Hamstring Injuries

Defying Gravity with the Alter-G

Alter G Anti Gravity Treadmill Sydney CBD

Alter G Anti Gravity Treadmill Sydney CBD

The AlterG Anti-Gravity Treadmill has finally arrived in Sydney CBD.

Here at Sydney Physiotherapy Solutions we understand how important it is for runners and other athletes to recover quickly so that they can continue participating in the sport that makes they love.

We are dedicated to continuously educating ourselves in order to provide the the most current and effective treatment possible. This is why we have decided to introduce the Alter-G anti-gravity treadmill to our brand new clinic at 155  Castlereagh Street in Sydney CBD.

Sydney Physio Solutions is proud to be one of the only clinics in Sydney to have an Alter-G anti-gravity treadmill.

Working with runners and athletes is a speciality here at the clinic. Many of our therapists are runners themselves which gives us an advantage when treating running injuries as we understand the sport and have the necessary experience in treating the associated injuries. More importantly, we understand that most of our athletes would prefer to keep running while injured and so we have introduced the Alter-G to ensure that we can keep our athletes running.

Advantages of the Alter-G Treadmill

  • Helps minimize time lost from training, especially those training for an event such as a marathon
  • Maintains cardiovascular fitness during rehab
  • Reduces stress on joints
  • Improves bone density measures
  • Suitable for runners who may be overweight
  • Allows gradual loading as our injury heals during rehabilitation

Specific injuries that the Alter-G is suitable for

  • Knee osteoarthritis
  • Complex regional pain syndrome
  • Fibula stress fracture
  • Lumbar disc herniation
  • Metatarsal stress fracture
  • Plantarfasciatis
  • Ankle sprains
  • Tibial stress fractures
  • Navicular stress fractures
  • All types of muscle strains

To find out how the Alter-G AntiGravity Treadmill works read more here.

Alter G Anti Gravity Treadmill Sydney

Alter G Anti Gravity Treadmill Sydney

The Alter G treadmill uses an inflatable bubble to enable users to walk and run in a reduced gravity environment. The effects of training in this environment is lowered impact on your lower body meaning a reduced risk of long term injury in addition to reducing the time to return to running post injury.

The Alter G in the Hi Performance Centre (HPC) is available to everyone whether you’re an athlete, returning to exercise from an injury or to aid weight loss.

Contact our Castlereagh Street clinic to make a booking on the AlterG Anti-gravity Treadmill machine.

Hamstring Injury Guide

WHAT ARE THE HAMSTRINGS?

The hamstrings are a group of 3 muscles located in the posterior of the thigh, between the hip and the knee. They consist of the semitendinosus, semimembranosus and biceps femoris.                                                                                                                                                                                                                            The hamstring muscles run from the “sitting bones” (ischial tuberosity) at the base of the pelvis and finish behind the knee, attaching to the top of the fibula on the outside of the knee (bicep femoris) and tibia on the inside of the knee (semimembranosus, semitendinosus).

WHAT DO THE HAMSTRINGS DO?

The main job of the hamstrings is to bend the knee, as well as helping to decelerate the knee during extension in activities such as walking and running. As the hamstrings cross both the hip and the knee, they also have role in extending the hip.

WHAT ARE THE HAMSTRINGS ATTACHED TO?

The main common origin of the hamstring complex is the ischial tuberosity. This is commonly called the seat bone and can be felt as a hard spot near the gluteal folds.

From here the hamstrings split into 3 muscle bundles. One passes towards the outside of the knee (biceps femoris) the other two head towards the inside of the knee (semimembranosus and semitendinosus).

The lateral hamstrings insert into the lateral tibia, lateral collateral ligament and fibular head.

The medial hamstrings insert into the superior and medial tibial border. They blend with the tendon of the gracillis muscle to become the pes anserinus tendon.

There may also be a bursa present at this location.

WHICH ACTIVITIES USE THE HAMSTRINGS?

The hamstring is a prime mover for all activities which include flexion (bending) of the knee and extension (straightening) of the hip. It is also responsible for braking a knee or hip movement in the opposite direction.  

 Activities which depend on the hamstring to do both of these functions include walking, running, squatting, bending, lifting, kicking and rowing to name a few.                                                                                                                                                                                                                                                 If you combine some of these activities such as running and bending, or picking a ball up from the ground while running, the intensity demanded of the hamstring increases dramatically. 

The hamstring is also responsible for pelvic control. It pulls the pelvis into posterior rotation and facilitates anterior rotation by not activating. This has great importance for pelvic stability during static and dynamic activities.

WHAT IS A TIGHT HAMSTRING?

The feeling of hamstring tightness is ambiguous and does not necessarily mean the hamstring’s physical and mechanical properties are under excess tension or shortened. It is possible to have one without the other.

It could be one of several different complaints which may include the following:

There has been a loss of range of motion around the hip joint, knee joint and lumbar spine.

End of range of motion around joints is restricted and requires extra effort to achieve this.

The movement around the joints may be fine but the hamstring just never feels relaxed.

The movement may be fine around the joints and the hamstring feels relaxed, but there is a mild pain in the hamstring, and is perceived as being “tight”.

WHERE WILL HAMSTRING PAIN OCCUR?

Depending on what hamstring injury you have, pain can either occur in the muscle or the tendon. There are 3 main muscles that make up your hamstring, therefore depending on which hamstring muscle you have injured this will indicate the area of pain.                                                                                                                                                                                                                                                     Common areas of pain are centre of the muscle belly, where the muscle meets the tendon, where the tendon inserts into the bone, such as your sitting bone or tendon pain above the back of the knee.

WHAT CAUSES HAMSTRING INJURY?

Acute Hamstring injuries such as a tear are generally due to high velocity, intensive load being placed on the muscle. These also occur as a result of weakened or unconditioned muscles around the hip/pelvis and quads which can in turn put more strain through the Hamstring as it tries to compensate.  

Posture-wise you may be more at risk if you stand and move with your pelvis tipping forwards, or slumping back - this can put the Hamstrings at a disadvantage mechanically and may render them in a long, weak and or tight position.

WHICH HAMSTRING IS MOST COMMONLY INJURED?

There are two distinct types of Hamstring injuries, therefore it depends on the situation and the Sport undertaken as to which hamstring muscle can become injured;

Type 1 Hamstring strains occur during high-speed running. This is the more common type of Hamstring strain, and usually affects the Biceps Femoris, one of the parts of the Hamstring muscle, which meets the tendon near your Ischial Tuberosity (sit bone). These injuries are often more severe in their initial presentation, but recover much more quickly.

Type 2 Hamstring strains occur during movements leading to extensive lengthening of the Hamstrings when the Hip is also flexed, such as high-kicking, sliding tackle, and front-split – these injuries may occur at slow speeds, such as in gymnasts and ballet dancers, and can take much longer to rehabilitate.

HOW DO I TREAT A HAMSTRING INJURY?

Early management following a hamstring tear is crucial in determining your recovery time frame. The hamstring may bleed for several days. A RICE (rest, ice, compression, elevation) regime should be incorporated, whilst stretching should be avoided in this early period.

As soon as possible, pain permitting, exercise should commence to strengthen the hamstring again whilst also maintaining strength and flexibility of the unaffected musculature (eg glutes, calf). The PATS (progressive agility and trunk stabilisation) program is an example of an exercise program that studies have shown improves return to sport times and reduces re-injury rates.                                                                                                                                                                                                      Hamstring strengthening programs should progressively increase in intensity and incorporate different speeds and movements specific to your sport. When the hamstring is strong enough, you may return to training but you should successfully complete one week of full training prior to match play.

If the tendon, as opposed to the muscle, of the hamstring is thought to be the injured then you should follow a tendinopathy protocol. If you suffer from recurrent hamstring injuries then you may have a 'driver' from another area such as nerve tension which should be addressed using a neural mobilisation regime. To get a rehabilitation program tailored to your injury and needs, see an experienced physiotherapist.

WHAT IS THE DIFFERENCE BETWEEN A HAMSTRING STRAIN AND A HAMSTRING TEAR?

A grading system is used to determine the extent of a hamstring injury:

Grade 1 = a mild strain - few muscle fibres torn, minimal/no loss of muscle strength, and minimal pain on contraction. May present with some mild swelling and bruising.

Grade 2 = moderate strain/tear - significant number of fibres torn, muscle weakness and significant pain on contraction of that muscle. Usually presents with significant bruising and swelling. Please note this can take a few days to appear particularly if the tear is very deep.

Grade 3 = Complete tear - this means the muscle has been torn completely with a severe weakness/loss of function and is often pain free on resisted testing. This injury presents with signficant swelling and bruising.

WHY DO HAMSTRING MUSCLES CRAMP?

Hamstring cramping, especially cramps associated with a physical performance, is common and can be a painful and frustrating experience. However, despite their prevalence the exact cause is still unknown.

There is likely to be a combination of contributing factors though muscle fatigue seems the most likely. Muscle fatigue, or overload, may result from insufficient training/preparation, environmental conditions, intensity and duration of activity. The result of this overload is an increase in the excitability of the motor neuron, which may lead to cramping.

Several other theories, including the serum electrolyte theory, where it is thought that decreased electrolytes (e.g. Sodium, magnesium, potassium) caused by excess sweating (or overhydration) are being explored further by leading medical and sports scientists.There is a lot of potential in these studies for explaining and perhaps helping to prevent cramping.

The best that a person can do to prevent exercise induced cramps, is to ensure they prepare adequately for an athletic performance. This includes completing proper training, warm up, having the correct equipment and having an adequate diet and hydration.

WHAT EXERCISES SHOULD I DO TO PREVENT HAMSTRING INJURY?

Stopping a future hamstring injury is impossible, however, minimizing the likelihood of injury can be achieved through specific hamstring exercises.

These exercises should aim to achieve ‘strong and long/flexible’ hamstrings in comparison to ‘weak and short/tight’.

Whilst stretching exercises can help achieve ‘long’ hamstrings, certain strengthening exercises are more effective. Think ‘strengthen to lengthen.’

The godfather of hamstring strengthening is the Nordic Hamstring Exercise. (See below). 

According to at least half a dozen recent studies, almost two-thirds of hamstring injuries might be prevented by practicing the simple steps below. 

nordic-hamstring-exercise

nordic-hamstring-exercise

Steps: 1) Grab a partner or lock your ankles under a stable bar. Place your knees on a padded surface

2) Maintaining a straight torso (no bending at the hips or arching lower back), slowly lower yourself forward towards the ground.

3) Maintain position for 5 seconds and then break your fall onto the ground by placing your hands out in front of you. (Similar to a push-up position)

4) Repeat 10 times.

HOW TO DO A HAMSTRING STRETCH AND A HAMSTRING CURL?

Hamstring curls:

As the hamstring muscles are knee flexors the aim of a hamstring curl is to strengthen these muscles by bending your knee.

Technique:

Lying on your front with foot pointing down over the edge of a couch/table/bed, the athlete fully bends the knee – trying to touch your buttock with your heel.

Provided this is pain free, a resistance band or ankle weights can be used to increase difficulty.

Advantages:

Lying leg curls are the most direct exercise in isolating pure hamstring activity and strength. Other exercises such as Romanian deadlift or hyperextension exercises are hinging movements at the waist, working the hamstrings via the hip joint. That makes it more of a stretch exercise. The lying leg curl is more of a true and direct hamstring contraction exercise.

Disadvantages:

The lying leg curl is difficult to load unless you have access to a machine in a gym setting. The movement is not very functional in a sense that it is not a movement that happens naturally during the course of daily living (vs squat or deadlift).

Recurrent Hamstring Strains

HamstringRecurrence of a hamstring strain is incredibly frustrating, not only for the injured person, but also to see as a physiotherapist!  A hamstring strain may reoccur if a person suffers a worsening of their original strain, or otherwise another area of muscle along the muscle/group becomes injured. Commonly this occurs when the person is just getting back into training or attempting to return to their previous sport. It is disappointing to see as a physiotherapist, since often re-injury is preventable with good management. Different outcomes will depend on factors such as the degree of the initial injury, its location (i.e. muscle versus tendon) as well as personal and external variables, however general guidance can be provided for optimal rehabilitation.

Best tips for best rehabilitation and avoiding re-injury:

  1. Progress your hamstring through a series of exercises aiming to achieve full concentric/eccentric strength, dynamic muscle length, power and plyometric ability (strength with speed), and endurance, before considering returning to sport and sport specific drills. See Dynamic Stretches
  2. Ensure your hamstring has been rehabilitated through sport-specific tasks, when it is appropriate to do so. Exercises need to consider the location of the injury in the hamstring, stage of injury, and the multiple functions of the hamstring muscle. Your hamstrings will work hard when you are speeding up and slowing down from a run, stopping quickly, kicking a ball, bending forward from the hips (e.g. picking something up), and control twists and turns of the leg when you are moving at quick speeds. As such – the muscle group needs to be trained well to be able to cope with these activities for a successful return to sport. Even if your main sport is running, your hamstring should still be progressed to be able to tackle less frequent tasks with confidence for best function.
  3. Perform a graded, specific running programme which is best advised by a suitable physiotherapist. This should incorporate graduated progressions of running distance for endurance, sprint exercises, forwards/backwards/sideways and cutting movements, and stop-start work. Hamstring strains most commonly occur during quick acceleration or deceleration – and therefore this needs to be trained back for the tissue to be able to cope with this, under high repetition/load.
  4. Return to sport gradually! Make sure you progress back carefully towards a previous level of activity/intensity. The tests we can do for a hamstring in a physiotherapy clinic and even outdoors assessment are only one level of assessment. Fatigue has big implications for muscle. Only when you can manage full training sessions at 100% intensity over the week, then consider playing or running at a competition level. And even then, only playing only part of the first game back rather than the full game is best, since you will likely be working a lot harder in this situation! De-conditioning occurs from not playing sport in a while, and this may be when you are more prone to injury.
  5. Listen to the muscle. The helpful thing about a hamstring strain is that it often gives you big clues as to how it is going, and when it might be about to restrain! If the muscle or group feels tired, or like it is “tightening”, or “about to go”, then stop! It is at a high risk of reinjury at this point. “Pushing it” has a high chance for reinjuring the torn tissue or injuring healthy hamstring tissue from overload.
  6. Address any contributing factors. Common culprits which contribute to hamstring strains include biomechanics and imbalances about the spine, pelvis, hips and legs. For example, players of kicking sports may have imbalances from constant rotational forces in one direction, influencing pelvic/hip stability. Optimising core stability and glute/hip timing/power and balance with specific exercises is important to prevent overwork through hamstrings. Neural tension through the injured tissue or from tight associated hip/back structures can also increase likelihood of restrain and there are treatments/exercises available to help this. Read more
  7. Maintain good hydration and nutrition throughout your rehabilitation, and  use good recovery practices, for optimal muscle tissue healing and recovery.

If recurrent hamstring strains are a problem for you, seek advice from a good physiotherapist to help answer any questions and assess for any contributing reasons that may be leading to re-injury, as above.

injury

Muscle Strains and Tears

• Acute strains occur from undue pressure or overstretching of a muscle which results in a tear and damage to the muscle fibres and/or its attaching tendons

• Damage can occur to a small area causing a partial tear to the muscle fibres, or a large portion of the muscle causing a complete rupture of the muscle belly. They are graded accordingly from 1 to 3
• Muscle strains can occur in all muscles of the body during normal activities of daily life, work tasks etc, but most commonly present as a sporting injury
• Typical symptoms are pain, swelling, weakness and bruising or discolouration around the site of injury
• Chronic muscle strains can occur as small tears which happen over time with a continuously overloaded muscle
• The grading of acute muscle strains can determine the prognosis of the injury and helps to plan for return to sport
• A bad grade 2 tear may take 2-3 months to completely heal
• Depending on how many fibres are affected, grade 3 tears may require surgery

 
What you can expect/look out for
• Expect to see swelling and bruising/discolouration, this may continue to worsen in the days following the injury
• Pain, swelling and bruising usually subsides gradually over 1-3 weeks and the torn muscle begins to heal through scar tissue
• In most cases, with proper treatment most people completely recover from a muscle strain

Exercise

Muscle Tears – More information

• If surrounding muscles and/or joints are not working properly, one particular muscle may be being overloaded, leading to that muscle being injured with a smaller force.

 
Hints for self-management
• Initial management is as for most soft-tissue injuries
• Rest, may involve immobilising the area, a sling for the arm or crutches for the leg
• Ice the area with an ice-pack or ice-blocks wrapped in a tea-towel, for 20 minutes, every 2-3 hours over the next 72 hours
• Compress the area with a bandage
• Elevate the area above the heart i.e. a lower limb injury should be rested lying down with the foot up on a small stool/pillows

 
Management options
• After a period of relative rest it is necessary to exercise the injured and surrounding muscles to regain full function
• Exercises to stretch, strengthen and correct muscle imbalances are necessary
• Deep tissue massage may be appropriate after an initial period of rest to release the thickened scar tissue

Running With Injury – Is It Time For A Rest?

Running With Injury – Is It Time For A Rest?

If you’re a runner, chances are you’ve asked yourself this question. Up to 80% of runners will sustain a running-related injury at some point. If we include running with a cold or flu, then the number jumps to 100%. The question is, do you rest, modify your training or continue on as if nothing’s wrong!

running-rest-day-myths

running-rest-day-myths

Whilst we’re all different and each of our circumstances unique, here’s what I suggest you think about as you contemplate whether to strap the shoes on or stay in bed:

  1. Is it acute? If you suffered an injury significant enough to cut a training session short, you should take 48-72 hours off, give it a chance to settle and throw some ice on it. If it’s still troubling you after this rest period, get it seen to.
  2. Is the injury bad enough to affect your running style? If you can’t run with your normal gait, continuing to train will lead to a worsening of the injury or a secondary injury somewhere else. We see this all the time. Take some time off, cross-train, and/or see a professional.
  3. Is this a recurrence of an old injury? Keep an eye on these ones. It may just be that your brain (and your genes) have some ‘memory’ of the old injury, but always better to get on to managing these injuries quickly. If you do, you can usually stop them from progressing.
  4. Is the injury getting worse? In most cases, if you record a worsening of an injury over the previous week of training, it’s not going in the direction you want! Take some time off and consider getting someone in the know to have a look at it.
  5. Is your ‘cold’ more than just a ‘cold’? If your symptoms are typical for an upper respiratory tract infection (sore throat, sniffles and other things above the neck) then you’re probably ok. Research suggests that training in this situation wont make you worse or slow your recovery. However, if you have symptoms of a fever or cough (i.e. anything below the neck) then you need to rest, or there’s a good chance you’ll regret it!

I hope these tips help, but regardless of your answers, as you start to feel better and make your way back into training, back off a little and build your training up slowly. Taking some time off and then jumping straight back in is one (if not the most-likely) reason for problems to occur.

Most injuries are simple to manage with a common-sense approach. Be wary of reading too much on the net, as there’s an awful lot out there and a lot of it is…not prudent advice! If you’re unsure whether you need to see someone, set up a Skype appointment with one of the expert Sydney Physio Solutions Physiotherapists. They’ll ask you a series of questions and help you wade through the plethora of information available to advise you how best to tackle it.

No pain, no gain

No Pain No Gain??

One of the most common things we get asked is how much pain is acceptable?

We watch images of pro athletes pushing it to the limit and we hear stories of people smashing themselves day in day out…but the question always remains…how do we know when to push and when to hold back?

The question is an interesting one and the answer (of course) is not a simple one.  There are many contributing factors….I’ll try to explain the most common ones.

  1. How used to this kind training are you?

If you have gone from a relative couch potato to captain motivation overnight you are HIGHLY likely to get injured.

Sudden changes in exposure of our bodies to unfamiliar movements means that we are often poorly prepared to cope.

SOLUTION:

Engage in a progressive demands system

Start light and easy and progress your exercise demands slowly

If you are completely new to exercise it may even be worthwhile in the long run to be assessed by a physio/exercise physiologist for identification of biomechanical ‘risk factors’ (e.g. tight calfs, flat feet, poor lumbopelvic stability) and integrate some preventative training into your actual training.

  1. The pain disappears when you are actually running, only to stiffen up again after you’ve rested

WHAT THIS MEANS:

Unfortunately pains that settle with more activity can often mean the tendons are struggling with the change in load.

SOLUTION:

You may have to reduce your training load if this is happening, identify what tendon is causing the trouble and treat it locally with ice and targeted exercises.

In extreme cases you can use GTN patches to reduce the tendon pain but you will have to talk to your physio/GP/sports physician to make sure that this approach is right for you.

 

  1. The pain comes on with training and then just gets worse and worse until I physically have to stop.

SOLUTION:

Stop

This is not ok pain.  If the pain is in your legs it can be a compartment syndrome (where the muscles swell and are compressed within the fascial outer casing of the muscle) or it could even be a stress reaction in the bone.  Either way you need to get this looked at by someone who knows their stuff.

 

  1. My muscles are sore for up to 3 days following activity, but then they feel fine.

WHAT THIS MEANS:

Well Done

You are experiencing delayed onset muscle soreness…this is the no pain no gain they talk about.

You have exercised just enough to cause damage to the muscles, but it will be repaired and new, improved sarcomeres (the building blocks of muscles) will be laid down.

It is however a good time to rest for a day or two while you are sore, or cross train by doing something different (go for a swim or hit a few tennis balls gently).

Overall some discomfort is a acceptable with training, but if it is impacting your ability to perform regularly you must get it checked out.

Stuart Doorbar-Baptist | Senior Clinician and Research

How to Avoid Overuse Running Injuries

With all the marketing hype around, you might be forgiven for thinking that footwear is the key to preventing running injuries. Especially now, with most runners at least aware of the “barefoot” craze, it’s becoming harder to know what is the right shoe. The “old” advice around finding the right shoe for a particular foot-type is slowly being tested, and the trend is towards a more lightweight, minimalistic running shoe.

This phenomenon is primarily due to Chris McDougall’s book, that I’m sure everyone has read or at least knows the context, and to a study published in the British Journal of Sports Medicine. There will likely many more studies popping up in the next couple of years to corroborate these findings, as this is a big shift in thinking around footwear and running.

The study, by Ryan et al., showed that matching the “correct” shoe to a foot type had no effect on injury rates in a group of 81 female runners. In fact, those that received the “correct” shoe were slightly more likely to get injured. I think it’s important not to take this conclusion too far, as this was a relatively small study and had some major limitations. It does, however, give some credence to the view that we need to reassess the way we professionals in sports medicine approach running footwear.

While a bit un-scientific, selecting a shoe based on comfort is probably our best bet at present. For example, a study on 206 military personnel, who were allowed to select a foot insert based on their feelings of comfort, showed a significant reduction in injury rates, even though the inserts often had no association with their “foot type” or what would normally have been considered the appropriate insert for their foot. If you have a specific injury, or history of injury, affecting your foot then a consultation with a good physiotherapist or sports podiatrist is probably appropriate.

Anyway, regardless of all this hype and innuendo, a far more important issue than footwear is how you manipulate your training variables. Some studies have suggested that up to 80% of overuse running injuries are attributable to training errors. How you build your training up—including mileage, terrain, speed, and frequency—is the most important single consideration in avoiding a running injury. Regardless of what shoes you wear, how you run, how tight your hamstrings are or how poor your core control, the body needs to adapt to new loads. If you haven’t run much before, or you’re ramping up in preparation for an event, how you choose to do this will be the major factor in determining success or injury.

The 3 keys to avoiding running injuries:

1) Plan your event preparation, including the training variables of mileage, terrain, speed, frequency and, of course, the rate of increase in these variables. Discuss your plan with a sports medicine professional as well as a coach.

2) If you’re unsure on the footwear issue, discuss it with a professional. At present, research evidence suggests that you select a shoe that is comfortable for you, rather than one that has been “prescribed”. The way I address this is to give you a few options and suggest you go for a run around the store and select the one that feels the most comfortable.

3) Have a good biomechanical assessment – it’s a small investment in the overall scheme of things and will allow you to deal with pre-existing issues and risks, and help to prevent further problems.

…and it really is preventing an injury that is the key. Once an overuse running injury has occurred, it’s much harder to fix the problem and get you back on track.

What should be covered at the 3-month check up? This is probably the most critical point in preparing for an event. Identifying problems at this stage gives us the time and opportunity to fix the issue before it takes you out of training or results in a serious injury.

The key elements are:

• Discuss previous history of injury and any current niggles
• Assess weaknesses and areas of potential overuse injury
• Discuss your training plan and current fitness level
• Discuss your footwear
• Assess running mechanics using video analysis
• Establish a plan to avoid any potential injuries

 

If you suffer from running injury why not contact the team at Sydney Physiotherapy Solutions to make an appointment at either of our Sydney CBD physiotherapy clinics or at our recently opened Chatswood Physiotherapy clinic.

Hamstring strains – When can I play?

Assessment during motion by monitoring data from sensors fixed to the body

These sensors are fixed to your body and transmit data to be analysed

As the soccer/football season ramps up locally, those of you with an old, recurrent or new hamstring injury will be asking………When am I safe  to play?

You no longer need to be unsure.

The latest technology which objectively measures when you are ready to resume full training and take the field again, as used by Manchester United, is dorsa Vi.

Sydney Physiotherapy Solutions is proud to have this cutting edge technology to assist you with your recent or recurrent hamstring injury. We use it to direct rehab and return you to any running sport without any guess work.

 

 

 

 

Pilates for Runners!

I spend at least 50% of my day treating injuries caused by running! Most of these injuries could have been avoided if my clients had adequate control of their pelvis and lower limbs so they could run with good technique.

I know some patients find Physio exercises to be super boring and hard to keep up with once your pain settles down, which is why I suggest my patients join Pilates… or more specifically ‘Pilates for Runners!’

Pilates for Runners classes involves functional strengthening of the butt, abs and thighs in running specific positions. This means we do plenty of single legwork to practice stabilising the pelvis for running.

I find my patients really enjoy the classes and even once they are pain free and have improved their running form they stay on for maintenance as they  find it reduces their incidence of injuries.

If you don’t have a specialised ‘Pilates for Runners’ class in your area – a general Pilates class is a great start! I would struggle to think of a client who wouldn’t benefit from having a bit more Pilates in their life!

Running Injury Free

running Tberg

Every year when the running season starts to pick and more and more recreational runners start to enter into events like the Blackmores Half or Full Marathon and even some of the international events like the New York or Boston Marathon we see an increase in the same running injuries.

Common injuries that are usually a result of a certain factors that can be changed.   One factor is the periodization of the training program.   This means the progression of volume and load that you’re subjecting your body to.  Another factor is muscle strength and stability, for example, poor hip strength leading to poor knee mechanics.   And lastly running technique has a huge impact on injuries, whether it is high ground reaction forces as you land hard and pound the pavement or things like over striding.

All of these factors can be altered whether it’s through strength training at the gym, running drills and/or sitting down and planning a run program that will see proper running progressions.

First of all its important to find someone who can help you identify what the issues may be but then you must know how to implement it.

Here are a few key points to consider

  1. Training program- Instead of just going out and running distances you feel like you’re comfortable with, sit down and actually plan your distances.  The program should included different intensity runs to train all your energy systems.   Sprint training for short durations to increase your anaerobic system.   Tempo runs to target your lactate threshold and really learn how to push your race pace.   Long slow distances to increase your aerobic capacity and get some more KMs under your belt.  I generally look to increase your weekly volume by a steady 10% each week for safe progressions and would suggest that every 4 weeks is a recovery week in which you reduce volume from the previous week to allow your body to recover and prep for the next 3 weeks of increasing workload.
  2. Leg Strength- Make sure that you’re training your hip stabilizer muscles such as gluteus medius to ensure running efficiency.  You will most likely need someone to visually look at your running and single leg control to figure out if you’re lacking stability but you could start with doing some single leg squats in front of a mirror.   Compare sides to see if you can find a noticeable asymmetry between them.  Watch your knees and see if they collapse inward.
  3. Have someone film your running from behind and side on.  Look for the foot  to land under your hips and torso not out in front.