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Hamstring Injuries Part 3

As we progress through the rehabilitation programme of our hamstring injury it is important to make it more dynamic, functional and sport specific. Sherry and Best compared and contrasted two hamstring rehabilitation programmes, one involving static stretching, isolated hamstring resistance training and icing (STST group), the other agility, trunk stabilization training and icing (PATS group). The results were published in the Journal of Orthopaedic and Sports Physical Therapy with surprising results.

24 athletes were involved in the study all with acute hamstring tears, 11 athletes were in the STST group and 13 athletes were in the PATS group. After 2 weeks, 6 of the 11 in the STST group had a reoccurring hamstring injury compared to the PATS group where no injury reoccurred.  After one year, 10 of the 11 from the STST group had reoccurring hamstring injuries compared to, 1 of the 13 from the PATS group had a reoccurring injury.

In conclusion agility, trunk stabilization training and icing is a much more effective form of rehabilitation compared to static stretching, isolated hamstring resistance training with ice.

Sample of an agility, trunk stabilization training programme:

Phase 1: low intensity

1)  Sidestepping 3 x 1min

2)  Leg crossover sidestepping 3 x 1min

3)  Front step 2 x 1min

4)  Single leg standing eyes open/closed 4 x 20secs

5)  Plank 4 x 20secs

6)  Two leg bridge 4 x 20secs

7)  Side bridge 4 x 20secs

8)  Ice 20mins

Phase 2: moderate/high intensity

1)  Sidestepping 3 x 1min

2)  Leg crossover sidestepping 3 x 1min

3)  Front step 2 x 1min

4)  Single leg windmill 4 x 20secs

5)  Push up with rotation 2 x 15reps

6)  Running on the spot fast feet 4 x 20secs

7)  Single leg standing

Criteria for return to sport

There is no standard time for return to sport after a hamstring injury as every injury is different. However there is a set of criteria which is considered a useful tool in gauging when an athlete is suitable to return to sport. These are:

1)  Full range of motion (equal to the uninjured leg)

2)  Full strength (equal or almost equal to uninjured leg)

3)  Pain free maximal contraction

4)  Ability to sprint from a standing start

5)  Ability to abruptly change pace during running

6)  Ability to bend to catch a ball running at full speed

Once these criteria are met it is safe to return to normal activity.

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