Hampered by the hamstring

Background

Acute hamstring injuries are most commonly associated with activities that require the body to complete fast actions of hip and knee flexion extension. Therefore it is no surprise that hamstring injuries are commonly seen in track sprinters.

Factors that cause a hamstring strain:

The most common reason for acute hamstring strains is a lack of task specific strength.  However, to say this is the only reason behind strains would be far too simplistic. Therefore when guiding our athletes rehabilitation we will always consider:

  1. Previous injury (hamstring, hip and lower back)
  2. When did the acute episode occur (competition/training)
  3. Biomechanical factors (compensatory loading patterns)
  4. Loading frequency
  5. Training history

The consideration of all of these factors will direct the level of  involvement required from the athlete’s team (Track coach, Strength and Conditioning coach, Physiotherapist) to ensure all factors are addressed and to promote the safest return.

Time-frame of injury return – what determines lay off?

Time frames for return to sport or training can be difficult to quantify due to  the specifics of the hamstring injury including location and size, the runner’s previous injury history and whether or not there are strict time-frames for competition.

Of course, most athletes would like to know approximate time frames for recovery so when pressed we give guidance based around the physiology of tissue repair and the latest evidence. The avoidance of a set “return to competition’ date is because runners may base their recovery on time frames rather than the achievement of their rehabilitation goals. The use of these task specific goals is pivotal for a safe return to training or competition.

When providing information around time lines we at The Stride consider:

  1. Central tendon involvement
  2. Location of the strain (distance from the proximal tendon)
  3. Patient presentation
  4. Pain limiting strength or movement
  5. Previous injury history
  6. Competition dates / goals of the runner
  7. Research surrounding rehabilitation
  8. The type of athlete and their compliance

Commencing the return to running:

Commencing the return to running effectively starts from the moment an athlete suffers an injury.

When working with runners and athletes returning from injury, our runners are always encouraged to cross train. This is because there is always something they can be doing to make the return to running easier. In the initial stages this may not necessarily be running, but some form of physical activity to help maintain fitness levels. The reason we encourage this is because athletes will begin to “detrain” after 12 days of inactivity. Therefore, when choosing a task it is imperative to choose tasks that won’t cause any further damage to the injured muscle group or region.

How runners load a hamstring:

Research suggests the appropriate time to load the hamstring is around day 5 (Askling, 2014). Many different protocols exist when it comes to rehabilitating a hamstring injury. Therefore is important to undergo a thorough physiotherapy assessment to help identify the underlying problems (as listed above), so a rehabilitation protocol can be suggested and specifically tailored to the injury presentation of the runner.

To assist our runners who may have suffered from an acute muscle strain to the long head of the bicep femoris, we have decided to share three quick exercises we incorporate into our rehabilitation: knee extension, arabesque and single leg slides.

Video: coming soon

Stride on!

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