It is surprising to know good flexibility of hamstring do more evidence in improving performance rather than as a strong predictor to prevent a hamstring injury. Current evidences have recognized eccentric strengthening exercises moving throughout a hamstring muscle length is more effective in stimulating adequate adaptation to loading compared to flexibility/stretching exercise. Askling et al conducted an identical study in footballers and the result showed that a rehabilitation protocol focusing mainly on lengthening type of exercises is more effective than a conventional protocol (stretching and concentric exercise) in promoting early return to play after an acute hamstring injury. The most impressive characteristics of the lengthening type-protocol
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They advocated that in sprinting sports, high-load eccentric contractions should be performed at a slow to moderate angular velocity and focused at the knee joint, while the hip is kept in a large flexion position (80°) in order to expose the hamstrings to a greater elongation stress than occurs in the terminal swing phase, thus preventing overstretch of the hamstrings. This study revealed an aspect of hamstring strain prevention is not only a question of strength, but also depends on the timing of contraction, or a combination of both. The inclusion of principles of hip/foot biomechanics and muscle activation patterns are still clinically useful, even though there is limited evidence available to suggest that they prevent hamstring re-injury. Their relevance is still important when considering the subsequent eccentric load occurring through the hamstring during sprinting in a soccer match that predisposed players to hamstring …show more content…
However, there is lack definitive guideline to suggest an athlete is safe to return to full participation. This proves a challenge in planning specific rehabilitation protocols, as well as outlining ideal times to return to play. A reasonable guideline would be for the athlete to train at full capacity twice in the week prior to returning to on-field. A pain reported the day after an exercise program may be a better indication of whether the chosen exercise (loading) is appropriate, as opposed to reporting pain during the exercise. Stiffness experienced in the morning (without excessive discomfort) is ideal, this would indicate an appropriate time to increase exercise load. In a case report, Schache et al 53 looked at the use of regular clinical monitoring of hamstring strength during a season in football players with a history of hamstring strain. It was concluded that measuring postgame hamstring maximal voluntary contraction asymmetry on a weekly basis may be helpful in identifying adverse reactions to load (ie, inhibition, presence of symptoms, or both) that could represent early warning signs for hamstring strain susceptibility. Successful management of hamstring injuries should include constant monitoring, even after the athlete has returned to full participation. This will involve a ‘maintenance’ phase, to continue progressing an appropriate
They advocated that in sprinting sports, high-load eccentric contractions should be performed at a slow to moderate angular velocity and focused at the knee joint, while the hip is kept in a large flexion position (80°) in order to expose the hamstrings to a greater elongation stress than occurs in the terminal swing phase, thus preventing overstretch of the hamstrings. This study revealed an aspect of hamstring strain prevention is not only a question of strength, but also depends on the timing of contraction, or a combination of both. The inclusion of principles of hip/foot biomechanics and muscle activation patterns are still clinically useful, even though there is limited evidence available to suggest that they prevent hamstring re-injury. Their relevance is still important when considering the subsequent eccentric load occurring through the hamstring during sprinting in a soccer match that predisposed players to hamstring …show more content…
However, there is lack definitive guideline to suggest an athlete is safe to return to full participation. This proves a challenge in planning specific rehabilitation protocols, as well as outlining ideal times to return to play. A reasonable guideline would be for the athlete to train at full capacity twice in the week prior to returning to on-field. A pain reported the day after an exercise program may be a better indication of whether the chosen exercise (loading) is appropriate, as opposed to reporting pain during the exercise. Stiffness experienced in the morning (without excessive discomfort) is ideal, this would indicate an appropriate time to increase exercise load. In a case report, Schache et al 53 looked at the use of regular clinical monitoring of hamstring strength during a season in football players with a history of hamstring strain. It was concluded that measuring postgame hamstring maximal voluntary contraction asymmetry on a weekly basis may be helpful in identifying adverse reactions to load (ie, inhibition, presence of symptoms, or both) that could represent early warning signs for hamstring strain susceptibility. Successful management of hamstring injuries should include constant monitoring, even after the athlete has returned to full participation. This will involve a ‘maintenance’ phase, to continue progressing an appropriate