Rethinking Hamstring Rehabilitation: Columbia University Researchers Using Myontec EMG to Measure Muscle Activation
After proximal hamstring tendon surgery, protecting the repaired tissue is essential. But which rehabilitation strategy actually minimizes muscle activation during walking?
Should patients avoid weightbearing? Should the knee be immobilized in a flexed position? Or could controlled flat-foot weightbearing place less demand on the healing hamstring than previously assumed?
Researchers affiliated with Columbia University and Duke University investigated these questions using Myontec Mbody 3 smart shorts, revealing findings that could help inform future postoperative rehabilitation protocols.
Their research, presented in 2024 and 2025 and published as a journal article in 2026, demonstrates how Myontec wearable electromyography (EMG) can provide objective information about muscle activation during functional movement.
The Challenge: Protecting the Hamstring After Surgery
Proximal hamstring tendon injuries can require surgical repair, particularly when the tendon has been significantly damaged or detached from its attachment at the pelvis. Following surgery, rehabilitation protocols aim to protect the repair while gradually restoring mobility and function.
However, there is no universal consensus on the optimal combination of weightbearing restrictions and postoperative bracing. Traditional approaches may include non-weightbearing with crutches, hinged-knee braces locked at different flexion angles, or
controlled flat-foot weightbearing.
Although these strategies are intended to protect the healing tissue, their actual effects on hamstring muscle activation are not always intuitive.
A more restrictive rehabilitation protocol does not necessarily mean the muscles are working less.
The Findings: More Restriction Did Not Always Mean Less Muscle Activation
The study identified statistically significant differences in both cumulative and peak hamstring activation across the tested rehabilitation conditions. One particularly important finding concerned cumulative muscle activation.
When participants walked without weightbearing while wearing a hinged-knee brace locked at 90° of flexion, normalized cumulative hamstring activation averaged 3.38. By comparison, participants walking with flat-foot weightbearing and an unlocked hinged-knee brace showed an average of 1.54. That represents approximately 54% lower mean normalized cumulative activation in the flat-foot weightbearing condition for this specific comparison (p = 0.01).
The researchers also found differences in peak activation. Non-weightbearing with the knee brace locked at 60° produced an average normalized peak hamstring activation of 1.12, compared with 0.58 during flat-foot weightbearing without a brace (p = 0.02).
These findings challenge the assumption that greater movement restriction automatically reduces muscular demand.
Flat-foot weightbearing protocols could result in lower hamstring activation than certain restrictive non-weightbearing bracing strategies.
Why These Results Matter for Rehabilitation
The findings highlight an important distinction between restricting movement and reducing muscle activation.
A patient may be instructed to avoid weightbearing to protect a surgical repair. However, walking with crutches and maintaining a highly flexed knee position can still require considerable muscular effort.
Wearable EMG makes it possible to investigate these demands directly.
For orthopedic surgeons, physiotherapists, rehabilitation specialists, and sports medicine professionals, objective muscle activation measurements could provide additional evidence when evaluating rehabilitation protocols.
This approach has potential applications in:
Comparing postoperative walking and bracing strategies
Understanding muscular demands during protected mobility
Developing evidence-informed rehabilitation protocols
Evaluating movement and muscle-loading patterns during rehabilitation
Supporting future research into safe progression toward functional activity
Advancing Evidence-Based Rehabilitation with Myontec Wearable EMG
The progression of this research from conference presentations to a peer-reviewed journal article demonstrates growing scientific interest in objectively evaluating postoperative mobility protocols.
For Myontec, it also highlights the relevance of wearable muscle measurement technology beyond sports performance.
From orthopedic surgery to physiotherapy and return-to-sport research, understanding how much muscles are working during functional movement can provide valuable information for researchers and clinicians.
Two walking strategies may appear similar, yet generate substantially different levels of muscular activity.
The Columbia University–affiliated research offers an important reminder:
Less movement does not always mean less muscle activation.
By making muscular activity measurable, Myontec technology helps clinicians, physiotherapists and researchers challenge assumptions and develop a more objective understanding of human movement.
Research References
2026 — Peer-reviewed journal article, Athanasian CE, Schwartz B, Czerwonka N, Trofa DP, Mather RC, Christian RA. Non-Weightbearing in Hinged-Knee Braces Locked in High Degrees of Flexion Shows High Hamstring Muscle Activation in Healthy Volunteers.
Arthroscopy, Sports Medicine, and Rehabilitation.
2025 — Conference abstract, Athanasian C, Czerwonka N, Reynolds A, Mather R, Christian R. Muscle Activation in Postoperative Ambulation Protocols following Proximal Hamstring Tendon Repair. Journal of Hip Preservation Surgery, 12(Supplement 1), i69–i70.
2024 — Conference poster abstract, Athanasian C, Czerwonka N, Reynolds A, Mather RC, Christian RA. Poster 207: Muscle Activation in Postoperative Ambulation Protocols Following Proximal Hamstring Tendon Repair. Orthopaedic Journal of Sports Medicine, 12(7_suppl2).
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