Posts tagged hamstring injury
Strengthening Cuts Hamstring Injury Rates In Half
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Hamstring injuries are common and can occur in any sport with any athlete. The three muscles of the hamstring are put through rapid lengthening and shortening contractions making them susceptible to strains or minor tears. Due to the common occurrence of these injuries, it is important to target proper strength and conditioning regimes to decrease the risk of injury to this muscle.

A recent article by the British Journal of Sports Medicine investigated the available research on the effectiveness of hamstring strengthening utilizing the Nordic Hamstring Exercise and its’ impact on injury rates (van Dyk. 2019). The review included over 8,459 athletes and found when the athlete's strengthening program included the Nordic Hamstring Exercises, the risk of injury to the hamstring decreases by 51%. As mentioned by a previous blog, the Nordic Hamstring Exercise recruits the hamstring more evenly with a eccentric contraction (contraction of muscles while lengthening) consistent with the demands of sport.

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Does Hamstring Stretching Improve Muscle Length?
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Stretching either dynamically or statically has long been shown to create both short and long term improvements in flexibility, but the mechanism of action behind this form of exercise continues to evolve. Changing human tissue takes considerable time and consistent forces. For example, consider muscle growth or bone density adaptions to exercise. Previous research on the benefits of stretching assumed a structural change in the muscle (sarcomeres in series) was responsible for improvements in muscle flexibility, but more recent research demonstrates improvements in stretch tolerance are more responsible for these positive changes. A recent article examined these mechanisms in a group of individuals with limited hamstring length.

Brusco and colleagues assessed the impact of static hamstring stretching in a group of individuals with limited hamstring flexibility (Eur J App Physiology. 2019). Participants performed a seated hamstring stretch on an isokinetic machine to their maximum tolerance. Hamstrings were stretched for 8 bouts of 60 seconds, twice a week for 6 weeks. Total duration under stretch equaled 96 minutes over the 6 weeks. Authored measured both flexibility and muscle characteristics before and after the study. Consistent with prior research each individual’s range of motion improved but no changes in muscle tendon mechanical properties were noted. This indicates improvements in flexibility were secondary to the improvements in an individual’s tolerance to stretch. Thus, trained individuals were conditioned to tolerate more stretch as they moved through the study.

Previous History of Hamstring Injury Associated With Reduced Sprint Performance
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Hamstring injuries are one of the most common injuries in both individual and team sports. In sports such as soccer and football these injuries involve a traumatic pull of the muscle while sprinting or accelerating. After the initial healing phase athletes must rehabilitate the injury with Physical Therapy exercises to regain optimal muscle function and reduce their risk for future injury. Hamstring injuries often become recurrent if strength is not normalized along the hip, knee, and ankle muscles along the back of the leg. A new article highlights how these injuries also limit performance in sprinting trials.

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Roksund and colleagues studied professional soccer players and collected data on previous hamstring injuries, as well as, each athlete’s strength, flexibility, aerobic capacity, and sprint performance (Front Physiol. 2017). Of the 75 athletes included in the study, 16% sustained a hamstring strain over the previous 2 years. The previously injured athletes demonstrated a significant loss of velocity during a 40 meter sprint test, as well as, a drop in performance over repeated sprints compared to their healthy peers. Interestingly, measures of flexibility, strength, aerobic capacity, and maximum power was not significantly different between groups. Injured athletes are encouraged to work with their local Physical Therapist to accelerate their recovery from muscle strains and eventual return to sport.

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Nordic Hamstring Exercise Shown to More Evenly Recruit Hamstring Muscles
Photo Credit: Jospt.org

Photo Credit: Jospt.org

Hamstring injuries are a common sports medicine injury treated in our Boulder Physical Therapy practice.  These injuries can be placed in two categories: acute trauma often related to sprinting and cutting movements or repetitive stress and overload to the hamstring often found in athletes with weak gluteus muscles.  In our previous blog posts, we have described the importance of gradual loading of the injured hamstring to promote an optimal healing (remodeling) response, as well as, utilizing a hamstring strengthening program to reduce the risk of future hamstring injury.  A recent article sheds light on common exercises used to strengthen the hamstring and how these different exercises target the 3 muscles which make up the hamstring.

Messer and colleagues studied the hamstrings of active women without a history of lower limb injury (JOSPT. 2018).  All participants underwent a MRI both before and after performing eccentric (lengthening) contractions of the hamstrings on both of the exercises pictured above.  Muscle activation levels were calculated based on changes between the two MRI images.  The authors reported both exercises targeted the inner (medial) hamstring muscle, but the commonly utilized nordic hamstring exercise more evenly recruited all 3 hamstring muscles.    

Contact the experts at MEND to learn more on which exercises are best for your sports or orthopedic injury

 

Hamstring Training for Sprinters
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Sprinting either in track or sport requires rapid, high force muscle contractions across the lower body.  If the forces utilized during the acceleration phase of running are greater than the capacity of the muscle to absorb these forces injuries can occur.  Hamstring strains in this population of runners are common due to the rapid shortening and lengthening of the contracting muscles.  We have previously written on our Physical Therapy blog on the diagnosis and treatment of these injuries, but off season and in season strengthening remains the standard of care.  Specifically, nordic hamstring curls are often prescribed for sprinting athletes but a recent research article highlights other exercises which be used for hamstring strengthening among sprinters.

photo credit: International Journal of Sports Physical Therapy

photo credit: International Journal of Sports Physical Therapy

In the International Journal of Sports Physical Therapy authors studied healthy male participants as they sprinted and performed a variety of hamstring strengthening exercises (van den Tillaar et al. 2017).  The authors measured hamstring muscle recruitment and lower body biomechanics during each of these tasks to determine which Physical Therapy exercises best represent the muscular and biomechanical demands of sprinting.  The authors report the nordic hamstring curl, as well as, the laying kick activate the hamstring muscles at a high enough level and similar joint angle to benefit sprinters' strength training programs. 

To learn more on which exercises are best for your activity contact your local Physical Therapist. 

Reducing Hamstring Strains in Sprinters
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Hamstring strains or pulls are a common injury among acceleration sports including rugby, soccer, and sprinting.  Our previous blogs have written about the causes and treatments of these muscle injuries.  One of the common causes of injury involves a lengthening contraction (eccentric) of the muscle during these explosive sports movements.  If the muscle is unable to handle the forces placed upon it an injury occurs.  To reduce this injury risk, researchers and clinicians have focused on improved the strength and tissue capacity of the hamstring through training.  

A long term study was reported in the Orthopedic Journal of Sports Medicine describing 3 different interventions utilized to reduce the risk of hamstring injury (Sugiura et al. 2017).  Authors assessed 3 different prevention methods in a group of top ranked collegiate and national level sprinters over a 24 year period.  The first training program utilized over a 4 year period consisted of strengthening on a leg curl machine.  During this period 16 strain injuries occurred in a group of 116 sprinters.  The staff then included hip strengthening, agility and hurdle work in addition to the leg curl.  The authors reported a 56% reduction in hamstring strains over this 9 year period.  Finally, the authors included exercises from the first two interventions as well as dynamic stretches and nordic curl training for the hamstring.  This group of close to 300 sprinters sustained only 2 strain injuries over a 12 year period, almost a 90% reduction in strain rates.  

Courtesy: bretcontreras.com

Courtesy: bretcontreras.com

This study adds to our existing evidence on the importance of of hamstring strengthening for both performance and injury prevention among sprinting athletes