may constitute a more relevant estimate of the ca-
pacity for muscular knee joint stabilization than that pro-
vided by the conventional H:Q ratio.1, 2 The present values
derived for conventional and functional H:Q ratios based
on the peak and 50° moments correspond well to those
from previous reports.1, 2 In the present study, the func-
tional and conventional H:Q ratios were also examined at
knee joint positions closer to full extension. The functional
H:Q ratio for knee extension was observed to increase at
more extended knee joint angles, reaching a value of about
1.4 at the most extended knee joint position (30°) at the
higher angular velocity (240 deg/sec). Similarly, the con-
ventional H:Q ratio displayed its highest values (about 0.6
to 0.8) at the 30° knee joint angle. The functional H:Q ratio
representative for knee flexion also showed its peak value
(0.6) at the 30° knee angle, at low rather than high angu-
lar velocity, however. The rise in H:Q ratio with more
extended knee joint positions was due to impaired length-
tension conditions for the quadriceps muscle (shortened)
and at the same time enhanced length-tension conditions
for the hamstring muscles (elongated).
In several types of knee joint movements, including
isokinetic knee extension, maximal quadriceps muscle
contraction may create anterior-directed shear forces on
the tibia relative to the femur, especially at high levels of
muscle force and at extended knee joint angles.5, 10, 15, 18, 20, 26
Several studies have suggested that the hamstring mus-
cles play an important role in assisting the ACL in pre-
venting such anterior tibial drawer forces.4, 6, 17, 22, 27 Even
though the exact magnitude of the influence from given
hamstring or quadriceps muscle moments on the amount
of tibial shear is unknown, the Hecc:Qcon ratio may repre-
sent an estimate of the ability of the hamstring muscles to
counteract this anterior-directed shear of the tibia. Based
on the measurements of peak and 50° moments, the func-
tional H:Q ratios of 0.96 to 1.01 presently observed for fast
knee extension suggest that the “braking” action of the
hamstring muscles is equal in magnitude to the maximal
quadriceps knee extension moment. Furthermore, this ca-
pacity for muscular knee joint stabilization was progres-
sively augmented at gradually more extended knee joint
positions, as indicated by the Hecc:Qcon values of 1.11 to
1.37 observed at the 40° and 30° knee joint positions. The
low functional Hcon:Qecc ratio values for fast isokinetic
knee flexion observed in the present study (0.3 to 0.4)
correspond well to findings of previous studies.1, 2 To-
gether, these results suggest that the hamstring muscles
may have a reduced capacity for dynamic knee joint sta-
bilization in active knee flexion movements that involve
eccentric quadriceps muscle contraction.
The values observed for the functional H:Q ratio ap-
peared to reflect the contractile force-length properties
Vol. 26, No. 2, 1998 Isokinetic Hamstring:Quadriceps Muscle Strength Ratio 235

TABLE 1
Conventional H:Q Strength Ratios for Eccentric and Concentric Muscle Contractions at Fast (240 deg/sec) and Slow (30 deg/sec)
Angular Velocitiesa
Eccentric Concentric
Strength variable
⫺240 b
⫺30 c
30 c
240c

Peak moment 55 ⫾ 4 53 ⫾ 9 50 ⫾ 6 61 ⫾ 7
50° moment 49 ⫾ 7 50 ⫾ 11 49 ⫾ 9 54 ⫾ 5
40° moment 59 ⫾ 9 62 ⫾ 14 61 ⫾ 10 66 ⫾ 7
30° moment 76 ⫾ 10 78 ⫾ 18 76 ⫾ 15 62 ⫾ 9
a
Values given as percentages ⫾ SD.
b
For values at this angular velocity, ratios based on 30° moments were significantly greater than those based on 40° moments, which
were significantly greater than those based on 50° moments (P ⬍ 0.001).
c
For values at this angular velocity, ratios based on 30° and 40° moments were significantly greater than those based on 50° moments
(P ⬍ 0.01).

TABLE 2
Functional H:Q Strength Ratios for Knee Extension (Hecc:Qcon) and Flexion (Hcon:Qecc) at Fast (240 deg/sec) and Slow (30 deg/sec)
Angular Velocitiesa
Flexion Extension
Strength variable
⫺240 b
⫺30 c
30 c
240c

Peak moment 33 ⫾ 4 43 ⫾ 8 61 ⫾ 8 101 ⫾ 17

50° moment 28 ⫾ 4 39 ⫾ 10 62 ⫾ 11 96 ⫾ 14
40° moment 36 ⫾ 5 49 ⫾ 11 78 ⫾ 12 111 ⫾ 20
30° moment 35 ⫾ 7 62 ⫾ 15 96 ⫾ 16 137 ⫾ 26
a
Values given as percentages ⫾ SD.
b
For values at this angular velocity, ratios based on 40° moments were significantly greater than those based on 50° moments (P ⬍
0.001).
c
For values at this angular velocity, ratios based on 30° moments were significantly greater than those based on 40° moments, which
were significantly greater than those based on 50° moments (P ⬍ 0.001).

and force-velocity properties of the agonist-antagonist
muscle synergists about the knee joint. In contrast, these
properties were not reflected by the conventional H:Q
ratio. In its basic form, the muscular force-length relation-
ship shows an ascending, optimum, and descending limb.
For the knee flexors, the optimum length is equivalent to
a knee angle of about 20° to 30°, and for the knee exten-
sors the optimum length corresponds to about 60° to 70°
knee angles.2, 24 As depicted by the contractile force-veloc-
ity relationship established for isolated muscle prepara-
tions, maximal concentric muscle force decreases with
increases in contraction velocity.9 During maximal eccen-
tric muscle contraction, however, large muscle forces ex-
ceeding those of concentric contraction are generated, in-
dependently of contraction velocity.14
Similar relationships have been observed for human
musculature in vivo, including the quadriceps and ham-
string muscles.2, 24 The high functional H:Q ratio values
observed for knee extension at fast velocity and at ex-
tended knee joint angles are the result of these relation-
ships of contractile force to muscle length and contraction
velocity. First, at the more extended knee angles the ham-
string muscles come closer to their optimal length,
whereas the length-tension conditions of the quadriceps
muscle are increasingly compromised. Second, based on
the contractile force-velocity relationship mentioned ear-
lier, rapid knee extension movements imply that high
eccentric hamstring muscle forces and low concentric
quadriceps muscle forces are generated. Consequently,
very high values for the functional H:Q ratio (Hecc:Qcon)
were observed. In comparison, conventional H:Q ratios
were essentially unaffected.
Clinical Implications
No studies so far have been able to demonstrate any clear
relationship between imbalance in thigh muscle strength
(deducted from conventional H:Q ratio) and an increased
incidence of knee injury.8 However, alternative isokinetic
muscle strength variables may prove important when
evaluating the prospect for injury prevention. In terms of
injury rehabilitation, positive correlations have been dem-
onstrated between postinjury increase in maximal quad-
riceps and hamstring muscle strength (evaluated isoki-
netically) and a successful return to functional activities
in subjects with ACL reconstructions.21 Also, in subjects
with ACL injuries a greater variance between the H:Q
ratio of the injured and noninjured leg has been associated
with a less successful degree of rehabilitation.13
For the protection or rehabilitation of the ACL, an iso-
lated goal could be to increase maximal eccentric ham-
string muscle strength, given the role of the hamstring
muscles in potentially counteracting anterior-directed
ACL shear.4, 6, 17, 27 Previously we have shown maximal
eccentric muscle strength to increase in response to high-
resistance strength training, whereas fast, low-resistance
types of strength training had no effect.1 Although only
small and inconclusive changes could be observed for the
conventional H:Q ratio, marked increases in the func-
tional H:Q ratio after high-resistance strength training

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236 Aagaard et al.
indicated an increased capacity for dynamic knee joint
stabilization by the hamstring muscles during fast and
forceful extension movements.1
Compared with conventional H:Q ratios, the functional
H:Q strength ratio thus appears better suited for the
evaluation of training-induced gains in maximal eccentric
hamstring muscle strength. From a rehabilitation point of
view, it is noteworthy that only concentric training was
performed in the study mentioned earlier,1 which in turn
shows that pure concentric high-resistance exercise (pre-
sumably less hazardous than eccentric-concentric exer-
cise) is effective in inducing significant gains in maximal
eccentric muscle strength. Low or lowered values for func-
tional H:Q ratios representative of knee extension (Hecc:
Qcon) (for example, as the result of increased concentric
quadriceps strength) may signify that more high-resis-
tance strength training should be performed for the knee
flexors, preferentially including eccentric muscle
contraction.
Training-induced increases in isolated muscle strength
probably should be combined with task-specific motor
training to establish knee flexor activation patterns that
are sufficiently effective in counteracting the knee joint
stresses associated with given types of physical activity.
The importance of specific neural muscle activation pat-
terns for dynamic knee joint stabilization, in terms of
proper time sequences of muscle recruitment, has recently
received increased attention, which raises the question of
the role of isolated strength training per se.11, 25
Interestingly, passive anterior-posterior knee joint lax-
ity has been reported to increase acutely in response to
sustained leg exercise such as running and basket train-
ing.23 Only increases in active muscle tone would counter-
balance this decline in passive knee joint stability. Also,
the recent finding of a decreased passive stiffness of the
hamstring muscles after bouts of repetitious contrac-
tions16 further emphasizes the importance of optimal neu-
ral hamstring-gastrocnemius muscle activation patterns
for maintaining dynamic knee joint stability.
In conclusion, the findings of the present study suggest
that the hamstring muscles possess the capacity to pro-
vide significant dynamic joint stability during fast and
forceful knee extension. This capacity for muscular knee
joint stabilization is progressively augmented at gradually
more extended knee joint positions and increasing angular
velocity. Thus, the present results reflect the basic phys-
iologic principles of the length-force relationship of skele-
tal muscle; the force-velocity relationship, characterized
by eccentric contractions generating higher forces than
corresponding concentric contractions; and the reciprocal
action of agonist-antagonist muscles. Together, these en-
sure a significant capacity for muscular joint stability
near the end of range of motion, especially at fast joint
angular velocities. It is noticeable that the principles men-
tioned are all inherent in the concept of the functional H:Q
ratio, whereas they are not reflected by the conventional
H:Q ratio. We suggest that the evaluation of knee joint
function should combine data on the functional H:Q ratio,
conventional H:Q ratio, and absolute maximal quadriceps
and hamstring muscle strength levels.
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American Journal of Sports Medicine
ACKNOWLEDGMENTS
This study was supported by The Danish Elite Sport
Association, Team Danmark. For the use of test and
laboratory facilities and for valuable help we would like
to express our gratitude to H. Overgaard at Team Dan-
mark Test Centre. We also thank M. Louie, D. Ferris,
M. Donelan, and Professors C. Farley and R. Kram at
the Department of Human Biodynamics, University of
California at Berkeley, for their valuable help and
support.
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