|
We're deep into the various football seasons and there are a range of injuries coming in.
This week I've seen a few more hamstring tears than normal. Whether you call it a “pull”, “strain”, or “tear”, it's essentially the same thing. I mostly use the word “tear”, but the technically correct term is "muscle strain injury". Hamstring strains are the most common injury in AFL, causing the most games to be missed. They are a common injury in any sport where top-end pace is required. |
Risk factors for hamstring strain:
We can’t change the first two risk factors. We don’t want to change the third risk factor.
Hamstrings are most commonly injured running at full pace, usually when going for a bit of extra speed to make a break. Sometimes when extra speed and stretch are required to catch a low ball. They tend to go late in each half, suggesting fatigue is an issue.
Anecdotally, it is a player that has turned up late and missed the warm up, they may be coming on for their second game, having cooled down, or they’ve done some heavy leg weights, plyometrics, or extra running in the couple of days before the game and are “pre-fatigued”.
- Previous hamstring injury.
- Age - being over 23 years old.
- Strength and power – the stronger and faster you are the more likely you are to tear.
We can’t change the first two risk factors. We don’t want to change the third risk factor.
Hamstrings are most commonly injured running at full pace, usually when going for a bit of extra speed to make a break. Sometimes when extra speed and stretch are required to catch a low ball. They tend to go late in each half, suggesting fatigue is an issue.
Anecdotally, it is a player that has turned up late and missed the warm up, they may be coming on for their second game, having cooled down, or they’ve done some heavy leg weights, plyometrics, or extra running in the couple of days before the game and are “pre-fatigued”.
First-aid for the 72 hours after injury should include compression. Skins or 2XU tights 24 hours a day. Sit on an ice pack on a chair for 20 mins, hourly, bending and straightening the knee to glide the hamstrings.
It feels like you want to stretch the hammy, but I recommend only the gentlest stretching for the first five days.
Don’t take anti-inflammatories as they slow down the healing. You can use paracetamol for pain relief if required.
The main component of rehab is strengthening, which you can start from day one. I recommend a large “volume” of loading. High reps / low resistance of some loading exercises for the first two weeks, before progressing to a heavier resistance program.
Theses are the exercises I like to start for a hamstring tear from day one.
A high-rep exercise you can do at home could be a single leg dead lift "arabesque", with or without dumbbell weight. Or a supine “bridge” with the knees almost straight.
A graded running program is important to progressively increase running speed.
The average time taken for return to play is 3-4 weeks. There is some testing on the acute injury which predicts how long it will actually be. A simple predictor is how many days you are initially limping. 24hrs of limping equates to a 3-week injury. Every 24hrs after that adds another week, e.g., if you’re limping 48hrs after injury it’s 4 weeks, 72hrs = 5 weeks.
Most hamstrings tear at the musculo-tendinous junction of biceps femoris, the biggest hamstring muscle that is in the outer side of the back of the thigh. If the tear is more towards the inside of the back of the thigh, involving the smaller hamstring muscles, there is a faster return to play with less chance of recurrence.
Most hamstrings tear at the musculo-tendinous junction of biceps femoris, the biggest hamstring muscle that is in the outer side of the back of the thigh. If the tear is more towards the inside of the back of the thigh, involving the smaller hamstring muscles, there is a faster return to play with less chance of recurrence.
Hamstring injuries do have a high rate of recurrence. 70% of injuries are recurrences of previous injury. 30% of injuries will re-tear in the same season. I use the analogy of going to prison: if you’ve been once, you’re more than likely to go back again.
Hammy strength and a volume of high-speed running at least three days a week are prophylactic against hammy injury or re-injury. Don't let game-day be the only time you hit top pace. Make sure you get a decent volume of sprinting during the week at training. And continued hammy strengthening for the rest of your playing career, specifically with some eccentric load, such as the Nordic Hamstring Curl.
Hammy tears are a common injury accounting for a lot of missed games so I think it is important to take them seriously. I find people tend to do the wrong thing: over-stretch them early, take anti-inflammatories, and rest them, and are surprised when they re-injure them in the first few weeks back playing.
Correct rehab from the start and you can avoid ongoing problems from your hamstring strain.
Hammy strength and a volume of high-speed running at least three days a week are prophylactic against hammy injury or re-injury. Don't let game-day be the only time you hit top pace. Make sure you get a decent volume of sprinting during the week at training. And continued hammy strengthening for the rest of your playing career, specifically with some eccentric load, such as the Nordic Hamstring Curl.
Hammy tears are a common injury accounting for a lot of missed games so I think it is important to take them seriously. I find people tend to do the wrong thing: over-stretch them early, take anti-inflammatories, and rest them, and are surprised when they re-injure them in the first few weeks back playing.
Correct rehab from the start and you can avoid ongoing problems from your hamstring strain.
