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The Curse of Recurring Hamstring Injuries

Are you plagued by Hamstring Injuries?

In today’s blog Chartered Physiotherapist, Ronan Buckley discusses hamstring injuries – from their risk factors and recurrence rates, to return to sport and preventative conditioning. Ronan, who works in our latest physiotherapy clinic in Newbridge, Co. Kildare, has a keen interest in treating sports injuries and has experience in treating professional and amateur athletes with hamstring problems.

“My hamstring gave way in an away game at Leeds at the tender age of 19 and from that moment on my career as a professional footballer was compromised” – Michael Owen.

Injury plagued, former England striker Michael Owen has announced he is to retire at the end of this season, citing his regret at “what   might have been” if hamstring injuries hadn’t blighted the latter stages of his career. He is certainly not alone. A two-year analysis of professional soccer teams showed that hamstring strains – or “pulled hammies” – account for 12% of all injuries. Rugby players, track athletes and dancers may also have suffered with this condition due to the specific demands of their sport, whilst recent research claims that 31% of all non-contact GAA injuries were hamstring related.

25 - 35 year olds more prone to Hamstring Problems

The high incidence rate of hamstring injuries has led to several researchers attempting to identify risk factors predisposing athletes to hamstring injury. Unfortunately some of the issues raised are unchangeable – for example the older we get the more prone we will be to muscle strains. However, with some guidance and a little bit of hard work flexibility, strength and core stability can be increased; muscle imbalances can be addressed and endurance can be developed thereby limiting the effects of fatigue on the muscle. The evidence suggests that this will greatly reduce our risk of developing hamstring problems.

Unluckily for Owen and countless others, the greatest single risk factor identified was previous hamstring injury. It is thought that this may be a result of incomplete rehabilitation and / or an early return to sport following initial injury. A study of Australian Rules footballers showed that 12.6% of players re-injured their hamstrings during the first week of return to sports, 8.1% during the second week and a massive 30.6% over the course of the rest of the season. It is worth noting that the second injury was usually more severe and required double the time away from sport.      

Owen’s initial hamstring injury was a bad one – it kept him out for 5 months of that season but on average hamstring injuries result in a period of 8 – 25 days away from sport. 

Hamstring Injury 1 Liverpool 0

Famously, Sir Alex Ferguson claimed Liverpool hampered Owens career by playing him too much around the time of his injuries. But in Liverpool’s defense, there is no definite consensus on the criteria an individual should meet prior to returning to sport following a hamstring injury. In general once full range of movement, strength and sport specific tasks can be performed pain free the player can be passed fit. Depending on your sport, this may include the ability to perform explosive sprints, stop quickly, change direction, or jump / hop.

However, these criteria are vague and a clinical assessment by a physiotherapist focusing on the individual’s characteristics, past history, mechanism of injury and functional progression since injury can provide a more specific return to your sport programme.

Given the high injury recurrence rate related to hamstring strains a preventative exercise programme should always be incorporated to training and warm ups following a return to sport. This should focus on agility, trunk stabilization, neuromuscular control and eccentric exercises. The effectiveness of such a programme was demonstrated in a recent study which compared it to a basic hamstring stretch and strengthening programme. Re-injury rates in the comprehensive programme were 0% at 2 week and 7.7% at 1 year, while the stretch and strengthening group were 54% at 2 weeks and 70% at 1 year.

As always, you should seek advice from a chartered Physiotherapist before engaging in any preventative exercise programme so that it can be tailored to you needs. 

Ronan Buckley is a Chartered Physiotherapist as has an extensive amount of experience in Ireland and in the UK where he worked with and treated professional players in both the Rugby and Football Premiership Leagues. If you would like to be treated by Ronan in our Newbridge clinic please contact us on 1890 746749 or just click here to book an appointment.