Last week I injured my hamstring whilst decelerating from a sprint at soccer training. Fortunately, it’s not a serious injury, however I will still miss 3 games. This injury is a wake-up call as two of the main factors were in my control. In the preceding nights, my sleep quality was poor, causing a state of fatigue, and henceforth an elevated injury risk. The second factor was my level of conditioning, which was good, but I know it could have been higher, especially for repeated sprints. So as part of my rehabilitation (and long-term goals) I will focus on maintaining a regular sleep pattern and increasing repeated sprint capacity, in addition to restoring hamstring function.
As with any injury, it is important to understand the mechanism of injury to devise an optimal plan of action. A key role of the hamstring muscle group is to decelerate the thigh and leg during the late swing phase of sprinting. During this phase, the hamstrings are working eccentrically. There is a large body of evidence indicating reduced eccentric hamstring force due to fatigue is associated with an augmented injury risk. My injury occurred whilst decelerating from a sprint, and during the latter stages of training when hamstring force capacity was reduced due to fatigue. Therefore, a key part of my rehabilitation will be to increase eccentric hamstring strength and fatiguability (as well as other factors). I have included the Nordic hamstring lower in my rehabilitation programme to target eccentric strength as it is reported to be an effective intervention for preventing hamstring injury. The world governing body of soccer/football, FIFA, has included the Nordic hamstring exercise in their injury prevention programme. Whilst a primary focus will be on restoring hamstring function, I will also increase my lumbo-pelvic stability and maintain aerobic fitness through cycling. As I return to running, I will progressively increase my repeated sprint capacity to facilitate my return to playing soccer.
Whilst the physical elements are vital for any rehabilitation programme, one of the most important factors for me is my mindset. I have a strong drive to return to both soccer and running as these are two of my hobbies. This mindset will facilitate my progress over the next 3 weeks by motivating me to complete my exercises each day. Additionally, a clear mindset will also lighten the burden of any potential setbacks, which I have experienced with past injuries.
Whilst watching from the sideline is not ideal, I have learnt the importance of having a clear goal and a plan in place to achieve that. I’m also aware that I need to take responsibility to reduce my future risk of injury and keep me on the playing field.
Please note hamstring injuries can be multi-factorial and those listed above are not an exhaustive list. If you would like more information on exercise rehabilitation programmes that Absolute Balance can provide, please don’t hesitate to contact us at firstname.lastname@example.org.
Daniel D’Avoine (B.Sc.Ex.Phys)
Senior Exercise Physiologist (AEP, AES) (ESSAM)
Al Attar, W.S.A., Soomro, N., Sinclar, P.J., Pappas, E., & Sanders, R.H. (2017). Effect of injury prevention programs that include the Nordic hamstring exercise on hamstring injury rates in soccer players: a systematic review and meta-analysis. Sports Medicine 47(5), 907-916.
Freckleton, G., & Pizzari, T. (2013). Risk factors for hamstring muscle strain injury in sport: a systematic review and meta-anaylsis. British Journal of Sports Medicine, 47(6), 351-358.
Small, K., McNaughton, L., Greig, M., & Lovell, R. (2010). The effects of multidirectional soccer-specific fatigue on markers of hamstring injury risk. Journal of Science and Medicine in Sport, 13(1), 120-125.