Hamstring Injury Workshop Notes

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This is a long post and wanted to include some notes on hamstring injuries in speed and power sports. Much of this information can apply to adductor injuries as some universal wisdom exists. With Usain Bolt being beat by Justin Gatlin recently, much of the talk on hamstring injuries was brought up on social media. Many coaches and therapists are asking what ways can we see what is going on with athletes with return to play strategies. For example, how do we know the hamstrings are healing outside MRI and MSK US use? What about Graston and other tools with heart rate variability, blood and saliva measures, and Tensiomyography?

The central themes were gait, foot mechanics and functional evaluation of the hip, soft tissue modeling, and medical timelines. Each presenter spoke for about 20 minutes on a very narrow topic followed by light discussion. Here are the highlights-

Hamstrings and Small-Sided Games- The best way to set-up injuries for athletes is to overdose on SSG and skip the weight room. While I do agree that team sport is about optimizing and not maximizing, allergies to iron create a big problem long term with hamstring development. Athletes must do short speed work weekly at least to get the nervous system firing at high rates. The big boys are almost hitting 40 kph and that means a few reps could be a hazard in games if one is just doing tap dancing with the ball. Look at all the ANS proponents and soft tissue injuries. Sure one can blame the coach, but without just tastes of sprints one is just sending one to war without practice shooting and I don’t mean the ball.

Tensiomyography– Monitoring experts are getting a lot of attention, and I see a focus from physiological to biomechanical and anatomical data sets in the future. I was surprised on how respected Jose Fernandez is with his work with TMG, as he is the world leader on the subject matter and his work was highlighted by a private therapist. Last year at the BSMPG conference Jose spoke, but even major organizations are still in the dark with TMG. I had an athlete tested by Jose last year and some follow up tests that are in the Kinetics Manual in super detail.

MRI is an attempt to get structural damage to estimate repair. The body is more complicated and imaging such as MSK ultrasound is very practical to do at high frequencies but local site specific diagnostics is a must. The nervous system and function is key, not just structure. Testing the athlete takes two minutes a day and can help get an indication of the methods and approaches are working. Tensiomyography is practical if set up right. Those that look at are often intimidated but I have tested athletes with the device and wall arm systems with guided cameras. Anytime someone says it takes too long think stock car racing and pit crews. You can get a lot done if you are creative. A multimillion dollar athlete should not go out to the field if they are injured and get hurt again. Professional Baseball is simply embarrassing themselves (research wise). Look the Nationals. Bryce Harper and Stephen Strasburg injuries are setting up the organization for a doomed future.

Thermography can be used if set up right to get hot spots or potential problems. Teams can cross-validate as the false positives are high with thermography but the speed of collection and the practical side of IP cameras make it like a high speed airport security set-up. Thermography was brought up by Dr. Sands at an earlier BSMPG, but people are not acting on this. Dr. Sands ran the USOC regeneration center and was excellent in his keynote a few years ago.

Speaking of Normatec, one needs to remember that passive recovery is still passive. This means that active pool workouts are vital for changes in HRV and tissue adaptations. It’s good to have a split of 50/50 with Normatec and pool training so that insulin sensitivity and angiogenesis is maintained. Normatec is worth 12-24 hours a week in regeneration units. Over a season those that don’t use it are weeks behind and are going to feel it in the playoffs.

Biomechanics of Injury- Foot mechanics and total body gait analysis is the future, and pressure mapping will eventually become mainstream when the hardware and software start to jive. I am not a fan of Novel’s Pedar system, but the German approach to hip and foot mechanics is interesting. The thought is that a chicken and egg relationship exists with foot and hip structure and podiatrists must test the hip better to ensure the orthotic is not treating a poor landing position. More information will be posted later, but if you are not scoring the foot for function besides a basic foot typing you are going to see problems that are mysterious. Look at the total amount of jones fractures in the NFL. Note the facilities that are using FMS screens and not seeing the obvious of fracture risk.

The details and research will be on my dropbox later when I have the time, but I figured I would showcase what is valuable in my mind.

Carl Valle

Carl Valle

Track & Field Coach
Carl is an expert coach who has produced champions in swimming, track and numerous other sports. He is one of the foremost experts in the fields of nutrition and restoration.
Carl Valle

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