Tuesday, September 28, 2010

Resolving Hamstring Injuries Part 5

Functional Hamstring Exercises
It is very important that the hamstrings are trained in same manner that they function during real life activities. The hamstrings work in synergy with multiple muscles and do not act as a singular isolated muscle. For example, to mimic hamstring muscle function during running the hamstrings need to be training in both open and closed kinetic chain movements. Closed chain exercise will mimic the stance phase of running, and open chain exercises can mimic the swing phase of running (eccentric actions).

  • Closed kinetic chain exercises – These are exercises where, in the case of the lower extremity, the foot is in constant contact with the ground. Examples would be: Lunges, squats, dead lifts, power cleans. These exercises focus on the co-contraction of multiple groups of muscles at the same time. They also involve multiple joints at the same time: those being the ankles, knees and hips.
  • Open kinetic chain exercises – These are exercises where the leg/foot is free to move and is not in contact with a surface. These exercises are usually non-weight bearing.
Numerous researchers recommend that your hamstrings should be 60 to 80% as strong as your quadriceps.

Strengthening Your Hamstrings
Strengthening your hamstrings is an essential component in reaching a full recovery from an injury. These are only a few of the strengthening exercises we recommend to our patients.

Romanian Dead Lift (Blog Photo) - This is a great closed kinetic chain exercise for training the hamstrings in eccentric contraction. Starting with low loads, for rehabilitation training, then building up to higher levels for athletic training.
· Stand straight with your lumbar spine in slight extension, with a barbell or dumbbells in your hands. Feet should be shoulder width apart, legs are straight, but not hyper extended.
· Flex forward from the hips moving the barbell or dumbbells down the front of your legs. Do not bend your knees all motion needs to come from the hips.
· As you lean forward, the hamstrings will lengthen, placing them under considerable eccentric load.
· Continue to lower the weight until you can no longer hold your back in the extension position. This will probably be when the weight is at the middle of your shins.

Single Leg Dead Lift – This is a similar exercise to the Romanian dead lift but is performed one leg at a time holding a dumbbell with both hands.
· The same procedure is used except that the back leg can be raised off of the ground for balance

B – Skip Drill
This is a common running drill that is great for strengthening the hamstrings (pawback). Follow this link to view a video on how to perform B-Skips. When doing this exercise, emphasis should be placed on pawing and driving the hip through. (Youtube Video of B-Skip Drill).

Stretching Your Hamstrings
Stretching after a hamstring injury is extremely important. Initially, stretching may have to be done passively within a pain free range of motion. To get a better idea of why stretching is so important, consider this. During the first two days to six weeks after an injury, collagen is formed and laid down to repair the injured area. If an injured person is performing the correct stretching exercises, the majority of the collagen will be laid down in the same direction as the tissue being repaired. This makes the repaired tissue stronger and more capable of performing its function. If the individual is not stretching, the tissue will be laid down in more random patterns, leading to the development of weaker tissue that is easily re-injured (scar tissue).

A word of caution, be careful not to be too aggressive with stretches after an injury. Do not stretch past the point of mild discomfort, doing so may delay healing and cause further injury.

Psoas Stretch
The psoas is a very important muscle to stretch if you have had a hamstring injury or wish to prevent one from occurring. There is an antagonistic relationship between the psoas muscle and your gluteal muscles. Essentially when the psoas become short and contracted it turns off your glute muscles. Your glutes and your hamstrings are your primary hip extensors. Therefore when your glutes get turned off, more of the load is placed on your hamstrings which then become susceptible to injury.

There are several ways that you can stretch out the psoas with either static or dynamic stretches.

Note: that after the psoas muscle is stretched out the gluteal muscles should be worked to regain activation of the muscle. This will help to take stress off of the hamstring.

Balance and Proprioceptive Training
Whenever a sprain/strain injury occurs it is not just the ligament, tendon, or muscle fibers that are damaged. Often, the embedded neurological structures within these soft-tissue structures are also damaged. These neurological structures (golgi tendon organs, muscle spindles, and joint receptors) are essential for postural control.
Both Golgi Tendon Organs and Muscle Spindle Cells are sensory neurons (proprioceptors). Sensory neurons monitor muscle and tendon motion (contraction and stretching) and relay this information back to your brain. This creates a feedback loop system that allows your body to discern its position and postural orientation. Joint receptors are located in joint capsules and respond to deep pressure and to other stimuli such as stress or change in position. They are also part of your body’s neurological feedback loop system.

What appears to be just a simple hamstring tear often involves some damage to several neurological structures. The good news is that the nervous system is very good at repairing itself given the right type of exercises.

That is why every patient that comes to us for a hamstring tear is also given exercises that involve balance training. Balance training helps to repair neurological damage, substantially decreasing the chance of re-injury

For more information, go to www.releaseyourbody.com
 If you would like information about our clinic please see http://kinetichealth.ca


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1 comment:

  1. I recommend the Romanian deadlift and its variations to many of my hamstring and lower back patients. It's an excellent whole body exercise.