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New Findings In Hamstring Injury Management

New Findings In Hamstring Injury Management
New Findings In Hamstring Injury Management

It’s Hamstring Strain Season

With winter sports starting to kick into gear and many people beginning their pre-season training in February and March, now is typically the time of year physiotherapists around Sydney are being kept busy seeing athletes with hamstring strains.
The October 2013 volume of the British Journal Of Sport and Exercise Medicine (BJSM) featured an article with some interesting findings regarding the management of hamstring injuries.
The study was looking at a new rehabilitation protocol for hamstring injuries in elite footballers (soccer players). It is suggested that 70% of hamstring injuries in football players occur during high-speed running and the other 30% with activities involving high kicking, sliding tackles, split motions, twisting, turning, passing, jumping and overuse. There are certain prognostic predictors mentioned in the paper providing important information regarding potential prolonged or shortened time to return to play. Poor prognostic recovery included suffering a stretching type of injury having on average 84% longer times to return to play than sprinting types of injury. Other poor prognostic predictors were the position of peak pain on palpation and proximity of swelling being closer to ischial tuberosity (your sit bones) as well as longer swelling length upon MRI indicated a likely longer time to return to play.

Studies Involving Professional Athletes, Results Can Still Apply To Your Average Sportsman

Although studies were performed on elite footballers arguably the cause of hamstring injuries and findings can be parallel to the weekend warrior, however noting the elite footballer eager to return to play as soon as possible may have greater motivation and resources enabling better adherence to any protocols and as a result potentially shorter recovery times than the amateur athlete so exact time frames to recovery vary from individual to individual depending on their situation and resources available.
As with any injury there are always individual variations in severity, pre injury status and ability to adhere to protocol among other things influencing final outcome, however the protocol in the study achieved a return to sport 45% (23 days) shorter than the conventional protocol used in the study. Obviously regardless of being a professional athlete or just a weekend battler any reduction in days lots through injury is important to both groups and reducing the number of days out of action as this study achieved with their new protocol means up to 2-3 few games lost through injury with each episode.

Loading The Hamstring In Lengthened Positions Is What Works

The specific protocol characteristics were aimed at putting load on the hamstrings during maximal dynamic lengthening involving movements at both the hip and knee. With the rehabilitation protocol following other research which has previously suggested that rehabilitation of acute hamstring injuries should build on attaining eccentric loading at as long muscle lengths as possible and they took the assumption that it should attempt to mirror the particular situation that lead to the injury.

Ultimately in the study population it was found that a rehabilitation protocol consisting of mainly lengthening type of exercises is more effective than a conventional protocol in promoting return to play in acute hamstring injuries. So a rehabilitation programme preferentially based on strength and flexibility exercises that primarily involve exercises with high loads at long muscle-tendon lengths is the most effective at reducing time to return to play.

Get Assessed And Get A Management Plan

If you suffer a hamstring injury be it playing football or another sporting activity book in to see a physio who’s interest lies in sports injuries and have them assess severity and give you an indication of your projected return to sport time frame and set up a rehabilitation protocol for you which will both help you return to play quicker and reduce your likelihood of any recurrence.

Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance regarding hamstring injury management should consult his or her orthopaedic surgeon, general practitioner, sports medicine specialist or physiotherapist.

Adapted from the article in BJSM:
Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols.
Written by: C M Askling, M Tengvar, A Thorstensson.

Hayden Latimer is the founder of and principle physiotherapist at Sydney Physio Clinic. Since graduating from Otago University, Dunedin, New Zealand he’s gained wide experience practicing across the globe for over 15 years and is now extremely knowledgeable in helping people reduce discomfort and restore function and mobility.