{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:07:53Z","timestamp":1785820073379,"version":"3.56.0"},"reference-count":51,"publisher":"Georg Thieme Verlag KG","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Sports Med"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The present study investigated muscle damage and the repeated-bout effect after a\n                    typical Nordic hamstring exercise session. Thirteen trained male adults were\n                    recruited. Muscle damage was monitored through eccentric strength, passive range\n                    of motion, muscle soreness, and muscle swelling. Assessments were performed at\n                    baseline and 1 (day 1), 2 (day 2), 3 (day 3), and 4 (day 4) days after 24 Nordic\n                    hamstring exercise repetitions. The procedures were replicated after 4 weeks to\n                    examine the repeated-bout effect. After the first bout, the hamstring eccentric\n                    strength decreased up to day 3 (effect size range:\u22122.28\/\u22121.95). The passive\n                    range of motion decreased up to day 4 (effect size range:\u22121.62\/\u22120.64), while the\n                    muscle soreness increased on day 2 (effect size=1.63) and day 3 (effect\n                    size=1.53). No change in muscle swelling was observed. After the second bout,\n                    the hamstring eccentric strength (effect size=\u2212\u20091.20) decreased only on day 1.\n                    The passive range of motion decreased up to day 3 (effect size=\u2212\u20090.85\/\u22120.34).\n                    These changes were by a smaller magnitude compared to the first bout. The first\n                    Nordic hamstring exercise bout impaired hamstring strength and passive range of\n                    motion, with muscle soreness also perceived, while the second bout reduced\n                    muscle damage symptoms and shortened the time to recovery. While recovery is\n                    needed when a Nordic hamstring exercise session is performed for the first time,\n                    following Nordic hamstring exercise sessions may scarcely interfere with the\n                    training routine.<\/jats:p>","DOI":"10.1055\/a-2595-3622","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T19:31:22Z","timestamp":1745609482000},"page":"759-767","source":"Crossref","is-referenced-by-count":1,"title":["Muscle Damage and the Repeated-bout Effect After a Typical Nordic\n                    Hamstring Exercise Session"],"prefix":"10.1055","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7523-9102","authenticated-orcid":false,"given":"Giuseppe","family":"Coratella","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di\n                    Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0691-3153","authenticated-orcid":false,"given":"Emiliano","family":"C\u00e8","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di\n                    Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"D\u2019Orlando","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di\n                    Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Steri","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di\n                    Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Padovan","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di\n                    Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar La","family":"Spina","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di\n                    Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4420-2611","authenticated-orcid":false,"given":"Fabio","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di\n                    Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5806-8305","authenticated-orcid":false,"given":"Stefano","family":"Longo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di\n                    Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,5,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1007\/s11332-014-0213-x","article-title":"Isoload vs isokinetic eccentric exercise: a direct comparison of\n                    exercise-induced muscle damage and repeated bout effect","volume":"11","author":"G Coratella","year":"2015","journal-title":"Sport Sci Health"},{"key":"ref2","first-page":"1540","article-title":"Muscle damage and repeated bout effect induced by enhanced eccentric squats","volume":"56","author":"G Coratella","year":"2016","journal-title":"J Sports Med Phys Fitness"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1875","DOI":"10.1007\/s00421-023-05412-z","article-title":"Downhill running increases markers of muscle damage and impairs the maximal\n                    voluntary force production as well as the late phase of the rate of voluntary\n                    force development","volume":"124","author":"G Coratella","year":"2024","journal-title":"Eur J Appl Physiol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1007\/s00421-020-04341-5","article-title":"Comparison between high- and low-intensity eccentric cycling of equal mechanical\n                    work for muscle damage and the repeated bout effect","volume":"120","author":"G Mavropalias","year":"2020","journal-title":"Eur J Appl Physiol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"S52","DOI":"10.1097\/01.PHM.0000029772.45258.43","article-title":"Exercise-induced muscle damage in humans","volume":"81","author":"P M Clarkson","year":"2002","journal-title":"Am J Phys Med Rehabil"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1249\/JES.0000000000000095","article-title":"Mechanisms and Mediators of the Skeletal Muscle Repeated Bout Effect","volume":"45","author":"R D Hyldahl","year":"2017","journal-title":"Exerc Sport Sci Rev"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1007\/s40279-013-0052-y","article-title":"Eccentric exercise training: modalities, applications and perspectives","volume":"43","author":"M-E Isner-Horobeti","year":"2013","journal-title":"Sports Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1136\/bjsports-2015-095359","article-title":"Hamstring injuries have increased by 4% annually in men\u2019s professional football,\n                    since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury\n                    study","volume":"50","author":"J Ekstrand","year":"2016","journal-title":"Br J Sports Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1136\/bjsports-2021-105407","article-title":"Hamstring injury rates have increased during recent seasons and now constitute\n                    24% of all injuries in men\u2019s professional football: the UEFA Elite Club Injury\n                    Study from 2001\/02 to 2021\/22","volume":"57","author":"J Ekstrand","year":"2022","journal-title":"Br J Sports Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1136\/bjsports-2017-098101","article-title":"Isokinetic strength assessment offers limited predictive validity for detecting\n                    risk of future hamstring strain in sport: a systematic review and\n                    meta-analysis","volume":"52","author":"B Green","year":"2018","journal-title":"Br J Sports Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1524","DOI":"10.1136\/bjsports-2015-095362","article-title":"Short biceps femoris fascicles and eccentric knee flexor weakness increase the\n                    risk of hamstring injury in elite football (soccer): A prospective cohort\n                    study","volume":"50","author":"R G Timmins","year":"2016","journal-title":"Br J Sports Med"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"807","DOI":"10.2165\/00007256-200737090-00004","article-title":"Altering the length-tension relationship with eccentric exercise\u202f: implications\n                    for performance and injury","volume":"37","author":"M Brughelli","year":"2007","journal-title":"Sports Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"669813","DOI":"10.3389\/fspor.2021.669813","article-title":"Biceps Femoris Long Head Muscle Fascicles Actively Lengthen During the Nordic\n                    Hamstring Exercise","volume":"3","author":"B J Raiteri","year":"2021","journal-title":"Front Sports Act Living"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1123\/JSR.2019-0388","article-title":"Effect of Nordic Hamstring Exercise Training on Knee Flexors Eccentric Strength\n                    and Fascicle Length: A Systematic Review and Meta-Analysis","volume":"30","author":"D M Medeiros","year":"2020","journal-title":"J Sport Rehabil"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"501","DOI":"10.4085\/1062-6050-194-19","article-title":"The effects of eccentric training on biceps femoris architecture and strength: A\n                    systematic review with meta-analysis","volume":"55","author":"R G\u00e9rard","year":"2020","journal-title":"J Athl Train"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1097\/JSM.0000000000000710","article-title":"Effective But Not Adhered to: How Can We Improve Adherence to Evidence-Based\n                    Hamstring Injury Prevention in Amateur Football?","volume":"31","author":"N Van Der Horst","year":"2021","journal-title":"Clin J Sport Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1123\/jsr.2021-0262","article-title":"The Uptake of Nordic Hamstring Exercise Program for Injury Prevention in Major\n                    League Soccer and Its Barriers to Implementation in Practice","volume":"31","author":"P Chesterton","year":"2022","journal-title":"J Sport Rehabil"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1466","DOI":"10.1136\/bjsports-2015-094826","article-title":"Evidence-based hamstring injury prevention is not adopted by the majority of\n                    Champions League or Norwegian Premier League football teams: The Nordic\n                    Hamstring survey","volume":"49","author":"R Bahr","year":"2015","journal-title":"Br J Sports Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"001368","DOI":"10.1136\/bmjsem-2022-001368","article-title":"Still poorly adopted in male professional football: but teams that used the\n                    Nordic Hamstring Exercise in team training had fewer hamstring injuries-a\n                    retrospective survey of 17 teams of the UEFA Elite Club Injury Study during the\n                    2020-2021 season","volume":"8","author":"J Ekstrand","year":"2022","journal-title":"BMJ Open Sport Exerc Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2286","DOI":"10.1080\/02640414.2016.1191661","article-title":"Acute neuromuscular and performance responses to Nordic hamstring exercises\n                    completed before or after football training","volume":"34","author":"R Lovell","year":"2016","journal-title":"J Sports Sci"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2216","DOI":"10.1111\/sms.13226","article-title":"Scheduling of eccentric lower limb injury prevention exercises during the soccer\n                    micro-cycle: Which day of the week?","volume":"28","author":"R Lovell","year":"2018","journal-title":"Scand J Med Sci Sports"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1249\/MSS.0b013e318168c82d","article-title":"Effect of lengthening contraction velocity on muscle damage of the elbow\n                    flexors","volume":"40","author":"D W Chapman","year":"2008","journal-title":"Med Sci Sports Exerc"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1123\/ijspp.2021-0451","article-title":"Defining Training and Performance Caliber: A Participant Classification\n                    Framework","volume":"17","author":"AK A McKay","year":"2022","journal-title":"Int J Sports Physiol Perform"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1055\/a-1957-2356","article-title":"Ethical Standards in Sport and Exercise Science Research: 2022 Update","volume":"43","author":"D J Harriss","year":"2022","journal-title":"Int J Sports Med"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"11225","DOI":"10.3390\/ijerph191811225","article-title":"Quo Vadis Nordic Hamstring Exercise-Related Research?\u2014A Scoping Review Revealing\n                    the Need for Improved Methodology and Reporting","volume":"19","author":"T Alt","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1186\/s40798-021-00383-x","article-title":"The ANHEQ Evaluation Criteria: Introducing Reliable Rating Scales for Assessing\n                    Nordic Hamstring Exercise Quality","volume":"7","author":"T Alt","year":"2021","journal-title":"Sports Med Open"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/s40798-022-00492-1","article-title":"Appropriate reporting of exercise variables in resistance training protocols:\n                    much more than load and number of repetitions","volume":"8","author":"G Coratella","year":"2022","journal-title":"Sports Med Open"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.jshs.2021.09.002","article-title":"Biceps femoris long head sarcomere and fascicle length adaptations after 3 weeks\n                    of eccentric exercise training","volume":"11","author":"P A Pincheira","year":"2022","journal-title":"J Sport Health Sci"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.3390\/diagnostics11071230","article-title":"Intra- and Inter-Rater Reliability of Strength Measurements Using a Pull\n                    Hand-Held Dynamometer Fixed to the Examiner\u2019s Body and Comparison with Push\n                    Dynamometry","volume":"11","author":"J Gonz\u00e1lez-Rosal\u00e9n","year":"2021","journal-title":"Diagnostics"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"S134","DOI":"10.1016\/j.jsams.2023.08.009","article-title":"Reliability testing of foot and ankle strength specific to Ballet using the\n                    ForceFrame and DynaMo","volume":"26","author":"I Thotawatta","year":"2023","journal-title":"J Sci Med Sport"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1671","DOI":"10.1111\/sms.13068","article-title":"The effects of flexibility training on exercise-induced muscle damage in young\n                    men with limited hamstrings flexibility","volume":"28","author":"C M Brusco","year":"2018","journal-title":"Scand J Med Sci Sports"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/0304-3959(87)90089-3","article-title":"Pressure algometry over normal muscles. Standard values, validity and\n                    reproducibility of pressure threshold","volume":"30","author":"A A Fischer","year":"1987","journal-title":"Pain"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"14144","DOI":"10.1038\/s41598-020-71123-6","article-title":"Panoramic ultrasound vs. MRI for the assessment of hamstrings cross-sectional\n                    area and volume in a large athletic cohort","volume":"10","author":"M V Franchi","year":"2020","journal-title":"Sci Rep"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1675","DOI":"10.1007\/s00256-019-03208-x","article-title":"Sonographic landmarks in hamstring muscles","volume":"48","author":"R Balius","year":"2019","journal-title":"Skeletal Radiol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"53","DOI":"10.5116\/ijme.4dfb.8dfd","article-title":"Making sense of Cronbach\u2019s alpha","volume":"2","author":"M Tavakol","year":"2011","journal-title":"Int J Med Educ"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1249\/MSS.0b013e31818cb278","article-title":"Progressive Statistics for Studies in Sports Medicine and Exercise Science","volume":"41","author":"W G Hopkins","year":"2009","journal-title":"Med Sci Sports Exerc"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.jsams.2006.03.012","article-title":"Effects of number of eccentric muscle actions on first and second bouts of\n                    eccentric exercise of the elbow flexors","volume":"9","author":"T C Chen","year":"2006","journal-title":"J Sci Med Sport"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1152\/japplphysiol.00425.2006","article-title":"Intensity of eccentric exercise, shift of optimum angle, and the magnitude of\n                    repeated-bout effect","volume":"102","author":"T C Chen","year":"2007","journal-title":"J Appl Physiol (1985)"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1055\/s-2005-865920","article-title":"Greater muscle damage induced by fast versus slow velocity eccentric\n                    exercise","volume":"27","author":"D Chapman","year":"2006","journal-title":"Int J Sports Med"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1080\/02640419808559358","article-title":"Comparison of eccentric knee extensor muscle actions at two muscle lengths on\n                    indices of damage and angle-specific force production in humans","volume":"16","author":"R B Child","year":"1998","journal-title":"J Sports Sci"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1519\/JSC.0b013e3181660003","article-title":"Comparison of responses to strenuous eccentric exercise of the elbow flexors\n                    between resistance-trained and untrained men","volume":"22","author":"M J Newton","year":"2008","journal-title":"J Strength Cond Res"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1249\/01.mss.0000247007.19127.da","article-title":"Mechanisms of variability in strength loss after muscle-lengthening actions","volume":"39","author":"M J Hubal","year":"2007","journal-title":"Med Sci Sports Exerc"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1671","DOI":"10.1111\/sms.13068","article-title":"The effects of flexibility training on exercise-induced muscle damage in young\n                    men with limited hamstrings flexibility","volume":"28","author":"C M Brusco","year":"2018","journal-title":"Scand J Med Sci Sports"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s12576-023-00896-y","article-title":"Neurochemical mechanism of muscular pain: Insight from the study on delayed\n                    onset muscle soreness","volume":"74","author":"K Mizumura","year":"2024","journal-title":"J Physiol Sci"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1034\/j.1600-0838.2002.10178.x","article-title":"Delayed-onset muscle soreness does not reflect the magnitude of eccentric\n                    exercise-induced muscle damage","volume":"12","author":"K Nosaka","year":"2002","journal-title":"Scand J Med Sci Sports"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1136\/bjsports-2015-095739","article-title":"Impact of exercise selection on hamstring muscle activation","volume":"51","author":"M N Bourne","year":"2017","journal-title":"Br J Sports Med"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1111\/sms.13016","article-title":"Region-dependent hamstrings activity in Nordic hamstring exercise and stiff-leg\n                    deadlift defined with high-density electromyography","volume":"28","author":"A Hegyi","year":"2018","journal-title":"Scand J Med Sci Sports"},{"key":"ref48","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1097\/00005768-200109000-00011","article-title":"How long does the protective effect on eccentric exercise induced muscle damage\n                    last?","volume":"33","author":"K Nosaka","year":"2001","journal-title":"Med Sci Sports Exerc"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/j.jsams.2007.03.005","article-title":"A light load eccentric exercise confers protection against a subsequent bout of\n                    more demanding eccentric exercise","volume":"11","author":"A P Lavender","year":"2008","journal-title":"J Sci Med Sport"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"100454","DOI":"10.1016\/j.apunsm.2024.100454","article-title":"Individual and region-specific hamstring muscles use during a novel Flywheel\n                    Russian belt Deadlift exercise","volume":"59","author":"P L Cosio","year":"2024","journal-title":"Apunts Sports Med"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1514","DOI":"10.1080\/14763141.2020.1810750","article-title":"Post flywheel squat vs. flywheel deadlift potentiation of lower limb isokinetic\n                    peak torques in male athletes","volume":"22","author":"M Beato","year":"2023","journal-title":"Sports Biomech"}],"container-title":["International Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2595-3622.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T22:42:35Z","timestamp":1756507355000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2595-3622"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,25]]},"references-count":51,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,8,29]]},"published-print":{"date-parts":[[2025,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2595-3622","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0172-4622","1439-3964"],"issn-type":[{"value":"0172-4622","type":"print"},{"value":"1439-3964","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,4,25]]},"published":{"date-parts":[[2025,4,25]]}}}