HAMSTRING PAIN? TRY SOME ECCENTRIC TRAINING!
This past weekend we had the opportunity to help treat runners at the finish line of the St. Augustine Half Marathon! During one of these events, one of the most common running injuries we tend to see in runners is hamstring tightness/pain due to strains or tendinopathies.
Although hamstring issues tend to be very common among runners, dancers, gymnasts and kickers, they can affect anyone especially those with limitations in hamstring flexibility. Unfortunately, these injuries often become recurrent and chronic in nature. A history of a previous hamstring strain is the number one predictor of sustaining a subsequent injury, so chances are if you have experienced one, you will experience another especially if preventative measures aren’t taken!
The hamstrings are a large muscle group(semitendinosus, semimembranosus located medially, biceps femoris located laterally) spanning from the ischial tuberosity (buttock region) to the tibia and fibula (picture shown below)1. Their muscle actions include bending the knee (knee flexion) and extending the hip. Eccentric musclecontraction occurs when the muscle is controlling the weight & motion of a limb while moving into a lengthened state. The hamstrings are required to work eccentrically during walking and running.
Additionally, the speed of the contraction matters in that fast eccentric contractions produce more force than slow eccentrics.1 Dysfunction of the hamstrings limits the ability to work eccentrically and is thought to contribute to overuse injuries to this area.2 Due to eccentric demands on the hamstrings, eccentric training is a crucialpart of rehabilitation in a hamstring injury, especially for athletes. Training eccentrically has been shown to enhance muscle hypertrophy, strength, normalize tendon structure & improve ability to return to sport after injury.3,4
Last week, Steve demonstrated a series of eccentric hamstring exercises as part of University of St. Augustine’s Continuing Education Facebook live event. These are just a component of hamstring rehabilitation and it is important to note that other impairments should also be addressed. We have included a video from this series below. All videos of exercises are available on our facebook & instagrampages!
Follow us on Instagram @vighettipt and Facebook (www.facebook.com/VASPhysicalTherapy) for more videos and tips on injury prevention & rehabilitation!
References
Gray M, Gray H. Gray’s Anatomy for Students.Philadelphia, PA. Elsevier/Churchill Livingstone; 2005.
Kisner C, Colby LA, Borstad J. Therapeutic Exercise: Foundations and Techniques. Vancouver, B.C.: Langara College; 2019.
Jayaseelan DJ, Moats N, Ricardo CR. Rehabilitation of proximal hamstring tendinopathy utilizing eccentric training, lumbopelvic stabilization and trigger point dry needling: 2 case reports. 2014;44(3):198-205.
Cacchio A, Rompe JD, Furia JP, Susi P, Santilli V, De Paulis F. Shockwave therapy for the treatment of chronic proximal hamstring tendinopathy in professional athletes. Am J Sports Med. 2011;39:146-153. http://dx.doi. org/10.1177/0363546510379324
Öhberg L, Lorentzon R, Alfredson H. Eccentric training in patients with chronic Achilles tendinosis: normalised tendon structure and decreased thickness at follow up. Br J Sports Med. 2004;38:8-11. http://dx.doi.org/10.1136/