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What we don't want this week: hamstring strains in footballers- prevention is better than cure


#football #footballmedicine #footballershamstring #hamstringstrain #preseason #embrace #therapiesinmotion #comeonengland #itscominghome


One of the biggest challenges we see in footballers is hamstring strains. The biggest risk factor for sustaining a future hamstring injury is simple- having had a previous hamstring injury. So why is this? Research shows that eccentric knee flexor (hamstring) strength is reduced and fascile length is reduced (the architecture of the muscle is changed and it is less compliant). I would also argue that there is sensitivity of the nervous system, but this harder to prove with research.


So what can we do about it?


Eccentric training refers to the ability of a muscle to contract, but simultaneously lengthen. When you kick a ball the hamstring lengthens as the knee extends. The hamstring has to control the movement and decelerate the foot as it reaches its end point in range. This similarly happens in sprinting and changes of direction. So you can see why hamstrings can be vulnerable.


Training the hamstring eccentrically has been shown to improve knee flexor strength and increase fascile length. Perhaps the most researched and familiar way of doing this is Nordic Hamstring exercises. In the field a player adopts a high kneeling position, his heels are fixed by another- keeping his knee- hips and trunk in line he lowers his body forward towards the floor as far as he can. In the gym a Nordic Curl is used. The hamstrings have to work tremendously hard to resist the pull of gravity.



You can load the hamstrings eccentrically in numerous other ways via deadlifts, flywheels or alternative whole body compound exercises. Whilst this is arguably more functional, these exercises (apart from flywheel) do not permit genuine hamstring overload and yielding to external load and force. Loads need to be very heavy, as such it is often implemented as part of a 5-10 week training program or once a week in season due to muscle soreness and recovery needed.


Regardless, this needs to be part of a comprehensive program that includes different muscle contractions, speed, functionality and neuromuscular control.


If you have had a previous hamstring injury and are playing next season, get some advice- at embrace we are a specialist clinic in musculoskeletal and sports injuries, based just outside Buckingham, and would be happy to helpJ embracetherapies.co.uk

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