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The biggest mistakes people make when returning to sport from a hamstring tear.

5/11/2020

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Have you ever felt a twinge or maybe more in your hamstring? It might have been from something as simple as running across the street to make the lights? Or maybe you were feeling good and pushing for a new personal best in the gym or out for a run? 
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However it happened, you definitely aren’t alone, the incidence of hamstring strains can be as high as 5 players per season per team in some cases (1) with a reoccurrence rate of 34%. So welcome, kick your feet up (unless that hurts) and let’s do a deep dive into the best and worst ways to recover from a hamstring injury.
 
The number one mistake people will make is to not respect the injury. Depending on the degree of muscle damage that has occurred you are looking at 3 to 6 months of recovery. During this time the body will undergo processes of “cleaning up” the dead/damaged cells and generating new blood vessels and tissue. These are complex tasks that cannot be sped up, but can most certainly be slowed down! If you start to get confident with your injury and want to “test it out” or “see how it goes” you risk damaging healing tissues and setting yourself back, which is the equivalent of picking at a scab while a cut is healing.

The second mistake people will make is too much too soon. While it’s fantastic to be working with highly motivated people, the recovery for a hamstring tear is similar to that of walking a tightrope, the muscle needs to me moved and loaded enough to promote healing and recovery but not so much that we end up doing more harm than good.

The third mistake people make is forget maintenance of strength. It’s very easy to get tunnel vision when it comes to injury and focus on the injured muscle and getting it back to strength but the trap people can fall into is that they will have a fantastic hamstring but the rest of their leg (and whole other leg) has been deconditioned from doing nothing for the past few months. When this happens, it can not only delay the return to sport but it can also lead to injuries in other muscles and joints.
 
So now that we have what not to do out of the way, before we talk about what to do it is important to mention that while this is based on the best current evidence it is still a “one size fits all” type of advice so it may not be best for your exact presentation.
 
Loading the hamstring early is the first tip, (this is where the tightrope analogy comes back into play) Hickey et al. (1) showed that inclusion of early eccentric hamstring exercises led to greater hamstring strength and length down the track (2). Timeframes for recovery were similar but by choosing tailored exercise and load to put through the hamstring allowed for better results.
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It wouldn’t be a hamstring rehabilitation program if we didn’t talk about the infamous Nordic hamstring exercise… The Nordic has come under fire recently for not being a functional exercise but you could argue that what it DOES do, is does VERY well. The Nordic has good evidence as an injury prevention tool (3) and as a means of increasing muscle length and strength. For these reasons, Nordics will still remain a staple for rehabilitation but it is important to combine them with sport/task specific training.

References:
  1. Br J Sports Med (2009), 45(7), 553-558
  2. J Sci Med Sport (2017), 20, 11-12
  3. Am J Sports Med (2011), 39(11), 2296-2303
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Take a swing at these golfing tips to level up your game! 2/2

8/10/2020

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Shoulder:
The rotator cuff plays a huge role in your golf swing and is frequently injured in lower handicap players (1). A simple theraband can go a long way to prevent injuries, physios will work with you to identify target shoulder weaknesses.

​Click on the image below to check out this great rotator cuff workout by Luca: 
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Back:
A targeted strength and mobility program for the back can not only reduce pain but it has also been shown to improve backswing hip turn and accuracy in golf (2). Physiotherapy programs will help you work towards a range of rotational movement as well as strengthen your back to handle rapid rotation during your swing.
 
Hips:
Along with other areas, the hips have been recognised to contribute to maximising distance and accuracy in golf (3). Other studies have also recognised, a correlation between hip rotation range of motion asymmetry and low back pain, suggesting that golfers experiencing low back pain need to also take their hips into strong consideration.
 
While these are key parts to managing or preventing pain while maximising your golf, a tailored assessment and program based on your history and body is the key to success.


Watch our videos about Thoracic Spine Health for even more info! Click on the images below !
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References:
  1. Physician Sportsmed 2009;37(1):92-96.
  2. Phys Ther Sport 2016;22:16-22.
  3. Int J Sports Med 2005;35(5):429-449.
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Take a swing at these golfing tips to level up your game! 1/2

1/10/2020

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Do you get aches and pains after even 9 holes of golf? Are you getting less movement from your body and it’s costing you your handicap?

Unfortunately, golf is not the exception to sporting injuries with up to 80% of golfers experiencing back pain at some stage. Of this percentage, too many cases are likely to have recurring and relapsing symptoms form a poorly managed condition.

Now more than ever an exercise program is an essential part of your golf game.  A long period of rest followed by a sudden increase in activity is the most efficient way to cause an injury. Without a structured exercise and mobility program you risk strains and sprains to your body that will not only effect your game but also put more demand on other body parts to compensate for any lack of movement. This can change muscle memory and the way you swing, skyrocketing the risk of injuring other parts of your body.

Due to the nature of golf, hips, backs and shoulders are often the most susceptible to injury. Each one of these body parts play a key role in your swing and can make life a nightmare when injured.

SALVAGE OR SAVAGE YOUR HANDICAP
A structured exercise and mobility program can be a lifesaver for your handicap, it can make sure that joints are moving smoothly and muscles are activating correctly. Not only can an exercise program ensure that all body parts are working together but it can also help take your golf swing to the next level.

Getting expert physiotherapy advice on your biomechanics and a program will identify areas to build healthy muscle, ligaments with the right exercises, the right exercising strategies beyond just swinging to make your golf comfortable, minimising the risk of injury and enhancing safety. The benefits are…
  • better management of injury and having the tools to look after yourself.
  • understanding what your physical limitations are and goal setting overcoming these with a clinically informed treatment plan.
  • Alternatives to just golf to train for golf involving other forms of exercise to target the same goals. Think of strength exercises and flexibility work.

If you have ever hurt yourself playing golf and then continue reinjuring yourself keep reading, we are going to touch maintenance and preventative exercises to make sure your body can handle anything golf swings at it!

​Watch out for part 2 next week!
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    Luca Scomazzon-Rossi APAM

    Luca graduated from a Bachelor of Physiotherapy with honours and has a background in personal training.

    Jayce Gilbert FACP, APAM

    Clinic director & Specialist Musculoskeletal Physiotherapist* in treatment for back, neck, headache and TMD (Jaw/Face) problems.

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