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Did you pull your hamstring? (or did your athlete pull their hamstring?)
Once you pull or strain it, the chance for re-injury is high. But it doesn’t have to be that way!!! There are several theories for this.
I discussed hamstring pulls in several past articles:
- Hamstring Injuries, the Iliopsoas and Imbalances
- Controversial Hamstring Workout for Rehab
- Rehab for Hamstring Pulls and Strains
This article is guest blogged by Thachvu Ho, the creator of REgel.
Visit his website at http://www.re-gel.com/Athletes_Almanac
Eccentric Loading to Prevent Hamstring Injury
THE THREE TYPES OF MUSCLE CONTRACTION:
Concentric contraction- Shortening of a muscle. This would be the ‘up” phase of an exercise. Examples would be curling a dumbbell for a bicep curl, pushing a barbell up in the bench press.
Eccentric contraction- Lengthening/Stretching of a muscle. Examples would be the lowering the dumbbell for a bicep curl or lowering the barbell down in the bench press.
Isometric contraction- No change or movement in muscle length while the muscle is contracting. Examples include pushing an immoveable object (wall), the pause between an eccentric/concentric phase.
ECCENTRIC TRAINING FOR SPORTS
With the many types of training programs, coaches, trainers and conditioning specialist use a variety of eccentric loading to improve performance including but not limited to rehabbing injuries. Numerous studies have shown that using a specific eccentric program can significantly reduce hamstring injuries and rehab tendonitis in various areas. Also, plyometrics use eccentric contractions to improve explosive power and elasticity which are important in sports that require jumping and sprinting. Here is a list of important facts about eccentric training:
- Eccentric Training can create a stiffer muscle, which can protect a hamstring from damage and also increase the amount of elastic energy available in the stretch shortening cycle. (Malliaropoulos et al, 2012)
- Eccentric contractions create more force and use less energy than a concentric contraction. (McHugh et al, 1999)
- Using eccentric training will provide protection from injury and re-injury (Proske and Allen, 2005)
- Heavy-load eccentric calf muscle training can treat and improve chronic Achillies tendinosis. (Alfredson et al 1998)
- Nordic hamstring exercise can be used as a hamstring injury and re-injury prevention tool. (Thorborg, 2012)
- Eccentric exercises are better first options than medication or surgery to improve function for chronic Achilles tendinosis (Alfredson, 2000)
- Using an eccentric training regime can improve symptoms for tennis elbow (Stasinopoulos, 2005)
- Emphasis on total body eccentric training can elevate resting metabolic rate for up to 2 hours post-workout. (Hackney et al 2008)
While sprinting, the hamstring has two functions: They act as shock absorbers when the leg hits the ground and they act as springs when hamstring lengthens to the optimum length to create enough elastic energy to produce beneficial forces.
Hamstring injury occurs frequently in sports that involve bursts of sprinting. Most hamstring strains occur during the late swing phase during the lengthening of the hamstring (when knees are coming up high) and load of the hamstring is the greatest. This is why hamstring strains are sometimes called pulled hamstring… You literally pulled your hamstring too far. Also, you feel the hamstring pain while slowing down because of breaking forces and your hamstring is absorbing the energy.
This is a common scenario that plays across many high schools and universities Track programs leading to a hamstring injury:
|DAY||HOW IS THE BODY||TRACK WORKOUT|
|Mon||Body feels good||3 x 150 at 90%|
|Tues||Legs are sore, left hamstring at 90%.||8 x 200 meters tempo (you ended up running too fast to meet time goals)|
|Wed||Legs are sore, left hamstring 80%||Ladder 1 x 100, 150, 200, 150, 100 at 85%|
|Thur||Legs less sore, left hamstring 75%||Blocks, 3 x 60 at 90%|
|Fri||Legs feel good except hamstring is 70%||Rest and stretching|
|Sat||Hamstring 70%||Run 100 meters…Pulled hamstring!|
WHAT WENT WRONG?
Once you pull/strain a hamstring you will be susceptible to the same injury because of formation of fibrous adhesions that have not healed correctly. These adhesions accumulate due to inactivity, inflammation, and overtraining. Also, too many hard days together lead the hamstring to have “weakness”. This weakness is when your mind wants to lengthen your stride and create more force but the hamstring is too weak to go full blast. The combination of adhesions and weakness will decrease range of motion and decrease strength. This is why the muscle feels tight, weak, and achy. Looking at the workouts and how the body feels you could see that the hamstring was getting weaker throughout the week. The one day of rest and stretching didn’t help. 4-5 days of rest and stretching would not have helped either because the hamstring needed to get to 90-100% of strength to run a race.
WHAT TO DO?
PREHAB the injury prone muscle with exercises and/or drills to prevent injuries or if you are injured you can set up a similar program to REHAB your leg. Personally, I like to spend a few minutes to prehab each week to prevent the agony of feeling injured. Numerous studies show the effective use of ECCENTRIC LOADING for preventing many injuries including: Achilles, groin, and hamstring.
Two Exercises that focus on eccentric loading and used in an effective prehab program are the Nordic hamstring Exercise and the Seated single-leg eccentric leg curl. Personally, I prefer the later because each individual has different hamstring strength for each leg, adjusting the amount of resistance is much easier and the exercise can be performed without a partner. Also, it allows utilization of a quick but controlled concentric phase which is necessary for the hamstring in jumping and sprinting. These exercises should be done 3-4 times a week before a workout because they can act as a dynamic exercise prepping the hamstring for an intense sprint session.
NORDIC HAMSTRING EXERCISE
Start by kneeling with your feet fixed by a partner or some device. Fall forward and use your hamstring to control the descent then catch yourself with your hands. Next, forcefully push yourself off the ground which will decrease the concentric load and return yourself to the original starting position.
Progress by decreasing speed of descent, adding a 5-10 lbs. dumbbell to increase resistance
SEATED SINGLE-LEG ECCENTRIC LEG CURL
Start by performing one set of double leg curls with a controllable working weight. After the initial warm up set, perform single leg curls of a weight about 60-70% of the weight used for the double leg curls. Slide one leg above the pad and one leg below (you can have both legs above the pad and perform the exercise with one leg a time). While performing the concentric phase of the exercise (pulling the weight and shortening the hamstring) focus on a quick and controlled butt kick. On the eccentric phase of the exercise (lengthening and straightening of the hamstring) focus on it being slow & steady, taking 3-5 seconds before my leg is straight. The eccentric phase of an exercise is important because the muscle can handle more weight during this phase and become stronger faster. Here is a sample progression I use for myself and other athletes dealing with hamstring issues:
Double leg set warm up sets
- 115lbs x 4-5 reps
Single leg (Start with the weaker leg & finish with the stronger leg)
- 75lbs x 5 reps
- 85lbs x 4 reps
- 95lbs x 3 reps
- 105lbs x 3 reps
- 115lbs x 3 reps
You may notice the low amount of reps and high weight resistance for both the warm up and the working weight sets. The reason the reps are reduced in a prehab routine is that you don’t necessarily want to overwork the muscle and have it tired. However you still need to increase the amount of resistance to have the hamstring strong enough to be ready for sprinting. Athletes sprinting at 100% effort, exert forces up to 2.5 times body weight (Weyand and Davis, 2005). Light weight of 10-20lb leg curls is not going get your legs strong enough to handle intense sprinting.
If you were to perform an eccentric set with 15 reps it could take up to 60 seconds and too much time under tension for the hamstring. A common mistake for athletes is to work with the lower resistance weight with higher reps but this is like doing 10 sets of 100 meters at 60%, the stimulus is not intense enough to copy running 2 sets of 60 meters at 90%. Use the old adage of quality not quantity.
Try adding either one of these exercises to warm up regimen and you will last the whole season without pulling your hamstring.
Please comment below your feedback and progress.