Hamstring injuries

“Problems cannot be solved by the same level of thinking that created them” A.E.

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Hamstrings

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Most common injury in

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Hamstring – Incidence & Severity

• Approximately 6 players/squad/season

• Miss approximately 3 matches or weeks of play

Woods et al., 2004 – Hoskins et al., 2005

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Risk factors

• Previous hamstring injury >2x risk• Age• ACL injury (altered proprioceptive feedback)

• Reduced flexibility ???• Low hamstring strength ???• Strength deficits or imbalances ???

Isokinetic testing – specificity?Engebretsen et al., 2010Arnason et al., 2004Tsuda et al., 2001Verrall et al., 2001Christensen et al., 2000Mathieu Gram

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Clinical reasoning

+ Psychosocial

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Anatomical links

TibFib joint

SI Joint

m. Romboidei

ACL

Tsuda et al., 2001Beltran et al., 2003Hoskins et al., 2005

m. Popliteus

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Strong framework?

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Strong framework?

Tension TLF

Hodges et al., 1997Barker et al., 2004

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Strong framework?

Tension TLF

Hodges et al., 1997Barker et al., 2004

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Strong framework?

Tension TLF

Hodges et al., 1997Barker et al., 2004

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Strong framework?

Tension TLFHodges et al., 1997Barker et al., 2004

SIJ

Lx

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Articular

When evaluating hamstring pain,Evaluate biomechanics of:

“Problems cannot be solved by the same level of thinking that created them” A.E.

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Articular

When evaluating hamstring pain,Evaluate biomechanics of:

TibFib Joint

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Articular

When evaluating hamstring pain,Evaluate biomechanics of:

TibFib Joint

SI Joint

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Articular

When evaluating hamstring pain,Evaluate biomechanics of:

TibFib Joint

SI Joint

Lx

Woods et al., 2004

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Muscular

When evaluating hamstring pain,Evaluate:

- Framework Lumbar-Pelvic dysfunction?

- Tension Trigger Points?

- Strength

- Length

Vogt et al., 2003

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Muscular

When evaluating hamstring pain,Evaluate:

- Framework Lumbar-Pelvic dysfunction?

- Tension Trigger Points?

- Strength

- Length

Vogt et al., 2003

Gluteus Maximusvs

Hamstrings

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Neural

When evaluating hamstring pain,Evaluate neurodynamics:

Piriformis syndrome

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“Problems cannot be solved by the same level of thinking that created them” A.E.

Treatment of hamstring injuries should also be directed at non-local hamstring factors.

Hoskins & Pollard, 2005

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