Hamstring injuries are one of the most prevalent, disabling and recurrent injuries that athletes/patients suffer. In the past high-profile Australian athletes have been hampered by ongoing hamstring concerns, Michael Clarke (Cricketer), Tom Trbojevic (League). These injuries have bought to the fore the perils involved with sustaining and rehabilitating a hamstring injury.
The Hamstrings are made up of 3 muscles – Bicep Femoris (most commonly injured), Semitendinosus and Semimembranosus. The action of these muscles is to flex the knee and extend the hip – thus injuries occur during running particularly with high speeds as the force generation required is significantly higher. Most commonly injuries occur whilst the muscle is extended to its longest point which also corresponds with its greatest force production - a perfect storm
But the conundrum many of us face is, how do we successfully rehab a hamstring injury when the re-aggravation rate is disproportionate (32%) to other soft tissues in the body (12%)?
Eccentric hamstring strengthening which includes loading the muscle whilst the muscle is lengthening, an effective alternative to concentric based exercise. Eccentric loading is a way to 'bullet proofing' your hamstrings. Eccentric exercise includes the Deadlift and variants, and the famous Nordic hamstring exercise, which has been shown to be one of the most effective exercises for hamstring injury.
Nordic hamstring exercises (NHE) as a first point of contact for prevention has been repeatedly shown to significantly reduce the prevalence of initial and subsequent hamstring injury. NHE is not only used as a preventative but can also be used as an assessment tool in assessing the level of chronic load which the hamstring is enduring. Increased or variable chronic load through the hamstring tendons can increase the risk of hamstring injury.
(See below one of our patients hitting some impressive Nordic's)
Repeated high speed running with adequate biomechanics matching that of the athlete/patients’ normal workloads has also been shown to decrease hamstring injury incidence. Given the likelihood of the injury occurring at high speed, conditioning the hamstring muscles to produce and absorb high loads consistently & regularly can be injury protective.
Often, we see injury incidence increased following a change in training/activity loads, the COVID situation has increasing highlighted this scenario, with a spike in soft tissue injuries (hamstring in particular) due in part to the enforced de-loading of soft tissue (isolation, limited access to high intensity exercise) followed by rapid re-introduction of pre-layoff loads or above that (catch up games, trainings).
If you are planning on returning to your normal sport/physical activity or undertaking an activity entirely different come and visit us at Gorokan Physio Solutions and see what we can do for you in reducing the risk of hamstring injury occurring upon your return to movement. Before you undertake a new exercises please discuss with a Physio or your GP to ensure the exercises are appropriate for you.