So, you have injured your hamstring and are unable to play sport or even stand on the start line of the event you have been training for. What do you need to do to help repair the damaged muscle and tendon and how do you prevent it from happening again? One of the most common mechanisms of hamstring injuries occurs from dancing and kicking activities, which tend to injure the upper tendon close to your sit bone.
You may have watched some of the Olympic hurdle events and seen an athlete pull up short gripping the back of their thigh. Sprinting and running activities is the other common mechanism which more often than not causes injury to the muscle belly itself as well as the muscular tendon.
Historically, hamstring injuries have been managed with stretching and strengthening of the hamstring muscle group itself with perhaps minimal focus on the ankle, knee, hip, pelvis and trunk regions. Because the tendon and muscle complex must heal, it has been advised that pure static stretching could be detrimental to the repair process and may in fact be a factor in recurrence rate of injuries.
Because the hamstring works across the hip and knee joint, it has to be able to work in a concentric (shortening) and eccentric (lengthening) manner to produce functional movement such as bending the knee and extending the hip. For this reason rehabilitation must include both concentric and eccentric strengthening exercises.
Rehabilitation can’t just be about the hamstring, it needs to look at the whole kinetic chain which means looking at not only the hamstring muscle region but including strengthening and agility work around the ankle, knee, hip, pelvis and trunk. It is important for the trunk to be stable to enable us to move our limbs to perform activities that we love to do, whether it is climbing, sprinting, playing soccer or just getting fit at the gym.
The rehabilitation process from hamstring injury is progressive following different phases as the tissue heals.
Phase one is all about helping to promote the healing process and developing a mobile healing tissue in a pain free motion. Typically activities in this phase start simple trunk stability work which can include such exercises as side bridges, prone and supine bridging, aerobic exercise usually in the form of an exercise bike, some agility work such as walking grapevine, fast feet and side stepping.
Phase two has a focus on promoting painfree strength, restoring the proper length of the muscle and neural tension while continuing on with trunk and pelvic control. Usually at this stage, running can be introduced as long as it is painfree. The exercises in this phase tend to increase in intensity.
The final Phase three is further advancing exercises and making them more sport or activity specific. So, if your goal was to get back to playing soccer then this stage would involve lots of change in direction, accelerating, decelerating and kicking activities as well as continuing on with trunk stabilising exercises, eccentric loading on the hamstring and balance type exercises.
The windmill exercise is one such example of an eccentrically loaded hamstring exercise which also combines trunk control and is usually introduced in phase two and further progressed in phase three. Come in and visit us for a demo.
