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Sat 20-Aug-2011 12:14
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Hamstrings, Injury and Better Training Methods
Dave is the head coach at
Wild Geese Fitness Training
which was set up mainly for training martial artists. However, his reputation for creating powerful, efficient and injury free fighters has spread to other sports. WG-Fit is now home to triathletes, GAA and football players alike.
I’ve had many a GAA player come through my door and I’m often shocked at the physical state these guys are in. And looking at the recent statistics released by the GAA on injury, there is nothing in there I find surprising, but also nothing that I feel can’t be significantly reduced by changing the way these guys train.
The following snippet is taken from www.gaaa.ie “Players Welfare, Hamstring injury”:
RECENT RESEARCH IRISH MEDICAL JOURNAL
Study: Glasgow University and NUI Galway (Newell Thesis)
• GAA players are more likely to be injured in the final quarter of games and
Training (47%). Recommends further investigation.
• Relative risk of injury was almost 11 times more likely in games (59%), rather
than in training (41%).
• Despite the high intensity and physical nature of Gaelic Football , there was
significantly higher proportion of non-contact injuries (60%).
• Main non-contact injuries were muscle strains which were caused mainly by
running, twisting, accelerating and decelerating.
Hamstrings 31% Groin 14%
So in a game renowned for its physicality, the majority of injury occurs without any outside influence. It is the players own body letting him down.
Here are some other injuries that commonly occur, again taken from GAA.ie
• Hamstring (football: 18.2% of all injuries, hurling: 16.5%)
• Knee (11.6% of injuries – both codes)
• Pelvis & Groin (football: 9.4% of all injuries, hurling: 10.4%)
• Ankle (9% of all injuries – both codes)
• Shoulder (football: 6.8% of all injuries, hurling: 6%)
• Wrist & Hand (football: 4.2% of all injuries, hurling: 10.3%)
We can see from these statistics that lower limb injuries are the most common, with the hamstrings being the most common injury, closely followed by knee and hip.
Are these injuries related? I believe so. The hamstring is made of three muscles, without going into too much detail the three act together to perform two functions and assist in several others. Their main job is to extend the hip and flex the knee. It also plays a part in adducting (bringing it towards the midline) the leg as well as rotating it. However these secondary functions could also be looked at as preventing the leg abducting (moving away from the midline) and counter rotating.
Does the hamstring work alone? Absolutely not, while it may be the prime mover in knee flexion, it is assisted by the gastrocnemius. In terms of hip extension it plays second fiddle to the glutes.
This is where the term Posterior chain becomes relevant. It refers to the muscles on the rear of the body, mostly used to extend and arch the body backwards. Thomas Myers refers to this as the superficial back line in his 'Anatomy Trains' book. Any break or weakness in the posterior chain will lead to extra stresses being placed elsewhere, which will undoubtedly lead to further injury.
A damaged hamstring muscle will no longer be able to fully assist hip extension thereby overloading the glutes inviting back pain and groin injury. It will no longer play a role in stabilising the knee inviting poor movement patterns at the knee inviting injury to this joint and the ankle below.
So why are hamstring injuries at the top of the list? Look at the main injury causes cited on the GAA site:
Main non-contact injuries were muscle strains which were caused mainly by running, twisting, accelerating and decelerating.
Hamstrings 31% Groin 14%
Running, twisting, accelerating and decelerating. All very basic movements. But movements that require strength, mobility and agility.
How can these be trained? Let’s look first at how not to train them. Endless hours of jogging and medium paced running. Many coaches, particularly the old school coaches in GAA and many other sports will have his players run and run.
In my opinion this outdated approach is a large contributing factor in the injury statistics. As a former endurance athlete and having spent time training many a triathlete, cyclist and runner, I’ve seen first hand that endurance running commonly causes two problems:
Quad Dominance in the athlete
Gluteal weakness in the athlete.
The Quadriceps muscle group mainly work on extending the knee, but also flex the hip. And while huge quads may look cool, they’re not nearly as important athletically as they are aesthetically.
Imbalances between the quads and hamstrings can often result in a lack of stability at the knee joint. Tightness in the quads, particularly the Rectus Femoris and TFL can cause an anterior pelvic tilt, placing the glutes and hamstrings in a stretched position where they are unable to function efficiently.
This tightening is often felt through the hip flexors (psoas group), which is a common cause of back pain and can prevent the hip from fully extending. As the Tensor facia latea becomes tight, so does the illiotibial band (ITB). The ITB is an article in itself, but needless to say, tightness in the ITB will pull on the lateral aspect of the knee and is often felt as pain on the medial side.
So what about the gluteal weakness? The Glutes are responsible for the hip extension, abduction and rotation of the leg, all vital movements for any athlete. Without proper firing of the glutes, other muscles will need to take the strain, more often than not the poor old hamstring is called upon as a prime mover as opposed to an assistance
The hamstring now overworked and most likely pulled tight by a tilted pelvis, is placed under enormous strain. At this point most athletes will attempt to stretch the muscle to relieve the tightness. The relief from this is usually temporary at best, as the muscle isn’t shortened, but already chronically stretched and overworked.
So we need to address these problems. The posterior chain must be brought back online, building strength in the glutes and hamstring muscles. In the standard gym setting hamstrings are often worked on the leg curl machine. This merely trains one aspect of hamstring function, knee flexion which is of relative unimportance to its other function, hip extension. The hip extension cannot and should not be trained without the glutes.
There are a range of training drills that can be used for training hip extension, but in my opinion the Kettlebell Swing is the best option. Even in a rehabilitation setting, the kettlebell swing is an extremely valuable tool.
The movement used to swing a kettlebell is similar to that of a deadlift. The deadlift is possibly the king of all weight room lifts and absolutely must be in your athletes program. But the deadlift has a short range of motion and doesn’t suit high reps (deads should be done heavy in the 1-5 rep range.)
The kettlebell swing however doesn’t start on the floor, it is swung through the legs forcing a greater angle at the hip and stretch of the posterior chain. The glutes, hamstrings and even low back are brought to and end range of motion, the fascia is loaded stimulating the Golgi Tendon Organs and activating the stretch shortening reflex. The stretch reflex then causes the Hamstrings, glutes and low back all fire in order to powerfully drive the hip through, swinging the bell forward. The finish position is like the top of a deadlift, except momentum will have carried the bell in an arc up to around chest height.
As the bell then starts to fall it will gather speed, which the athlete will use to push the bell back once again between the legs and again loading the fascia and activating the stretch shortening cycle to gain a powerful forward contraction.
This repetitive loading
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