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Reducing Hamstring Injuries

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Our resident exercise specialist, physiotherapist Peter Langford offers advice on prevention and cure of the hockey players’ curse – hamstring injuries.

Hamstring injuries are a common complaint for athletes. They can be very painful, quite debilitating and hard to fix properly. Once you have had a hamstring strain then it increases the likelihood that you will have another one at some point.

So obviously the best thing you can do for a hamstring injury is avoid one in the first place. The good news is there is a simple exercise that has been found to significantly reduce the risk of hamstring injury.

Mechanism of Injury

The hamstrings are a group of three muscles in the back of the thigh. There are two main ways that people strain their hamstrings. They occur by

1.stretching the muscles beyond their limits and tearing them

2.powerful forces going through the muscles as they contract

Out of these options, the second one is more common in athletes. This type of injury happens when a player accelerates rapidly. People who have suffered a hamstring strain will attest to this. They take off quickly to chase a player or the ball and suddenly feel like they have been shot in the back of the leg.

Once you have suffered a hamstring tear they can be troublesome and difficult to rehabilitate, as well as causing ongoing issues.

Injury Prevention

A number of factors have been identified which can predispose people to suffering hamstring injuries. These include age, previous injury, reduced movement in the hip and weak hamstrings.

Strangely enough, there is no real link between hamstring tightness and risk of injury. So stretching programs have been found not to reduce your risk of hamstring injury.

Warm up

Part of protecting yourself from hamstring injury is making sure you warm up properly and consistently. It needs to be done every time players train and every time they play. It is generally agreed these days that an active warm up is best. This should include things like running, leg swings forwards and backwards and bending forward to touch the ground.

Warm down

Warming down tends to be the most forgotten part of the whole process. It is very easy to come off the playing field, exhausted, and head straight for the change rooms. It is important to warm down your muscles with some gentle running and stretching. At this time static stretching can be done, that is a prolonged stretch for 30-plus seconds. Hamstring stretches are commonly done incorrectly so it is important to have the correct technique.

Handy Tips For Hamstring Stretch

Hamstring stretches are often done wrong. Bending over to try and touch your toes or put your head on your knee will not necessarily stretch the muscle properly. The stretch needs to be felt in the belly of the muscle, that is, the back of your thigh.

If you feel the stretch behind your knee then it is likely that all you are doing is putting tension on the nerves in your leg and not through the muscle.

Specific exercise

This exercise is most commonly known as “Nordic Hamstring”. It is a simple exercise that has been shown by several studies to significantly reduce hamstring injuries in athletes. The key to making this exercise successful is for people to do it consistently.

Just like any training, if you do not stick with the program then you will miss out on the benefits.

A number of high quality studies have now been performed using the Nordic Hamstring exercise. One of the best was a Danish study using almost 1000 athletes. The outcome of this study was significant. They were able to cut the incidence of hamstring injuries in their athlete population by 65 per cent!

The exercise program used in this research ran for 10 weeks, followed by weekly “maintenance” sessions. So just doing the exercise now and then for a couple of weeks will be a waste of your time.

One way to make sure the exercises are done regularly and compliance rates remain high is to incorporate it into the team’s training session. Making it compulsory for the entire team tends to make individual athletes more accountable to the rest of the group.

How to perform the Nordic Hamstring exercise:

Nordic Hamstring start position

●Kneeling down with a partner holding firmly around your ankles to hold you stable throughout the movement

●Stay up tall and brace your core muscles so that your trunk does not bend during the movement

●Your arms can remain by your side

The Movement

●Gradually lean forward, keeping your trunk straight.

●As your weight comes forward you should feel your hamstrings start working hard

●Continue to lean into the movement very slowly, using your hamstrings to control the movement

End Position

●When you reach a point where your hamstrings can no longer control your movement, allow yourself to drop to the floor

●Use your hands to catch your descent onto the floor and you should end up in a “push up” type position

●Work your way back up to the start position and repeat

The Protocol

Week Sessions per Week Sets Repetitions
Week 1 1 2 5
Week 2 2 2 6
Week 3 3 3 6 to 8
Week 4 3 3 8 to 10
Week 5-10 3 3 12 then 10 then 8

After week 10 ongoing maintenance consisted of one session per week of one set each of 12 then 10 then eight repetitions.

When talking about injury prevention there are not many things that are this simple and this effective. Just one simple exercise that can cut your risk of hamstring tear enormously. It makes sense to add Nordic Hamstrings to your training routine.

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