Resistance training is often recommended for combined increases in traditional and alternative hamstrings-to-quadriceps (H:Q) ratios in order to reduce knee strength imbalance and associated hamstrings and knee ligament injury risk. The aim of this study was to investigate the effect of different concentric and eccentric resistance training programs on traditional and alternative H:Q ratios. Forty male volunteers were assigned to one of 4 groups: concentric quadriceps and concentric hamstrings (CON/CON, n = 10), eccentric quadriceps and eccentric hamstrings (ECC/ECC, n = 10), concentric quadriceps and eccentric hamstrings (CON/ECC, n = 10), or no training (control (CNTRL), n = 10). Traditional conventional (CR) and functional (FR), alternative rate of torque development (RTD), muscle size (MS), and muscle activation (MA) H:Q ratios were measured before and after six weeks of unilateral nondominant knee extension–flexion resistance training performed on an isokinetic dynamometer. The ECC/ECC training significantly increased FR (pre = 0.75 ± 0.11; post = 0.85 ± 0.15), whereas the lack of training (CNTRL) decreased the RTD H:Q ratio (pre = 1.10 ± 0.67; post = 0.73 ± 0.33). There were no differences between groups for the other traditional and alternative ratios following resistance training protocols. These findings suggest eccentric exercise for quadriceps and hamstrings as the most beneficial training program for inducing increases in the traditional FR. However, different resistance training strategies may be needed to also elicit increases in the alternative RTD, MS, and MA H:Q ratios for fully restoring muscle balance and reducing potential hamstrings and knee ligament injury risk.
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