Hamstring Strain: Prevention & Rehabilitation (Part 3)

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Guest blog by Paul Head

Paul holds a BSc Sports Therapy degree from University of Central Lancashire (UCLAN) and is a pre reg physiotherapy student. He received first Class Honours Classification (78% average) and  an award for Academic Excellence in the field of sports therapy / physiotherapy from DJO UK. Find out more about Paul here…

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Hamstring Strain Prevention

Nordic Hamstring exercise

In a recent study Peterson et al, (2011) added the Nordic hamstring exercise to conventional pre season soccer exercise programs and showed it to be beneficial in reducing injury rates in soccer. The Nordic hamstring exercise is a partner exercise. The athlete starts in a kneeling position, with his torso from the knees upward held rigid and straight. A training partner applies pressure to the athlete’s heels/lower legs to ensure that the feet stay in contact with the ground throughout the movement. The athlete then attempts to resist a forward-falling motion using his hamstring muscles to maximize loading in the eccentric phase. The participants were asked to brake the forward fall for as long as possible using the hamstrings. The athletes were asked to use their hands to buffer the fall, let the chest touch the surface, and immediately get back to the starting position by pushing with their hands to minimize loading in the concentric phase (Mjolsnes et al, 2004).

Nordic Hamstring Exercise Start     Nordic hamstring exercise End

Nordic Hamstring Exercise Start and  end positions.

Peterson et al (2011) used 942 soccer players who performed the Nordic hamstring exercise in a progressive 10 week program during pre season that was added to their conventional training program. They compared injury rates between players that performed the Nordic hamstring progressive exercise program (table below) and those that did not.

Week

Sessions

Sets

Reps

1

1

2

5

2

2

2

6

3

3

3

6-8

4

3

3

8-10

5-10

3

3

12-10-8

They found that injury rates were reduced by 85% when compared to the control group who did not perform the eccentric protocol. The 10 week protocol was made progressive to reduce the negative effect of delayed onset of muscle soreness (DOMS). This study showed that adding in the Nordic hamstring exercise alone to conventional pre season training programs reduced hamstring injury rates.

The most consistently thought of explanation for the beneficial role of eccentric exercises for the hamstring muscle group in preventing injury and re injury is that they cause a shift in the optimum angle for eccentric torque generation, to longer hamstring muscle lengths which can protect against hamstring injuries and re-injuries. Peak muscle-tendinous force and strain for the hamstring muscle group occurs during the terminal swing phase, just before ground contact, and it is suggested that it is in this period of the stride cycle that the bi-articular hamstrings are at the greatest risk of injury. It is therefore suggested that eccentric muscle strength training should be performed at longer muscle-tendinous lengths, mimicking movements and muscle length occurring at both the knee and the hip (Thorborg, 2012).

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