Have You Actually Got A Torn Hamstring

a torn hamstringThe biggest question on the mind of any athlete after a sudden discomfort in the hamstring area is – have I just sustained a torn hamstring?

After any event that causes an instant change you should stop to assess.

Did what I just feel mean that this is for real? Did the event actually do the damage I didn’t want it to do?

Have I actually done something serious and how can I be sure? [Read more…]

2 Approaches To Hamstring Rehab That You Need To Know

2 Approaches to hamstring recovery

It is no secret that a successful return to sport will involve hamstring strengthening. But, how often should you exercise your recently injured hamstring? And what exercises should you do?

The first question you need to answer is – why are you doing the exercises?

Answer this before you tackle “what exercises to do?” and “how often?” [Read more…]

The TA

For those who haven’t heard the transverse abdominis (TA) plays a crucial role in core stability.

Most athletes do not know how to effectively active this muscle.

What you may have heard is someone saying “draw the belly to the spine” or “engage the core” or “turn on your core”. This generally means contract your TA and hold the contraction while you complete whatever exercise your are currently attempting.

The TA is located deep in the abdomen below the outer six pack muscles it is used to stabilize the spine. It acts like a girdle and holds the torso of the body together tight, stabilized and controlled.

When a person injures their lower back often a dysfunction TA will result. It is important that control and activation is regained to reduce pressure and instability in the spine.

Very often a torn hamstring occurs as a result of an issue with the lower back or can lead to an issue with the lower back. If so, it is likely that the TA will be dysfunctional as a result.

If the athlete can learn to retrain this muscle and improve their pelvic stability, they will reduce the chance of re-injuring the hamstrings and back in the future.

Turning on the TA is a process which is not easy if you are not used to it. Start by lying on your back, with knees bent at a 45 degree angle. At first, the natural and most common reaction is to tense the rectus abdominis (six pack muscles). Or alternatively suck in the belly by holding your breath. It is important that you continue to breath normally and that the six pack muscles are relaxed.

Place you fingers just inside the hips:

find the transverse abdominis

Start by contracting your pelvic floor muscle, the muscle you use to go to the toilet, then slowly breathe out. You should feel a muscle under your fingers contract, if not keep going until you feel it. This can take some practice and getting used to. You should be able to hold the contraction and breathe normally.

It is important to understand that the TA is not a power muscle. It is a muscle that is designed for endurance, control and longevity and should be trained that way. When training the TA it is important to keep this in mind. You should not contract it as hard as you can, instead try to tense between 50% and 70% and learn to hold it for long and extended periods of time.

You should eventually get to the point that you can contract this muscle easily and should so before carrying out any exercise at the gym or at training.

There is an old adage says that when learning a new skill there are 4 stages:

1. Unconsciously – Incompetent
2. Consciously – Incompetent
3. Consciously – Competent
4. Unconsciously – Competent

Always continue to practice contracting the TA and eventually you will reach a point when you contract it without even thinking about it. When this point is reached you will have developed a more stable inner core and will be better prepared to deal with the challenges and force that is put on the body when competing on the sporting field.

Cause and Effect

One essential factor that can often be overlooked when testing and assessing a torn hamstring is the potential cause of the hamstring strain.

Too often hamstring rehab advice and programs are based around the recovery of the existing muscle injury without addressing the underlying cause.

It is possible that the strain was a freak accident that just happened because you were in the wrong place at the wrong time. However, if it was caused by an underlying issue, there is no doubt that another strain will eventuate if the issue is not addressed.

There are a number of potential causes that could lead to a hamstring strain these include:
• Strength Imbalances
• Flexibility Imbalances
• Insufficient Warm Up
• Poor Conditioning
• Poor Core Strength And Stability
• Back Injury
• Compensation From Another Injury
• Lazy and Misfiring Glutes
• Pinched Nerve
• Poor Pelvic Alignment
• Stressed Nervous System
• Weak Adductors / Abductors
• Insufficient Recovery From Previous Session
• Running Technique
• Etc.

Once the potential cause of hamstring strain is determined, it can then be addressed. The most appropriate rehab program would then be one where the weakness or imbalance is addressed AND the hamstring is treated, healed and strengthened.

Addressing imbalances may provide additional benefits such as reducing the chance of an injury to other parts of the body. For example addressing a hamstring and quad imbalance may aid in reducing the chances of damaging the quad muscle. Similarly, addressing an issue with the posterior chain may reduce the chance of a back, glute or calf strain.

There are many reasons to address the cause of the issue apart from the obvious. Improvements in muscle imbalances could lead to improved performance!

If the underlying issue is not addressed, not only will you be in the same position as before with regard to the imbalance you will now have a hamstring that has repairing and remodeling scar tissue which will act as a point of weakness that will fail first when the body is put back under stress.

The Pillar Exercise

The pillar of any rehab program for a torn hamstring is the Glute Brigde.

If you have just sustained a torn hamstring, learn to love this exercise. As you will be doing it … a lot!

Most physiotherapists will recommend you start with this base exercise for strengthening your recently damaged hamstring.

Why is it so good?

Well, for starters it can be used to build up your glutes as well, which is useful for any athlete. For those who haven’t heard, strong glutes is key to more athletic performance.

Secondly, the Glute Bridge allows a way to load the hamstring lightly without increasing the load too rapidly and too early.

Thirdly, there a number of hamstring injuries caused because of a ‘lazy glutes’ where the glute muscles don’t fire as they should when running. This exercise helps combat this issue.

As you progress through your rehab program you can make the glute bridge progressively harder for your hamstrings by changing the angle at your knee and moving your feet further from your butt. Conversely, if it is too hard then you can bring you legs back towards your butt. Eventually, once you have built up some strength you can transition to one leg.

When conducting this exercise:

  • Start on you back, feet flat on the floor and knees approximately at 90 degrees.
  • Engage and ‘turn on’ you inner core.
  • Squeeze your glutes and raise you butt off the floor.
  • Hold at the top and lower slower to the ground.

Start will two sets of 10 reps. Remember to stop if you feel pain or discomfort. It is important to note even mid levels of awareness and stop if you are unsure.

Pain Free Rehab

Once you have moved past the initial acute phase of muscle recovery for a torn hamstring, you will now be in the sub-acute phase where the body is starts to form and synthesize scar tissue.

The key at this stage of recovery is to start to introduce movement slowly and progressively to promote elasticity and suppleness of the newly formed scar tissue. This is best done by a hamstring rehab program, where you slowly add more challenging exercises overtime. The program should be developed to include exercises that promote range of movement and flexibility well as improve muscle strength.

However it is very important to ensure that you do not do further damage to the injured muscle during this phase. The best way to make sure this happens is to allow sufficient time for the body to heal and avoid pain in any exercise or movement that you are doing.

So what is pain?

This is an incredibly difficult thing to quantify as everybody sees it differently. Entire books, university courses and branches of philosophy have been dedicated to the topic. So to make it easy let’s talk about some of the things to look for during a rehab program.

The main idea is to try to differentiate between muscle fatigue and pain.

For example, remember the first time you attempted to do a set of push-ups or weighted exercise. Maybe you could get to 10 reps before your arms gave way underneath you and as you approached your last rep on the 8th or 9th rep you started to slow as you approached your limit.

This feeling is best described as muscle fatigue. It is generally symmetrical across the body (if you are doing exercises such as push-ups or squats) and you will be well aware that you approaching your limit.

Pain on the other hand, particularly when recovering from a torn hamstring, will tend to be asymmetrical and could happen suddenly and unexpectedly.

Say you have started your program with a simple double legged bridging exercise, it may be at say 3 reps you feel something that causes discomfort, something that only affects the injured muscle. If this happens then … STOP! It likely that you are experiencing pain around the injured muscle and should cease the set you were trying to complete.

Pain is a sign that your brain is telling you to stop as you have caused or may be about to cause damage to the body.

However, don’t fret, it doesn’t necessarily mean you have done further damage to the muscle, its more often than not a warning that you need to stop and wait a little longer before you can attempt that exercise again.

It is best to wait a day and try the exercise again. If you can’t do it without pain the following day, try again in another two days etc.

The idea is that eventually you want to build up to a point where you can go to muscle fatigue without pain!!!

It is also important to remember that the point of a rehab program is not to accelerate the rate at which the body is healing but to promote elasticity of the newly formed scar tissue that will reduce chance of re-injuring the muscle in the future.