Hamstring strains are the dreaded injury of most footballers. The Holy Grail of sports medicine is how to prevent hamstring strains, as they are a very frustrating and time consuming injury.

Ever since straining my own hamstring in the late ‘90’s on the eve of our Round 1 match, I have been fascinated as to why hamstring strains occur, the best ways to treat them when they do occur, and how to prevent them reoccurring down the track.

Over the last 15 years I have been working I have attended every type of education course there is available on this topic, including spending time at the Australian Institute of Sport and writing a Master’s thesis on why Hamstring Strains occur.  I now apply this in our clinic, Leading Edge Physiotherapy, as well as with elite sporting teams in Adelaide.

WHAT DO WE KNOW ABOUT HAMSTRING STRAINS?

They are the most significant injury in Australian Rules Football, as well as Soccer, Rugby Codes and other major field sports.

The AFL keeps excellent, detailed injury records that they publish each and every year about the injuries that occur in the sport.  From this research, what we know is that over the last 20 years, hamstring strains have accounted for the most time lost through injury in the AFL.  Over this time there have been nearly 3000 hamstrings strains, resulting in more than 7000 games lost!

We also know that, on average, hamstrings take about 3 ½ weeks to recover from.

What’s worse, is that there is a 20% chance that you will re-injure your hamstring in the same season!

WHAT DO WE KNOW ABOUT PREVENTING HAMSTRING STRAINS?

What we do now from the research, is that there are some risk factors for people getting hamstring strains.  Some of these we can address and reduce our risk of injury, some of them we can’t counter against becuase they are things we can’t change!  These include:

• Increasing age
• Ethnicity (Aboriginal and African athletes are more prone to hamstring strains)
• A previous hamstring strain

As Sports Physios, we try to focus our efforts on affecting change in the risk factors that we can potentially influence.

OUR TOP 5 TIPS TO PREVENT HAMSTRING STRAINS

Tip 1. Loosen Up Your Back

The lower back is where the nerves that control the hamstrings come from.  We know that a lot of people who develop hamstring strains have co-existing back symptoms.  This may as simple as a sensation of tightness with certain activities, or may be as significant as disc bulges and the like.

Either way, a good functioning and flexible lower back is vital to allow your hamstrings to function properly.  Our top tips for keeping your back flexible:

Lumbar rotation stretches – roll your knees from side to side to loosen up the joints and muscles in your back

Lumbar flexion stretches – take your knees to your chest to stretch your muscles and give the nerves more room to move

Lumbar Side Flexion stretches – kneel on one knee and stretch sideways to loosen up the muscles that get tight on the side of the spine.

 2. Release Your Glutes

Towards the end of a tough pre-season I see heaps of footballers getting really tight in their glutes.  The workload involved in training and the increase in intensity as games start can see these muscles around your hip get knots (or what we call trigger points) develop.  This can cause referred pain in the hamstring, reduce your flexibility, and increase the risk of actually straining your hamstring

The best ways to get your glutes loose:

Basic Glute Stretches – put your foot on the opposite knee and take the opposite knee to your chest.

Hold these stretches for at least 20 secs each and repeat a few times each side

Foam roller release – foam rollers are great to help “knead” out the trigger point in your glutes.  Position the roller under the affected glute and put the muscle on stretch, then roll either side of the knot in the muscle until it starts to release.

Tennis Ball release – using tennis, or cricket or baseballs can have a similar, but sometimes more potent effect that the foam rollers, as it focuses the force to a smaller area.  I have good success with this in combination with stretching – so pack a ball into your kit bag and use it as a good pre-game routine

3. Get Your Nerves Gliding Properly

 A tight back and glutes affect the timing and flexibility of the nervous system.  This can then lead to “mis-firing” of the hamstrings and put them at risk of injury – a bit similar to a mis-firing cylinder in a car.

 So the solution is firstly to keep on top of the back and glute work we mentioned before, but also to keep your nerve system moving properly.  To do this:

Slump Stretches – Sit on the edge of a chair/bed and slump down into a bent over position. Bend your ankles up and then alternately straighten and bend your knees to the point of stretch, and then release and swap legs.  Keep alternating this 20-30 times each side

Slump Leg Swings – In your warm-up – do active leg swings to warm up the legs, but also include a slump action of the back into it and bend up the ankle as you swing to stretch out the sciatic nerve at the back of the thigh.

4. Keep Your Strength Up

We know that people who strain their hamstrings tend to have an asymmetry in their strength from side to side, or that the strength in the muscle occurs at the wrong angle – ideally we have our muscles as strong as possible when the muscle is at length, as it allows us to bend over and pick up a ball for instance.

I’d recommend most field sports athletes incorporate some sort of hamstring strengthening into their weekly routine, just to keep on top of this important risk factor in terms of developing hamstring strains.

The sorts of exercises that could help would work for this would include:

Drinking Birds – This exercise helps strengthen the muscle as it lengthens which is really important in keeping up hamstring strength.  Stand on one leg with your arms out, shift the weight onto the back of your foot as you bend over at the waist, keeping your back straight.  You should feel a pull in the back of the thigh. Return and repeat in sets of 10-12 reps each side – a few sets each side

Body Bridges – put your foot on a chair or bench and with your knee bent, raise your bum up off the ground and extend your leg.  Repeat this 10-15 times each side, 3 sets each side.

5. Recover

What we do know about muscles is that they are more likely to strain if they are fatigued.  Fatigue can be a normal thing that occurs during a training session or match, but you can also get cumulative fatigue that can creep up on your muscular system over a number of weeks as your training builds up.

The way to counter cumulative fatigue is to utilise simple recovery strategies to give your body the best environment to heal and recover and ADAPT to exercise – bearing in mind you actually get the benefit from exercise when you are resting and your body builds on its strength.

Simple recovery strategies include:

• Nutrition – re-fuel after activity to help replenish the energy stores you have used up.  Take something simple with you to training and games – such as a piece of fruit or an energy bar – to allow you to get onto this as soon as possible

• Cold Water Immersion – walking and exercising in water can help flush out any waste products left over from vigorous exercise.  This can be as simple as a walk in the water at the beach or in a pool, or can extend to taking the dreaded ice bath for 5-10 minutes.  Bear in mind, the water can be in the vicinity of 15deg celcius to be effective, so you don’t need to kill yourself doing this

• Sleep – sleep is the best way to recover.  If you’re feeling flat – go to bed early or have a sleep in, and let your body use this time to help repair what you are doing to it at training.

So, there you have it – the five simple strategies to reduce your risk of developing a hamstring strain this winter.  They are:

Tip 1. Loosen Up your Back
Tip 2. Release Your Glutes
Tip 3. Get Your Nerves Gliding Properly
Tip 4. Keep Your Strength Up
Tip 5. Recover

We hope you have success with this and have an injury-free season.

If you’re not sure about anything, or if you are actually having trouble with your hamstring, then make contact with us and we’d be happy to explain in more detail.

If you suffer a hamstring strain at any point in the season, the first thing to do is to apply the RICE method and then to BOOK ONLINE so that we can get you moving in the right direction as soon as possible.