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What do you call a pig’s leash? A HAMSTRING I don’t know what’s funnier - the joke or this Game of Thrones meme:  Now that I have your attention, let’s dive into this much-needed blog post. I’ve been seeing a number of hamstring injuries in the clinic and on the field, so this blog will focus on what you can do to recover from a hamstring injury. Disclaimer: This should not be used as medical advice. If you are dealing with an injury, please seek out a local Physical Therapist or healthcare provider. So, let’s get started: Anatomy of the Hamstrings:  The hamstrings are comprised of 4 different muscles (5 if you include the adductor magnus, but we’ll keep it simple here). These 4 muscles are:
All cross both hip and knee joints except for the short head of biceps femoris and are innervated by the tibial/fibular divisions of the sciatic nerve. These muscles work together to extend the hip and flex the knee. Mechanism of Injury: If you watch any video with a hamstring strain, it typically occurs when an athlete is decelerating (slowing down). The muscle is being loaded while it is lengthening (eccentric loading) – which is where we tend to be the weakest. Acute Stage: When someone first strains their hamstring, there’s a few things you can do to help optimize the recovery process. Follow the guidelines of POLICE:
Once you’ve put some of this in play, you can start to implement some soft tissue and mobility techniques. It’s important to note, loading is going to be the most important component in this process. Soft Tissue and Joint Mobility The goal here isn’t to release any adhesions or scar tissue. We’re just trying to decrease some sensitivity and pain to allow other movement opportunities and progressive loading. Tack and Stretch Loading This is where we build strength and resiliency in the hamstrings. Here’s our loading progressions in a nutshell: Isometric Loading 🡪 Isotonic Loading 🡪 Heavy Slow Resistance Training (high load/low velocity exercise) 🡪 Slow Stretch-Shortening Cycle 🡪 Fast Stretch-Shortening Cycle  Isometric Loading Glute Bridge – Isometric Hold Variations (Dosage: 3-5 sets x 15-45 second holds) Isotonic Loading (Dosage: 3-4 sets x 10-20 reps) Glute Bridge Straight Leg Glute Bridge Band Pull Through Hamstring Roll Out Heavy Slow Resistance Training (high load/low velocity exercise) Kickstand RDL Nordic Hamstring Curl Half-Kneeling Hamstring Slide Slow Stretch-Shortening Cycle 🡪 Fast Stretch-Shortening Cycle Band Step Down Kettlebell Swing Supine Band Kickdown Standing Band Kickback – Slow Standing Band Kickback – Fast Single Leg Plyometrics Hamstring Tantrum – Supine Hamstring Tantrum – Prone Knee Bend What’s the biggest risk factor for a hamstring injury you ask? A previous hamstring injury. Make sure to take the appropriate steps to get your hamstrings taken care of. You don’t want to be that person that looks like a sniper took them out. If you’re dealing with an injury, reach out with any questions. We design and implement rehab and performance programs to help our athletes, whether you’re someone who doesn’t know where to start or has had an unsuccessful rehab experience. It is our goal for the people we work with to return to their sport or activity performing better than they did before. Cheers, Dr. Ravi Patel, PT, DPT, CSCS
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 [Credit: San Francisco Chronicles] Did you know that 70-85% of ACL injuries are typically non-contact? Or, that female athletes have a greater risk of ACL injury compared to males playing similar sports? It seems like every week you hear about another athlete who tears their ACL. In the NFL, 36 season-ending ACL injuries have been reported this year. Three took place this past Sunday, including a non-contact ACL injury by 49er’s QB Jimmy Garoppolo.  [Credit: Fox Sports] What’s even worse is when it comes from a celebration… A contact ACL injury seems to justify itself more so than a non-contact ACL injury. These season-ending injuries can have a huge impact on an athlete. Not only is it a long and costly process, but it can take a toll on you as an individual from a physical and mental standpoint. Take it from someone who has had two ACL injuries himself. I’ve even talked to parents who keep their kids out of sports due to the risk of an ACL tear. After my first ACL injury, my mom begged me to stop playing football and cheer my team on from the stands…HA! Love you Mom, but no way was that happening. I had to come back to play my senior year and it was 100% worth it. My second ACL tear was non-contact and didn’t come until six years later – which has fueled me on a path to help those who have suffered this same injury. So……Can ACL injuries be prevented? Prevented? Not really. Reduced? Definitely. Prevention means that we can stop something from happening, which means we can predict it. We’re not quite there yet. Reduction means we are making it smaller or less in amount, degree, or size. We have proof of this. For simplicity's sake, you will still see prevention and reduction used interchangeably, but keep in mind what we discussed above. A powerful research study came out this year by Webster et al. 2018 - Meta-Analysis of Meta- Analyses of Anterior Cruciate Ligament Injury Reduction Training Programs. It conclusively shows that 50% of all ACL injuries and 67% of non-contact ACL injuries in females can be reduced with the simple implementation of 2-3x per week of injury reduction/prevention programs.  [Credit: Woodcreek Soccer] Some important components of these programs are: Dynamic Warm-Ups Foundational Strength Proprioceptive Training Plyometric and Power Development Acceleration/Deceleration, Multi-directional Sport-Specific Training In later posts, we will break down these different components of a well-designed injury prevention program. At Athletes’ Potential, we design and implement these programs often to help our athletes, whether you’re someone who has had their first surgery or an unsuccessful rehab experience. It is our goal for the athletes we work with to return to their sport not only physically prepared, but mentally as well. Please feel free to reach out to our Docs if you have any questions. Cheers, Dr. Ravi, PT, DPT, CSCS |
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