Hamstring Muscle‐Tendon Geometric Adaptations to Resistance Training Using the Hip Extension and Nordic Hamstring Exercises

Targeted resistance training stimulates hamstring muscle hypertrophy, but its effect on tendon‐aponeurosis geometry is unknown. This study examined changes in hamstring muscle, free tendon, and aponeurosis geometry following a 10 week Nordic or hip extension exercise intervention. Thirty recreationally active males were randomly allocated (n = 10 per group) to a Nordic, hip extension, or control group. Magnetic resonance imaging of both thighs was acquired pre‐ and post‐intervention. Changes in free tendon and aponeurosis volume for each hamstring muscle, biceps femoris long head (BFlh) aponeurosis interface area and muscle volume‐to‐interface area ratio were compared between groups. Regional changes in muscle CSA were examined via statistical parametric mapping. The change in semimembranosus free tendon volume was greater for the Nordic than control group (mean difference = 0.06 cm3, 95% CI = 0.02–0.11 cm3). No significant between‐group differences existed for other hamstring free tendons or aponeuroses. There were no between‐group differences in change in BFlh interface area. Change in BFlh muscle volume‐to‐interface area ratio was greater in the hip extension than Nordic (mean difference = 0.10, 95% CI = 0.007–0.19, p = 0.03) and control (mean difference = 0.12, 95% CI = 0.03–0.22, p = 0.009) groups. Change in muscle CSA following training was greatest in the mid‐portion of semitendinosus for both intervention groups, and the mid‐portion of BFlh for the hip extension group. There was limited evidence for tendon‐aponeurosis hypertrophy after 10 weeks of training with the Nordic or hip extension exercises. For the BFlh, neither intervention altered the interface area although hip extension training stimulated an increase in the muscle volume‐to‐interface area ratio, which may have implications for localized tissue strains. Alternative muscle‐tendon loading strategies appear necessary to stimulate hamstring tendon adaptations.