This is part 9 of a multi-part series on hamstring pulls and rehabilitation.
I also discussed hamstring pulls in several past articles:
- Hamstring Pulls: Gerard Mach Revisited
- How to Recover a Hamstring Pull: Eccentric Loading
- Hamstring Injuries, the Iliopsoas and Imbalances
- Controversial Hamstring Workout for Rehab
- Rehab for Hamstring Pulls and Strains
Hamstring Rehabilitation and Running Mechanics, Part 4
Written by Derek Hansen
So, what else is going on during the rehabilitation progression? In the weight room, we are staying away from any lower body work in the first week. The work on the track is providing enough of a controlled stimulus. We are, however, having the athletes continue their heavy bench press workouts to ensure that some very high intensity work is maintained by the athlete. The stress of the bench press translates into stress adaptations at a nervous system level and on a hormonal level that will benefit the athlete when they are able to run at higher speeds.
By the second week, we are doing some lighter squatting movements, but also working on power movements – such as power cleans and power snatches from the hang position – over shorter ranges of motion. By the end of the second week and entering the third week, normal heavy lifting workouts have been restored. We are not doing any isolated resistance training work in the hamstring region (i.e. hamstring curls, Romanian dead lifts) as we are trying to avoid any exercises that may lead to stiffness or soreness that could impede our progress on the track. By the third week of rehabilitation, our full weight lifting programming is resumed. This return to normal training coincides nicely with our resumption of normal sprint workouts.
One final method that we used throughout the rehabilitation process was the application of Electronic Muscle Stimulation (EMS). In the initial stages of rehabilitation (Weeks 1 to 2), we used EMS for increasing circulation to and from the injury site. In the first few days of the rehabilitation process, we place the EMS pads away from the injury site (regions above or below the site) to pulse the muscles and enhance overall circulation to the site. By the end of the first week, we had placed pads on either end of the hamstring to lightly pulse the entire hamstring muscle. Although the main purpose was to enhance circulation, there are other side benefits of using electrical muscle stimulation including general stimulation and strengthening, as well as pain management. We did not intend to rely on the EMS for the strengthening benefit, as our needs were being met by the on-track sprinting. Additionally, there are problems of coordination with hamstring strengthening. Although electrical muscle stimulation will strengthen individual muscles, the coordination and sequencing issues must be developed through actual sprinting. Strength without coordination can be problematic.
In summary, coaches and rehabilitation specialists must do everything in their power to allow an athlete to resume normal sprint activities (even at sub-maximal speeds) as soon as possible in order to effect a successful hamstring recovery. This includes everything from massage, stretching around the injury, wrapping, electronic muscle stimulation and appropriate rest periods. Every training session must be an information gathering opportunity. Your next move will be based on what you see and what the athlete tells you. Shooting video is also useful so that you can compare one day to the next to identify improvements and changes in stride patterns. As in regular training, if improvements are not being effected, steps must be taken to ensure that the athlete continually gets better.