Hamstrings and Harry Potter Part 2: Injury Care and Prevention

Last week's post was about the potential reasons for “tight” hamstrings. Armed with that information, let us dive into the second part: hamstring injury care/prevention. I should make a note that I am NOT a doctor, therefore do not use this post to diagnose anything. If you suspect an injury please consult a doctor! Also, this advice should not supersede any licensed therapist’s recommendations. This is just lay-man’s stuff.

Ok, so let’s talk prevention. Hamstring pulls often occur because of a) a previous pull (number 1 reason!) or b) hamstrings are required to do something they can’t handle on their own (like sprinting full tilt with form resembling poop). The latter is like Neville Longbottom in Potions class: imposing demand that produces in disastrous consequences.

So how do we prevent hamstring pulls in the first place? In no particular order:

1. Soft tissue work- stay on top of it, literally, jump on that foam roller and lacrosse ball! Work out the nasty, gunky tissue that tends to form in the adductors (especially near the insertion points on the pelvis and knee joint), hamstrings, calves (specifically the gastronemius since it crosses over the knee joint), and of course, the glutes. If the glutes are gunked up, they’re not going to fire properly or contract with full force thus leaving an increased burden on the hamstrings to extend the hip. For example, if the glutes aren’t firing properly during a sprint, guess who has to extend the hip? Yup, the hamstrings. And as I’ve mentioned before, the hammies are strong hip extensors but they’re woefully under qualified to handle the brunt of it without the neighbors to the north. Gunky muscles = dysfunction = potential injury.

2. Strengthen your glutes- as mentioned above, the hamstrings need help extending the hip. The glutes are MUCH better at doing so and are at a more advantageous position, mechanically, to do so anyway. Check out this diagram:

See how LONG the hamstrings are compared to the glutes? Also note the fibers: hamstrings have long, parallel-to-the-femur (thigh bone) fibers whilst the glutes’ fibers are short and diagonal to the femur. The glutes can produce more force because they’re shorter and can do so with less stress to the fibers. Every hear about anyone tearing their glute? Didn’t think so. Anyway, all that to say, GET YOUR BUTT STRONGER, and you’ll be half way there to hamstring ouchie prevention. (I could also go into activation, teaching your glutes to fire sooner during the movement, but this post will get too long if I do so).

3. Don’t be stupid- don’t jump into do intense exercise without warming up or without working up to it. If you haven’t sprinted in a while, probably not a good idea to go out and do 100 m sprints all out. Use your brain.

There you have it, simple yet rather effective preventive measures.

But what happens if you’ve already pulled it? Couple of methods that we use with our athletes:

1. Don’t be stupid- This is a common one isn’t it? Don’t do anything that irritates the injured hamstring. It’s already pissed off at you, no point in angering it further and prolonging the recovery period. Seriously, if it hurts, don’t do it. We tend to take a very conservative approach with out athletes and we’ll replace any exercise that might hurt it.

2. Soft tissue work- Oh look, this one is back too! It’s almost as if we turned the Time-Turner and are reading the prevention methods.

Be careful with this though. Sometimes the injured tissue should NOT be touched, but this doesn’t mean you can’t work on the surrounding areas. Depending on the severity of the injury, a good ART or massage therapy session might be in order. Gently working on the tissue can aid in the healing process. Perhaps some gentle stretching is in order, but be careful with that too.

3. Rest- Lay off of it. It’s not going to heal if you keep aggravating it. This is often the hardest part of recovery for athletes; they want to jump back in too soon. One day pain-free does NOT mean the hamstring is healed. Sorry. Give it a couple weeks and ease back into your regular activity with pain as you guide.

There you have it. Hamstring injuries are usually not terribly complicated, thus prevention and care should not be either. Honestly, if you follow the given rules, particularly Number 3 on the first list, your hamstrings should be safe!

Oh Dem Hammies! Hamstring Info and Harry Potter Analogies Part 1

Do you have tight hamstrings? Do you stretch them only to find that you’re not any closer to the suppleness that you desire in those posterior hip extenders? Have you tweaked/pulled your hamstring (due to your tightness maybe...)? Do you feel they’re tighter than Gringotts Bank Security?

 Today, we’ll go over some of the reasons why the hamstrings might be tight and in part 2 we’ll go over some of the prevention/rehabilitation techniques to deal with hamstring tweaks.

You may be surprised to find that your tight hamstrings are not actually tight… That sounds like something Professor Dumbledore might say.

Below are some of the potential culprits of “tight” hamstrings. (You’ll see why I put “tight” in quotation marks at the end.)

1. Protective tension.

This is when the brain is telling the hamstrings to remain “on,” for one reason or another, and it creates a sensation of tightness when the hamstrings are stretched. Why does this happen? I’m actually a good example of this. I have congenital laxity (meaning my joints are loose and I’m rather flexible) but for a period of about 3 years, my hamstrings were constantly tight and I could feel them being tugged on every time I bent over, and because of my laxity -and a lifetime of NEVER feeling tight- this was as odd as Hagrid’s love for horribly frightening beasts.

Here’s what was happening: my pelvis tilted, wildly I might add, anteriorly (forward).

Hamstrings pull the pelvis posteriorly or down and backwards.

The hamstrings attach to the (posterior) bottom of the pelvis (your “sit” bones) and my brain sensed the constant pelvic tilt and was desperately trying to prevent me tilting forward anymore by firing my hamstrings continually in an attempt to pull my pelvis back into a neutral position. That pelvic tilt results in instability throughout the lower back and pelvis. The brain HATES it when the body is unstable and will do anything necessary to regain stability, which in this case was locking down those hamstrings tighter than a Full Body-Bind Curse.

How do you fix APT? Through lots of dedicated anterior core work (i.e. plank variations) and glute strength. Once my pelvic tilt  was in a more neutral position… voilaThe tightness was gone. So, if your hamstrings feel tight, check our your pelvic alignment.  Stretching the hamstrings will NOT improve your flexibility in this case; they're already stretched to the max!

2. Neural tension.

I know this will sound similar to the above reason, but this particular tension generally results from an injury. The most likely answer is an injury to a lower back disc. (since the nerve for the hamstrings runs through that region.) If there’s damage to a disc in the L1-S1 region, there’s potentially compression on the nerve for the hamstrings which could result in mishaps in the neural messages (communication between brain and muscles) causing hamstring tightness. Usually this type of tension is accompanied by other symptoms such as tingling, shooting pain, electric pain or numbness. Two common tests to check for spinal issues are the slump test and the heel drop test (which consists of standing on your toes then dropping to you heels. If pain occurs, congratulations! You might have a compression issue.)

3 and 4. Nasty fibrotic tissue or tendonosis in the hamstring.

Sometimes muscle fibers get junky and gunky, from poor movements, overuse, or prior injury, -or all of the above- which changes the length and function of the muscle. Instead of the muscle fibers running parallel and working harmoniously, they’re twisted up like spaghetti noodles (and work as well together and a plate of spaghetti). Soft tissue work such as SMR or possibly work by a professional is in order to help restore the tissue quality.

adductor

Other areas to target for soft tissue would would be the adductors (since they attach to the pelvis as well) and those fellas are Gunk-City in a lot of folks.

5. The hamstring muscles are truly short.

Yep, they're are people out there either because of their genes (not their jeans. Ha!) or a surgery where the hamstring was immobilized in a shortened position (though this is not common), their hamstrings are physically shorter than they should be. This can happen over time (but to a small-ish degree) in folks who sit down a lot during the day because the pelvis is tilted posteriorly (tucking your butt under) which does shorten the hamstrings a bit. However, this probably isn’t the main source of tightness since they are only short at the very end range of motion.

So what have we learned? If your hamstring is tight, it’s not necessarily it’s fault nor will endless hamstring stretches change anything (even if you’re drew the genetic short stick. Stretching won’t do that much. Sorry.).  Soft tissue work in the hamstrings, adductors, and glutes as well as some dedicated anterior core work and glute training (*cough* swings *cough*) can help to solve some tight hamstring issues.

Check back in next week for some hamstring injury causes and care.

Oh Those Hammies! Hamstring Info Part 1

Do you have tight hamstrings? Do you stretch them only to find that you're not any closer to the suppleness that you desire in those posterior hip extenders? Do you feel they're tighter than Gringotts Bank Security?

Thieves Beware...

Have you tweaked/pulled your hamstring (due to your tightness maybe?)? Today, we'll go over some of the reasons why the hamstrings might be tight and in part 2 we'll go over some of the prevention/rehabilitation techniques to deal with hamstring tweaks. You may be surprised to find that your tight hamstrings are not actually tight... That sounds like something Professor Dumbledore might say.

Ok, so here's some of the causes of "tight" hamstrings. (You'll see why I put "tight" in quotation marks at the end.)

1. Protective tension.

This is when the brain is telling the hamstrings to remain "on," for one reason or another, and it creates a sensation of tightness when the hamstrings are stretched. Why does this happen? I'm actually a good example of this. I have congenital laxity (meaning my joints are loose and I'm fairly flexible) but for a period of about 3 years, my hamstrings were constantly tight and I could feel them being tugged on every time I would put them in a stretched position, and because of my laxity (and a lifetime of NEVER feeling tight) this was as odd as Hagrid's love for horribly frightening beasts.

Yep. That weird.

Here's what was happening: my pelvis tilted, wildly I might add, anteriorly (forward).

The hamstrings attach to the (posterior) bottom of the pelvis (your "sit" bones) and my brain sensed the pelvic tilt I was constantly in and was desperately trying to prevent me tilting forward anymore by causing my hamstrings to fire constantly to pull me back into a neutral position. Thus, this unceasing firing of my hamstring was causing a sense of "tightness" in my hamstrings despite the fact that the actual muscles were not tight. Once my pelvic tilt (through lots of KB swings and anterior core work) was in a more neutral position... voilaThe tightness was gone. So, if your hamstrings feel tight, check our your pelvic alignment.  Stretching the hamstrings will NOT improve your flexibility in this case.

2. Neural tension.

I know this sounds similar to the above reason, but this tension generally results from an injury. The most likely answer is an injury to a lower back disc. (since the nerve for the hamstrings runs through that region.) If there's damage to a disc in the L1-S1 region, there's probably compression on the nerve for the hamstrings which could be causing mishaps in the neural messages causing hamstring tightness. Usually this type of tension is accompanied by other symptoms such as tingling, shooting pain, electric pain or numbness. Two common tests to check for spinal issues are the slump test and the heel drop test (which consists of standing on your toes then dropping to you heels. If pain occurs, congratulations! You might have a compression issue.)

3 and 4. Nasty fibrotic tissue or tendonosis in the hamstring.

Sometimes muscle fibers get junky and gunky, either from poor movements, overuse, or prior injury, which changes the length and function of the muscle. Instead of the muscle fibers running parallel and working harmoniously, they're twisted up like spaghetti noodles (and work as well together and a plate of spaghetti). Soft tissue work such as SMR or possibly work by a professional is in order to help restore the tissue quality.

Not the way muscle fibers should be...

5. The hamstring muscles are truly short.

Yep, you're one of those people who either because of your genes (not your jeans. Ha!) or a surgery where the hamstring was immobilized in a shortened position (though this is not common), your hamstrings are actually shorter than they should be. This can happen in folks who sit down a lot during the day because the pelvis is tilted posteriorly (tucking your butt under) which does shorten the hamstrings a bit. However, this probably isn't the main source of tightness since they are only short at the very end range of motion.

So what have we learned? If your hamstring is tight, it's not necessarily it's fault nor will endless hamstring stretches change anything (even if you're drew the genetic short stick. Stretching won't do that much. Sorry.).  Soft tissue work in the hamstrings, adductors, and glutes as well as some dedicated anterior core work and glute training (*cough* swings *cough*) can help to solve some tight hamstring issues.

Hamstring issues, begone!

Check back in tomorrow for some hamstring injury causes and care.

Torch Your Hammies with The Band-Assisted Sissy Ham

Confession: I have weak hamstrings. Very weak hamstrings. As such, I’ve needed to ensure that my training includes exercises that will bring up the strength of those stubborn muscles on the back of my legs. In the process of solving this dilemma, I came up with an exercise that will also help athletes improve their performance via stronger hamstrings. Now, one of the last exercises we would have one of our (healthy) athletes perform to increase their hamstring strength is the leg curl.

glute-max3

For most, they’re a terrible waste of time (yes, they certainly have a place in rehab settings  and with older/deconditioned individuals, and bodybuilders could make an argument for them). While the majority of people understand that hamstrings function to flex the knee - which is what the leg curl trains - they often neglect that the hamstrings play a CRITICAL role in hip extension. The hamstrings are the body’s second most powerful hip extensor – just behind the glute max! (pun fully intended) For athletes, strong hamstrings can be invaluable as they play crucial role: resisting (eccentrically) knee flexion during sprinting. Take home point: stronger hamstrings make you faster!

As they say, necessity is the mother of invention. Enter the Band-Assisted Sissy Ham (or “Russian Leg Curl”). I came up with this exercise as I was helping some of our athletes perform pullups with band assistance. I had an “ah-ha” moment and decided to find a way to give myself (and others) band assistance during the sissy ham. In the video below, the first half will show me performing the sissy ham without the band. Then, I perform it with the aid of a band (attached above me). Notice there is now no arm push needed to help on the concentric (the “up”) portion of the lift.

(Note: Yes, upon looking at this video in retrospect, my pelvis is slightly tilted anteriorly and there's a bit of excessive low back arch. If I could travel back in time a year I'd go kick my own arse. Comon' Stevo! Get it right. Geez....)

This is such a fantastic exercise as it trains, simultaneously, both functions of the hamstrings: knee flexion and hip extension (which is how our hamstrings are utilized in athletics, anyway). It also makes for a more tangible progression than the regular sissy ham/russian leg curl. As you get stronger, you can lessen the band tension (as opposed to subjectively measuring "how fast you fall" during the regular sissy ham).

If you don't have a power rack that makes it easy to set up something like this, you could either just have someone manually hold your ankles, or latch your ankles under the pads of a lat pulldown apparatus (your knees would be resting where your butt normally goes). Then all you need is a sturdy 1/2" or 1/4" resistance band, which can be purchased through companies like Iron Woody, Perform Better, or EliteFTS.

As strength coaches, our mission (behind keeping people healthy) is to improve movement quality, performance, and strength and power. We also have only, roughly, 150 minutes a week to do this. This being the case, you won't find us filling 10 of those 150 minutes wasting time on an isolated leg curl. I could think of a million things athletes would be better off spending their time doing (placing their hand on a heated frying pan being one of them). Even if you're not an athlete, this exercise will still be wayy more beneficial for developing your hamstrings than the leg curl. It will also work well for the long-distance runners in the crowd!

This exercise isn't appropriate for everyone, as it's EXTREMELY difficult, even though it may not appear so if you haven't tried it. I definitely recommend a healthy dose of glute walks, slider hamstring curl eccentrics, and hip thrusts before attempting something like this.