Hamstring Injury

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SnappyHappy

Club Legend
Veteran
Jul 2, 2008
2,292
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Brisbane
AFL Club
Geelong
Hey guys,

I'm chasing some advice regarding a recurring Hamstring injury that is preventing me from playing football at the moment. I have strained my hamstring 4 times while playing football. (once in 2006, once in 2010, once in 2012 and once in 2013). Every time I have strained it it has been a grade 1 strain, at worst a grade 2 possibly in 2013. In 2013, after injuring it I went overseas so I didn't do proper rehab. Also I'm 24 years old.

In the past it has been suggested my Sciatic nerve could be the problem (I sometimes get sharp jolting pains through both hamstrings). I recently had an x-ray on my back and nothing of interest showed up. I returned to football training in November and for the past 6 weeks have been having niggles and have been pulling out of training. It is fine with high intensity running, however when I start kicking is when I start to feel pain (fatigue, dull ache, feeling as if it's going to go again). I have been doing solid rehab for the past 4 or so weeks (bike training only for the first 2-3, foam roller, massage). But it's not showing any signs of improvement. Wondering if anyone here is able to help with some advice? Cheers guys.
 
cptkirk said:
give us a look at what rehab your doing - exercises, sets/reps, frequency etc
Click to expand...

Hamstring strengthening exercises: 3 sets, 3 times a week:
Nordic hamstring curl: 10 reps
Kettle ball swings: 10 reps
Single leg bridge lift: 15 reps each leg
Single leg chair lift: 15 reps each leg
Swiss ball Hamstring curl: 10 reps
Trx band reverse lunge: 10 each leg

I do this 3 times a week, 3 sets total. Training nights I have been doing a 20 minute bike session (2 x 30on/30off 5 min block, 1 x 15on/45off 5 min block)

I also roll on a foam roller every day for around 15-20 minutes, doing back, glutes, itb, quads and then focusing on sore spots in hamstring trying to work out any scar tissue. Also massage 3 times a week
 

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rehab stuff seems alright but if its not sciatica which isn't that hard to diagnose if you're seeing someone then you might need some better/hardcore manual therapy for any scar tissue in there...foam rolling doesn't break down scar tissue

give the add a roll and good stretch too because they can become a major hip extensor when glutes and/or hams are weak
 
cptkirk said:
rehab stuff seems alright but if its not sciatica which isn't that hard to diagnose if you're seeing someone then you might need some better/hardcore manual therapy for any scar tissue in there...foam rolling doesn't break down scar tissue

give the add a roll and good stretch too because they can become a major hip extensor when glutes and/or hams are weak
Click to expand...

By better/hardcore manual therapy are you referring to deep tissue massage? Is it possible that the continuing niggle is due to scar tissue that hasn't been worked out?
Also, sorry what's the 'add' you refer to? Cheers mate.
 
your hamstring rehab looks great.
It sounds like a back related hamstring and maybe not actually a hamstring issue. When you stretch your hamstrings with the knee straight, do you feel a good mid thigh stretch or more a discomfort behind the knee?
Do you get pain with anything else. eg. getting out of a car?
Increased neural tension through your sciatic nerve is going to mimic recurrent hamstring strains and is better off treated by release work through the lumbar spine, glutes and piriformis muscles. I'd be looking into some dry needling as well.
Look up 'slump slider' exercise and add that in as a neural stretch.
 
If it is sciatic nerve related I would back off the riding, position on the bike compromises that lumbar spine and can effect sciatic nerve sliding. A good physio should be able to get it sliding with the use of some needles and ultrasound for guidance.
 
Cats fan 16 said:
It sounds like a back related hamstring and maybe not actually a hamstring issue. When you stretch your hamstrings with the knee straight, do you feel a good mid thigh stretch or more a discomfort behind the knee?
Click to expand...

I've never actually had problems with my hammies, but when I stretch it's definitely more a discomfort behind the knee than a "good mid thigh stretch"

What does this point to? Since you've asked the question of Snappy.

I'm thinking it would allude to the problem not being hamstring flexibility but something else? If so how does I go about correcting this because flexibility is something I really need to work on.
 

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Chunderboy said:
I've never actually had problems with my hammies, but when I stretch it's definitely more a discomfort behind the knee than a "good mid thigh stretch"

What does this point to? Since you've asked the question of Snappy.

I'm thinking it would allude to the problem not being hamstring flexibility but something else? If so how does I go about correcting this because flexibility is something I really need to work on.
Click to expand...
This is definitely more likely to be increased neural tension through your sciatic nerve. Basically your nerve is tight from your lower back which then runs down behind your hamstring. Sometimes it is tight because it is protecting something and stopping you from stretching any further. So it can be tight because of tightness higher up - lumbar spine tightness, gluteal muscle tightness, piriformis muscle tightness. So get onto some self massage of your glutes and piriformis with a tennis ball, some lower back stretches and some sciatic nerve slider exercises. Stop stretching your hamstring with your knee striahgt, instead bend it at the knee and lean forwards.
 
ben_1301 said:
Dry needling whilst viewing it on ultrasound, sorry should have made that clearer.
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Fair enough. I don't think you really need ultrasound guidance to dry needle though, unless you are being super specific about a small trigger point in a particular muscle that is hard to find. Have you had it under ultrasound guidance?
 
Cats fan 16 said:
Fair enough. I don't think you really need ultrasound guidance to dry needle though, unless you are being super specific about a small trigger point in a particular muscle that is hard to find. Have you had it under ultrasound guidance?
Click to expand...
Not needed but very cool! not ultrasound guided, just using the ultrasound pre and post needling to see the difference in sciatic nerve sliding.
 
Cats fan 16 said:
This is definitely more likely to be increased neural tension through your sciatic nerve. Basically your nerve is tight from your lower back which then runs down behind your hamstring. Sometimes it is tight because it is protecting something and stopping you from stretching any further. So it can be tight because of tightness higher up - lumbar spine tightness, gluteal muscle tightness, piriformis muscle tightness. So get onto some self massage of your glutes and piriformis with a tennis ball, some lower back stretches and some sciatic nerve slider exercises. Stop stretching your hamstring with your knee striahgt, instead bend it at the knee and lean forwards.
Click to expand...

Ahh legend! Thanks a lot, it's something that has had me curious for a while now but I'm just never really done anything for it
 
Cats fan 16 said:
your hamstring rehab looks great.
It sounds like a back related hamstring and maybe not actually a hamstring issue. When you stretch your hamstrings with the knee straight, do you feel a good mid thigh stretch or more a discomfort behind the knee?
Do you get pain with anything else. eg. getting out of a car?
Increased neural tension through your sciatic nerve is going to mimic recurrent hamstring strains and is better off treated by release work through the lumbar spine, glutes and piriformis muscles. I'd be looking into some dry needling as well.
Look up 'slump slider' exercise and add that in as a neural stretch.
Click to expand...

Sorry for the delayed response. I feel more of a discomfort behind the knee, but like you said in a later post, I usually stretch with the knee slightly bent. Yes, getting out of the car, bending over, getting out of bed sometimes. Since my original post I have pulled back on cycling and running (no running, hardly any bike) and have concentrated on foam roller and strengthening exercises, as well as some deeper massage on my hamstring. The problem isn't getting any better however, and doing strengthening tonight was probably the worst it has been, while doing single leg chair lift, I felt a constant sharp pain through my right hamstring and up into my glute. Any other feedback would be great. I'll look up slump slider, would needling or ultrasound still be worth while? Cheers
 
SnappyHappy said:
Sorry for the delayed response. I feel more of a discomfort behind the knee, but like you said in a later post, I usually stretch with the knee slightly bent. Yes, getting out of the car, bending over, getting out of bed sometimes. Since my original post I have pulled back on cycling and running (no running, hardly any bike) and have concentrated on foam roller and strengthening exercises, as well as some deeper massage on my hamstring. The problem isn't getting any better however, and doing strengthening tonight was probably the worst it has been, while doing single leg chair lift, I felt a constant sharp pain through my right hamstring and up into my glute. Any other feedback would be great. I'll look up slump slider, would needling or ultrasound still be worth while? Cheers
Click to expand...
Okay, well it's not your hamstring...it's sciatic pain. You need some release through your lower back, possibly thoracic spine and glutes/piriformis. Dry needling would be helpful.
 
Cats fan 16 said:
Okay, well it's not your hamstring...it's sciatic pain. You need some release through your lower back, possibly thoracic spine and glutes/piriformis. Dry needling would be helpful.
Click to expand...

Okay I will get some dry needling done. Is there an reason why sciatic pain would have an impact on hamstring? Running is usually fine, it's kicking the football that strains my hamstring.

Also, is this the slump exercise you referred to:
 
SnappyHappy said:
Okay I will get some dry needling done. Is there an reason why sciatic pain would have an impact on hamstring? Running is usually fine, it's kicking the football that strains my hamstring.

Also, is this the slump exercise you referred to:
Click to expand...

Yeah, but you should extend your head back as you straighten your knee. Sciatic nerve travels down hamstring. When you kick you put tension through the sciatic nerve - nothing wrong with your hamstring by the sounds of it. All lower back.
 
Cats fan 16 said:
Yeah, but you should extend your head back as you straighten your knee. Sciatic nerve travels down hamstring. When you kick you put tension through the sciatic nerve - nothing wrong with your hamstring by the sounds of it. All lower back.
Click to expand...

Okay, so how often would you recommend doing the slump slider exercise? I'm booked in for dry needling tomorrow. Any other advice for ways to treat/manage it? Thanks very much for your help mate!
 

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