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Showing posts with label Prehab. Show all posts
Showing posts with label Prehab. Show all posts

Wednesday, 17 April 2019

The Effect of Core Training on Athletic Performance


In this literature review, the question, “What is the effect of core training on athletic performance?” will be explored to see if core training really does improve an athlete’s performance. This is a widely discussed area in sport and is well studied. Personal trainers talk about “training the core”, but what they are usually referring to is just the abdominal muscles which is incorrect. The “core” is the area below the pectoral muscles, down to and including the hips. This is the area from which the body stabilises itself, so its extremities - such as arms, head and legs - can move efficiently. A strong core means stronger arms and legs which will improve any movement whether it is running, jumping, throwing etc. The literature's reviewed range from 1992 and 2014.

The core can be scientifically defined as “the trunk or more specifically the lumbo-pelvic region of the body” (Willardson 2007). Most people misinterpret the meanings of core stability and core strength. Core stability means “The ability to control the position and motion of the trunk over the pelvis to allow optimum production, transfer and control of force and motion to the terminal segment in integrated athletic activities” (Kibler. 2006, Lawrence 2007, Willson JD, Davis 2005). A stable core prevents the body moving into incorrect planes of motion such as having an anterior pelvic tilt and will prevent any injuries in the trunk area.

Core strength can be defined as “the muscles surrounding the spinal column’s ability to maintain stability while acting on an external perturbation” (Hibbs 2008, Akuthota, Nadler 2004). When completing either strength training, endurance training or stability training, we are making the core more efficient at these roles.



Core training has two key roles: -

“1/ the first role is protecting (stabilizing) the spine from excessive (and potentially injurious) forces.

2/ the second is in the creation and transfer of forces in a proximal to distal sequence” (Brumitt, 2010, Panjabi,1992)



In theory the effect of core training on athletic performance for either a power based sport or an endurance based sport, should improve performance. The reasons we need to have a strong core is because the core is the base for all movements our body makes. When we throw, push, pull or jump, the core is always involved to give the body a stable base to work off. A stronger core increases the strength/power/endurance capabilities of the upper and lower extremities. Mark Rippetoe further confirms that the core is used for transferring power/force to the extremities (Rippetoe, 2009).

In this literature review we will be looking at the effect of core training in NFL (National Football League) players (power/strength sport) and comparing their results with 5000m runners results (endurance sport).

 “The Relationship between Core Stability and Performance in Division 1 Football Players” Nesser, TW, Huxel, KC, Tincher, JL, and Okado, T. (2008)

 “Does Core Strength Training Influence Running Kinetics, Lower Extremity Stability and 5000m Performance in Runners”.  Kimitake. S, Monique. M (2009)

These are diverse sports, each of which requires different skills and different components of fitness. NFL requires more strength and power which relies heavily on the ATP-PC energy system, whereas the 5000m runners rely upon muscular endurance and aerobic capacity to complete their task. However, the common denominating factor is that both of these sports need a strong and efficient set of core muscles to carry out their prescribed sporting demands.


Credit: https://keithclinic.com/posts/exercise-tips/core-strength-beyond-the-six-pack/ 





Reviewing these studies, both sets of subjects improved their performance - one group minimally and one group significantly. The 5000m metre study showed that during the testing, the CST (Core Strength Training) group had a significant improvement in 5000m times after 6 weeks of implementing their core training intervention. It should be mentioned CST did not significantly influence GRF (Ground Reaction Force) variables and lower-leg stability. The CST group average time improved by 47 seconds and the control group improved by 7 seconds on average. There were minimal differences in pre and post climates for the 5000m tests performed. The main difference between the pre and post was the introduction of the core strengthening programme and increase in training volume/intensity. It could be theorised that the introduction of this core training may have influenced the results (Kimitake, Monique 2009).

The NFL study showed that with core training, their athletes’ performances only improved marginally. The results of this study indicated that core stability is moderately related to the strength and performance of the athlete. They concluded that “increases in core strength are not going to contribute significantly to strength and power improvements and should not be the focus of the strength and conditioning” (Nesser, Huxel, Tincher, Okado, 2008).  The aim of this study was to “determine whether core strength is related to more specific measurements of strength and power in strength and power athletes”. The 29 male athletes were tested during their pre-season. The independent variables which were used to measure the athletes’ core strength/stability included back extension, trunk flexion, right and left side bridge. The dependent variables are the 1RM (one repetition maximum), CMJ (Countermovement Vertical Jump), Pro Agility Shuttle Run, 20 yard and 40 yard Sprints.


Reviewing both studies highlighted certain limitations. In the 5000m study the data for both the GRF groups were affected by inconsistent running velocity due to the subjects not following experimental protocol which resulted in inaccurate pre and post-test times. Subjects ran faster post-test but were instructed to run at same speed (at a natural pace) pre-test for a more reliable and valid comparison between pre and post training GRF tests. However, especially within the CST group, its subjects ran faster during the post training GRF test (Kimitake, Monique 2009). This improvement, specifically in the CST group, may be due to the subjects putting more effort in and possibly manipulating results - this is described as the Hawthorn Effect. This is known as “Participant’s performance changes when attention is paid to them, which is likely to reduce the ability to generalize the results” (Thomas, Nelson, Silverman, 2011). This enhancement will have affected the internal validity of the study due to the subjects not following the specific instructions. The Hawthorn Effect may have been present in this study as they were testing themselves to try and improve their own scores. Their study does mention the enhancement in the results which includes the factor of “test/re-test”.

It could be summarised that the internal validity is affected more as the subjects were given a second attempt to improve their 5000m times. This led to a noticeable difference in temperature, pre =86 F (Fahrenheit), 64% humidity; post=73 F, 58% humidity (Kimitake, Monique 2009). Running in a hot environment makes the body work harder as it has to sweat more to keep the body cool and this excessive sweating costs the body lots of sodium and energy. Endurance training in hot environments will decrease in performance over time (Armstrong 1986, Neilsen 2003, Nybo 2004, Lepage 2011). Another factor which may have affected the results is the body shape and mass of the runners. The control group were slightly heavier than the experimental group so their times would have been slower on average when compared. However internal validity is verified as the subjects were randomly allocated in this study.


Credit: https://www.studyblue.com/notes/note/n/trunk-muscles/deck/16843955 





When analysing the results of the NFL study, they are not consistent. It can be seen that there is too much variance around the mean as shown from Table 2 below.

Having a large variance around the mean of results reduces the validity and reliability of the study.



(Nesser, Huxel, Tincher, Okado, 2008). 



The study incorporated McGill’s core stability tests which are taken from his own study which was solely to find and “collect isometric endurance times from a healthy normal population performing the "side bridge" or lateral flexion exercise, as well as isometric flexion and isometric extension exercises”. These endurance times can be used to form "normal" relative ratios to guide clinicians and identify endurance deficits within specific patients” (McGill, 1999).


Dr Stuart McGill. Image Credit: https://kabukistrength.com/category/articles/dr-stuart-mcgill/ 





However, there is a major limitation using McGill’s testing methods as McGill was testing for a different component of fitness i.e. Muscular Endurance and in Nesser’s study he is applying these tests to power and strength athletes. Using a test aimed at endurance then comparing it to tests of 1RM, CMJ, Agility Testing and 20/40 yard will not produce a significant difference in pre and post test results. With using an inappropriate method of testing and the study’s own results being inconsistent we can conclude that the “The Relationship between Core Stability Training and Performance in Division 1 Football Players” isn’t reliable to determine if core training has an impact on power/strength athlete’s performance.



However, this doesn’t mean that core training won’t have any benefit for strength/power based athletes. As shown from the Kata Karate study, their performance improved (Sameh, Tantawi 2011). Looking at Justin Shinkle’s study the Effect of Core Strength on the Measure of Power in the Extremities – it states that “Core strength does have a significant effect on an athlete’s ability to create and transfer forces to the extremities” (Shinkle 2012). Strength and power athletes such as powerlifters and weightlifters, may not need to do specific core exercises as they are always using their core muscles for their sport (squats, cleans, snatches). In theory, their core stability is constantly improving as they are constantly engaging their core.



Another point of note from the 5000m study, is that the CST group became more aware of their posture when running, which in turn may have contributed to a better post-test result. When asked for their feedback the subjects were more conscious of their core muscles to stabilize themselves when running (Kimitake, Monique 2009). The study did state that their own work may have produced this improvement due to more training sessions compared to others which only did 2 sessions per week over a 6 week period. A higher training volume is needed to increase core strength which may have improved 5000m running times post-test (Kimitake, Monique 2009). This again brings in the Test Re-Test Effect and Hawthorn Effect.



It has been proven that better posture when running does improve biomechanics which in turn improves performance through more efficient running mechanics as shown from numerous studies such as “The Effects of Posture on Running Performance: A Case Study” (Comereski, Niedzielski 2004). These results showed that by doing postural repositioning exercises over a 5 week period, the performance of the track athlete improved. Postural repositioning focused on getting the pelvis into a neutral position, stretching the lower back muscles, strengthening the weaker core muscles such as obliques - this led to an improvement in performance. Improvement was shown from a 14 second improvement over 1 mile and 6 second improvement over the 800m.The main limitations for this study are that it was only performed on one individual.

To summarise all the literature reviewed, it could be postulated that core training is important for all athletes but it has more significance for those athletes who partake in endurance events. This is supported from the 5000m study by Kimitake, Monique 2009. It could be theorised that endurance sports utilize the core muscles to a greater extent and for a longer period. This is evidenced as core training has significantly more of an impact on endurance athletes than power/strength athletes. It could be argued that whilst competing in endurance events, these core muscles are being used for longer and have a greater stress placed upon them - especially the diaphragm muscles when breathing. The abdominals need to be very strong and energy efficient to help improve an athlete’s ventilation ability (increase rate and depth of breaths).






Looking at the demands of the core muscles on an NFL athlete, they need to be able to contract and relax quickly to produce a large amount of force/power and be able to stabilize itself when releasing this force upon or towards an object. This happens for a few seconds and then stops. This “stop start” (interval) way of this sport, doesn’t require their athletes to place a huge significance onto core training. Perhaps NFL could focus more on compound movements to improve their performance such as squats, deadlifts, cleans etc which works the whole body and engages the core muscles in a way that has a positive effect towards their sport.

In conclusion, analysis and comparison shows that the results from the 5000m study shows very positive data (such as 47 second improvement). However, the NFL study is significantly different, as their athletes minimally improved. This could be due to different testing procedures, internal/external variables influencing the data and different subjects for each group having their own individual effects on the data collection.

When compared to the power/strength studies of NFL their performances did improve but not to the same extent as the 5000m runners. The NFL subjects improved marginally on their strength/power tests after their core intervention. The NFL evidence is flawed due to the testing methods, as the study used endurance tests exercise programme.

In future research regarding the topic of core training, practitioners should devise a core test protocol which is generic and then create sport specific core tests relevant to strength and conditioning core training programmes for their athletes. Core training is still a developmental part of sports science today as we are still learning how it can be most effective and applicable to different sports.


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References

1.    Akuthota V, Nadler SF. (2004) “Core strengthening”. American Academy of Physical Medicine and Rehabilitation; 85 (3 Suppl. 1): S86-92

2.    Armstrong LE,Hubbard RW, JonesBH, et al. (1986) “Preparing Alberto  Salazar for the heat of the 1984 Olympic Marathon”. Phys Sportsmed. 14 (3): 73-81

3.    Brummit, J., (2010). Core Assessment and Training, USA, Human Kinetics

4. Comereski.S.J, Niedzielski. M. (2004) “The Effects of Posture on Running Performance: A Case Study”. American Medical Athletic Association Journal Spring 2004

5.    Hibbs AE, Thompson, K. G., French, D., Wrigley, A., Spears, I. (2008) “Optimizing performance by improving core stability and core strength”. Sports Medicine, 38(12):995-1008.

6.    J.M.Willardson (2007) “Core Stability Training: Applications to Sports Conditioning Programs”. Journal of Strength and Conditioning Research 21 (3) 979-985

7.    Kibler, W., Press. J, Sciascia. A (2006). “The Role of Core Stability in Athletic Function”. Sports Medicine, 36(3): 189-198.

8.    Kimitake. S, Monique. M (2009) “Does Core Strength Training Influence Running Kinetics, Lower-Extremity Stability, and 5000-M Performance In Runners?” Journal of Strength and Conditioning, 23 (1) 133.

9.    Lawerence, M. (2007). Core Stability.  2nd Edition.  , London, A&C Black Publishers Ltd.

10. Lepage.W, (2011) Optimum Temperature for Elite Running Performance http://runjeffcity.org/optimum-temperature/. Accessed February 15th 2014

11. McGill, SM, Childs, A, and Liebenson, C. (1999) “Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database”.  American Academy of Physical Medicine and Rehabilitation 80: 941–944, 1999.

12. Nesser, TW, Huxel, KC, Tincher, JL, and Okado, T. (2008) “The relationship between core stability and performance in Division I football players”. Journal of Strength and Conditioning Research 22(6):1750–1754

13. NIELSEN. B., and L. NYBO. (2003) “Cerebral changes during exercise in the heat”. Sports Med. (New Zealand) 33:1–11.

14. NYBO. L., and N. H. SECHER. (2004) “Cerebral perturbations provoked by prolonged exercise”. Progr. Neurobiol. 72(4):223–261.

15. Panjabi M. (1992) “The Stabilising System of the Spine, Part I: Function, Dysfunction, Adaptation and Enhancement”. Journal of  Spinal Disorders and Techniques; 5 (4): 383-9

16. Rippetoe, M., (2009).Core Stability Training. http:// startingstrength.com/articles/ core_stability_rippetoe. Accessed Febuary 15th 2014

17. Sameh Sh. Tantawi, (2011) “Effect of Core Stability Training on Some Physical Variables and the Performance Level of the Compulsory Kata for Karate Players”

18. Shinkle, J, Nesser, TW, Demchak, TJ, and McMannus, DM. (2012) “Effect of Core Strength on the Measure of Power in the Extremities”. Journal of Strength and Conditioning Research 26(2): 373–380

19. Thomas. J, Nelson. J, Silverman. S (2011) Research Methods in Physical Activity. 6th Edition. Stanningley: Human Kinetics p335

20. Willson JD, Dougherty CP, Ireland ML, Davis IM. (2005) “Core Stability and its Relationship to Lower Extremity Function and Injury”. Journal of American Academy of Orthopaedic Surgeons. 13(5):316-25.

21. World Journal of Sport Sciences.  5 (4): 288-296, 2011






Andrew Richardson, Founder of Strength is Never a Weakness Blog





















I have a BSc (Hons) in Applied Sport Science and a Merit in my MSc in Sport and Exercise Science and I passed my PGCE at Teesside University. 
Now I will be commencing my PhD into "Investigating Sedentary Lifestyles of the Tees Valley" this October 2019. 

I am employed by Teesside University Sport and WellBeing Department as a PT/Fitness Instructor.  


My long term goal is to become a Sport Science and/or Sport and Exercise Lecturer. I am also keen to contribute to academia via continued research in a quest for new knowledge.


My most recent publications: 


My passion is for Sport Science which has led to additional interests incorporating Sports Psychology, Body Dysmorphia, AAS, Doping and Strength and Conditioning. 
Within these respective fields, I have a passion for Strength Training, Fitness Testing, Periodisation and Tapering. 
I write for numerous websites across the UK and Ireland including my own blog Strength is Never a Weakness. 
























I had my own business for providing training plans for teams and athletes. 
I was one of the Irish National Coaches for Powerlifting, and have attained two 3rd places at the first World University Championships, 
in Belarus in July 2016.Feel free to email me or call me as I am always looking for the next challenge. 



Contact details below; 

Facebook: Andrew Richardson (search for)

Facebook Page: @StrengthisNeveraWeakness

Twitter: @arichie17 

Instagram: @arichiepowerlifting

Snapchat: @andypowerlifter 

Email: a.s.richardson@tees.ac.uk

Linkedin: https://www.linkedin.com/in/andrew-richardson-b0039278 







Monday, 20 July 2015

Hamstring Heaven!!


Hamstring Injuries/Surgery/Anatomy/Exercises. Its Hamstring Heaven Here!!

By Andrew Richardson

In this article I will be looking at the anatomy of the hip and knee, the Hamstring muscles and its role, how does the hamstring tear, the surgical procedure to repair it. Then to finish looking at a range of hamstring topics. I will be making reference to my day spent in SSC (Santry Sports Clinic) in Dublin, where I learned a lot more about Hamstrings and their own Return to Play Protocol.

Structure of Hamstrings and Type of Joints at Knee, Hip and Ankle

Structure of Hamstrings

The three muscles of the posterior thigh (semitendinosus, semimembranosus, biceps femoris long & short head) flex (bend) the knee, while all but the short head of biceps femoris extend (straighten) the hip. The three 'true' hamstrings cross both the hip and the knee joint and are therefore involved in knee flexion and hip extension. The short head of the biceps femoris crosses only one joint (knee) and is therefore not involved in hip extension. With its divergent origin and innervation it is sometimes excluded from the 'hamstring' characterization.

Two photos: Left deeper anatomical analysis of the hamstrings and what is surrounding them, right photo showing the 3 parts of the hamstrings.









Function of Hamstrings


The hamstrings cross and act upon two joints - the hip and the knee. Semitendinosus and semimembranosus extend the hip when the trunk is fixed; they also flex the knee and medially (inwardly) rotate the lower leg when the knee is bent. The long head of the biceps femoris extends the hip as when beginning to walk; both short and long heads flex the knee and laterally (outwardly) rotates the lower leg when the knee is bent.




The hamstrings play a crucial role in many daily activities, such as, walking, running, jumping, and controlling some movement in the trunk. In walking, they are most important as an antagonist to the quadriceps in the deceleration of knee extension.



Clinical significance


Imaging the hamstring muscles is usually performed with an ultrasound and/or MRI.[1]  The biceps femoris is most commonly injured, followed by semitendinosus. Semimembranosus injury is rare. Imaging is useful in differentiating the grade of strain, especially if the muscle is completely torn.[2] In this setting, the level and degree of retraction can be determined, serving as a useful roadmap prior to any surgery. Those with a hamstring strain of greater than 60mm in length have a greater risk of recurrence.[3]


Tear of the hamstrings muscles at the ischial tuberosity seen on MRI (coronal STIR). The arrowheads indicate the tuber and the retracted tendon stump. Significant bleeding around and into the muscles.



Use in surgery

The distal semitendinosus tendon is one of the tendons that can be used in the surgical procedure ACL reconstruction. In this procedure, a piece of it is used to replace the anterior cruciate ligament (ACL). The ACL is one of the four major ligaments in the knee. Here is a video of a semitendoinous surgery in action (WARNING GRAPHIC) https://www.youtube.com/watch?v=tQUd5JwykzY and thr ACL replacement surgery (again WARNING GRAPHIC) https://www.youtube.com/watch?v=iFniNyUpVKw



Reason for looking at knee and hip joints, is because the hamstring plays such a role in both of them.


Knee Joint

The knee joint joins the thigh with the leg and consists of two articulations: one between the femur and tibia, and one between the femur and patella.[4] It is the largest joint in the human body.[5] The knee is a mobile trocho-ginglymus (a hinge joint), which permits flexion and extension as well as slight internal and external rotation. The knee joint is vulnerable to both acute injury and the development of osteoarthritis. It is often grouped into tibiofemoral and patellofemoral components.[6][7] (The fibular collateral ligament is often considered with tibiofemoral components.)[8] Below are a few images of the knee from a range of angles.




Hip Joint

The hip region is located lateral and anterior to the gluteal region (i.e., the buttock), inferior to the iliac crest, and overlying the greater trochanter of the femur, or "thigh bone". In adults, three of the bones of the pelvis have fused into the hip bone or acetabulum which forms part of the hip region.

The hip joint, scientifically referred to as the acetabulofemoral joint (art. coxae), is the joint between the femur and acetabulum of the pelvis and its primary function is to support the weight of the body in both static (e.g. standing) and dynamic (e.g. walking or running) postures. The hip joints are the most important part in retaining balance. The pelvic inclination angle, which is the single most important element of human body posture, is mostly adjusted at the hips



Here is a good video by Nabil Ebrahiem, Professor & Chairman of the Department of Orthopaedic Surgery at the University of Toledo Medical Centre: Looking at Hamstrings Injuries.


Now after gaining a better understanding of the anatomy of the hamstrings and their function. We can now look at detail the assessment of a hamstring injury. I was fortunate enough to spend a day at Santry Surgery Clinic (SSC) in Dublin where I was introduced to their Hamstring assessment protocol (which is shown below). I hope you find it very useful as I did.



Assessment of Injury

Subjective: Previous history (specifically hamstrings), age (over 22), VAS, site of injury. Mechanism, Training Load. Normal subjective assessment. Walking ability. Objective, straight leg raise, prone hamstring curl at 0 degress, 45 degrees and 90 degrees. Strength. Bridge – functional ability. Hip flex/knee flex, iso contraction +/-. Bridge (weakness), location of tenderness, palpation, length of tenderness, Hip Int/Ext rotation. Thomas Test, Slump Test.

For physios here is an excellent video by Joe Keegan Physiotherapist of Loughborough Sports Injury Clinic on how to assess and treat an injured athlete with a hamstring injury.



Factors Affecting Progress


-          Negative: Aclusion fracture, Grade III hamstring rupture, Recurrent Hamstring Injury, Involvement proximal tendon, large and deep hematoma, excessive slow speed stretching injury. High Vas pain?

-          MRI Needed? Aclusion, Grade III rupture. Proximal/Distal Tendon injury. Excessive stretching injury.

-          Positive: Gr1/Gr2 hamstring Injury, pain free walking within 24 hours, short muscle tear on MRI.


Diagnostic and Rehabilitation

Acute injury Management: Compression bandage, ice bi-hourly for 20 minutes. Elevation, Analgesics, PRP within 48 hours, MRI within 48 hours if required.

-          Manual Therpay

-          Cardiovascular: Boxing Steam (anaerobic session, metabolic session, aerobic session), Rope Session (anaerobic session, metabolic session, aerobic session), Bike Session (anaerobic session, metabolic session, aerobic session).

Neuromuscular Control = Lumbopelvic Flexibility.

Hamstring Strengthening

Isometric Stream: Within a controlled symptom free range

-          Isometric quad/hamstring holds

-          Isometric heel holds

-          Prone knee bends

-          Nordic hold at 15 degrees

-          Single leg prone isometric bar pull (with bands)

Bridging Stream: Within a controlled symptom free range

-          Double leg bridge

-          DL bridge – hands in air

-          SL bridge

-          SL bridge hands in air

-          Nordic Hold at 15 degrees

Deadlift Stream (to include one set with feet at different width): Within a controlled symptom free range. Speed deadlifting when SL deadlifting

-          Hip Hinge

-          Kettle bell raise

-          Sumo deadlift

-          Double leg deadlift

-          Stiff leg deadlift

-          SL stiff leg deadlift

Squat Stream (to include one set with feet narrow/normal/wide/angular load): Within a controlled symptom free range. Speed Squat when SL squatting

-          Banded squat

-          Squat (unloaded)

-          Loaded squat

-          High single leg squat

-          Single leg squat

Lengthening: Day 3 post injury, within a controlled symptom free range.

-          The extender

-          The Diver

-          The glider

Lunge Stream: Within a controlled symptom free range

-          Split lunge

-          Lunge unloaded

-          Loaded lunge

-          Lunge with twist

-          Lunge 360 degree with twist

Jumping Stream: Unload Squat

-          Drop squat

-          Drop Landing and DL Jump

-          Drop Landing with alternate leg land

-          Drop Squat with SL hurdle hope

-          Drop Squat with multiple hurdle hop.

Running Stream: Unloaded lunge, Day 3 post injury Normal Gait Pattern

-          Level 1

-          Level 2

-          Level 3

-          Level 4

Agility Drills: Begins Level 3 SL deadlifting

-          E.g. Gaelic Football/Hurling Pickups

-          Rugby-Throwing from Ground

Sports Specific Drills: Begins Level 3, SL deadlifting

-          E.g. Gaelic Football/Hurling Pickups

-          Rugby-Throwing from Ground

Multidirectional: Begins Level 3 Lunge with a twist SL deadlift

-          Slalom running

-          Cutting

Box Jumping: Begins when drop squats +multiple hurdle hops Sl deadlifting

Level 4 running

-          Small box to small box

-          Medium box to small box

-          Small box to medium box

-          Medium box to medium box

Return to Play

-          NIL Top

-          SSC VU Test

-          100% Straight Line & MD

-          Symmetrical HIP ROM

-          <10% hamstring strength deficit

-          Sports Specific Drills


Here is the protocol in photo format (hence the need to write it out as picture becomes blurry):



My Personal Thoughts on Hamstrings

Now when people come to me saying they have a tight/sore lower back my first thought is their glutes/hamstrings are affecting this. Why? Well if the hamstrings are tight then that’s due to the calves. Hamstrings being tight causes the glutes and hips to be tight as they are being pulled on. This has a knock on effect by making the lower back (erector spinale) aggravated.

This can lead to a pelvic tilt especially if the glutes and lower back are tight. They will be pulled down. It will look like this;


Myofasical release on calves, glutes. Do a dynamic warm up on the trunk and legs. Another thing that could be done to help release tightness is doing a glute/hip activation protocol as shown; https://www.youtube.com/watch?v=vwspH14-D04

Any injury site isn’t the cause it’s the victim of something else

Quick tips

If your knee hurts have your hip & ankle checked out

If you’re hip hurts look at your shoulder and your knee (could be the opposite side not always on the same side).

Assessment of Hamstring Flexibility

Hamstring extension is key to determining flexibility, assessed by performing a sit and reach test. This is a very basic assessment for assessing the flexibility of the hamstrings and lower back (erectors).

All you need is the following;Sit & Reach Box and the Score Chart





Dr David Opar on Hamstring Injuries in Football Players


Dr Opar is a lecturer at the School of Exercise, Australian Catholic University, Melbourne. His focus on hamstring injuries and injury prevention.


One of the studies he looked at was eccentric strength of hamstrings related to age and likelihood of injuries. The older you are and weaker you are eccentrically speaking you are a candidate for a hamstring injury but regardless of age if you keep up a strong eccentric hamstring you have a very slim chance of injury.


When looking at the sport of football/soccer it is the most common injury in the Premier League and accounts for 49.3% of all muscular injuries reported. Yet risk management rather than prevention is the key when it comes to hamstring injuries.


He goes in detail of the Nordic Hamstring exercises


A great article by Eamon O’Reily, Senior Performance Rehabiliation Physiotherapist at Sports Surgery Clinic entitled; De-Mystifying Hamstring Injuries.



My 4 Favourite Hamstring Exercises

Nordic Curl, as it’s a great exercise eccentrically but it’s a fantastic for injury prevention. I have all my athletes doing this regardless of sport.




RDL (Romainian Deadlift). Myself being a powerlifter enjoy this as it gets the hamstrings firing in both the concentric and eccentric portions of the lift. More so on the concentric from the floor pulling up it’s a great transfer of strength to the skill of deadlifting.






Hamstring Curl, simple bodybuilding movement to isolate the hamstring belly. I like to finish off with a few sets of them high reps.




Good Mornings, again like the RDL transfer of strength to the skill of squatting/deadlift is good as it helps maintain upright posture during the lifts whilst training a weaker portion of the movement. The good morning is an exercise to be used in case you end in a bad position during heavy lifting, if you train it well enough you can always recover from it. Now being a bad position isn’t something you should intend to get yourself into.

Video: https://www.youtube.com/watch?v=hllFsZIEuAs


Running Mechanics (relating back to Hamstrings role in running)

What are hamstrings normally used for? While the quads support our body-weight, our hamstrings help us break free from the pull of gravity. When we increase our cadence to 180 or more strides per minute we need hamstrings that are capable of quickly pulling the foot from the ground. However, larger and stronger muscles, trained in static conditions in the gym, do not necessarily translate to better performance when running. The key to developing great hamstrings is performing dynamic drills in order to train the hamstrings.

Some excellent drills are foot tapping and front lunge. Try these drills with stretch cords to increase resistance. The key use of our hamstrings in running is to be able to quickly pull the support foot from the ground.

This was taken from the video Running Technique: Confusion About the Role of Hamstrings in Running: https://www.youtube.com/watch?v=pmyBTespnHc

Juggernaut Program Director, James "The Thinker" Smith, discusses the role different muscles play during different phases of the sprint. We also show you why the GHR is NOT the best option for hamstring training for sprinters and a reverse hyper variation that is superior for hamstring strength and health. 

Very good demonstrations, I quite liked using the prowler as a way of demonstrating the running motion.
Video: https://www.youtube.com/watch?v=gikFNVeOmXI






Hamstrings in the Squat


Below is a detailed description (in article, picture and video) of the role of the hamstrings in the squat. Greg Nuckols of Strength Theory has done a great job analysing the role of hamstrings in the squat under 90% 1RM loads. This has brought back some interesting data. What the main areas you will find are the following;


1. In general, the body utilizes single-joint muscles before two-joint muscles really kick in.  This makes movement more efficient.


2. At the bottom of the squat, overactive hamstrings make the movement unnecessarily difficult, so squatting in a manner that maximizes hamstrings involvement in the hole is probably unwise.


3. If you find yourself getting pitched forward in the squat, strengthening your glutes helps your hamstrings relax a bit, taking some strain off your quads and making the bottom half of the squat easier.

4. The place you want your hamstrings to kick in is at the sticking point, when demands on the quads have decreased a bit, and the added hip extension torque can help you keep the bar moving.

(4 points take from article as a preview to it).

If you have the time read and watch the content below as it will make more sense as having overactive hamstrings is a bad thing.





Studies done on Hamstrings looking at injury/emg/force etc

Some good studies done on Hamstrings from three perspectives.

Eccentrics:

-          Askling, C., Karlsson, J., & Thorstensson, A. (2003). Hamstring injury occurrence in elite soccer players after preseason strength training with eccentric overload. Scandinavian journal of medicine & science in sports, 13(4), 244-250.

-          Jonhagen, S., Nemeth, G., & Eriksson, E. (1994). Hamstring injuries in sprinters the role of concentric and eccentric hamstring muscle strength and flexibility. The American Journal of Sports Medicine, 22(2), 262-266.

EMG:

-          Caterisano, A., MOSS, R. E., PELLINGER, T. K., WOODRUFF, K., LEWIS, V. C., BOOTH, W., & KHADRA, T. (2002). The effect of back squat depth on the EMG activity of 4 superficial hip and thigh muscles. The Journal of Strength & Conditioning Research, 16(3), 428-432.

-          More, R. C., Karras, B. T., Neiman, R., Fritschy, D., Woo, S. L., & Daniel, D. M. (1993). Hamstrings—an anterior cruciate ligament protagonist An in vitro study. The American journal of sports medicine, 21(2), 231-237.

Force Production
- Ogura, Y., Miyahara, Y., Naito, H., Katamoto, S., & Aoki, J. (2007). Duration of static stretching influences muscle force production in hamstring muscles. The Journal of Strength & Conditioning Research, 21(3), 788-792
- Stanton, P., & Purdam, C. (1989). Hamstring injuries in sprinting—the role of eccentric exercise. Journal of Orthopaedic & Sports Physical Therapy, 10(9), 343-349







I hope you found the article interesting to read. It was heavy at points to read but if you take your time reading it, it will become digestible.  It was a very broad article I could have done individual articles on all the sections but I will leave that for another day.


Regards


Andrew Richardson


References


1.                   Jump up ^ Koulouris G, Connell D. (2003). "Evaluation of the hamstring muscle complex following acute injury".  Skeletal Radiol. 32 (10): 582–9. doi:10.1007/s00256-003-0674-5. PMID 12942206.

2.                   5.Jump up ^ Schache AG, Koulouris G, Kofoed W, Morris HG, Pandy MG (2008). "Rupture of the conjoint tendon at the proximal musculotendinous junction of the biceps femoris long head: a case report.".  Knee Surg Sports Traumatol Arthrosc. 16 (8): 797–802. doi:10.1007/s00167-008-0517-y. PMID 18360748.

3.                   6.Jump up ^ Koulouris G, Connell DA, Brukner P, Schneider-Kolsky M. (2007). "Magnetic resonance imaging parameters for assessing risk of recurrent hamstring injuries in elite athletes.".  Am J Sports Med. 35 (9): 1500–6. doi:10.1177/0363546507301258. PMID 17426283.

4.                   Chhajer, Bimal (2006). "Anatomy of Knee". Knee Pain. Fusion Books. pp. 10–1. ISBN 978-81-8419-181-3.

5.                   Jump up ^ Kulowski, Jacob (July 1932). "Flexion contracture of the knee". The Journal of Bone & Joint Surgery 14 (3): 618–63.  Republished as: Kulowski, J (2007). "Flexion contracture of the knee: The mechanics of the muscular contracture and the turnbuckle cast method of treatment; with a review of fifty-five cases. 1932". Clinical orthopaedics and related research 464: 4–10. doi:10.1097/BLO.0b013e31815760ca (inactive 2015-05-08). PMID 17975372.

6.                   Jump up ^ Rytter, Søren; Egund, Niels; Jensen, Lilli; Bonde, Jens (2009). "Occupational kneeling and radiographic tibiofemoral and patellofemoral osteoarthritis". Journal of Occupational Medicine and Toxicology 4: 19. doi:10.1186/1745-6673-4-19. PMC 2726153. PMID 19594940.

7.                   Jump up ^ Gill, T. J.; Van De Velde, S. K.; Wing, D. W.; Oh, L. S.; Hosseini, A.; Li, G. (2009). "Tibiofemoral and Patellofemoral Kinematics After Reconstruction of an Isolated Posterior Cruciate Ligament Injury: In Vivo Analysis During Lunge". The American Journal of Sports Medicine 37 (12): 2377–85. doi:10.1177/0363546509341829. PMC 3832057. PMID 19726621.

8.                   Jump up ^ Scott, Jacob; Lee, Ho; Barsoum, Wael; Van Den Bogert, Antonie J. (2007). "The effect of tibiofemoral loading on proximal tibiofibular joint motion". Journal of Anatomy 211 (5): 647–53. doi:10.1111/j.1469-7580.2007.00803.x. PMC 2375777. PMID 1776452

  





Andrew Richardson, Founder of Strength is Never a Weakness Blog





















I have a BSc (Hons) in Applied Sport Science and a Merit in my MSc in Sport and Exercise Science and I passed my PGCE at Teesside University. 
Now I will be commencing my PhD into "Investigating Sedentary Lifestyles of the Tees Valley" this October 2019. 

I am employed by Teesside University Sport and WellBeing Department as a PT/Fitness Instructor.  


My long term goal is to become a Sport Science and/or Sport and Exercise Lecturer. I am also keen to contribute to academia via continued research in a quest for new knowledge.


My most recent publications: 


My passion is for Sport Science which has led to additional interests incorporating Sports Psychology, Body Dysmorphia, AAS, Doping and Strength and Conditioning. 
Within these respective fields, I have a passion for Strength Training, Fitness Testing, Periodisation and Tapering. 
I write for numerous websites across the UK and Ireland including my own blog Strength is Never a Weakness. 
























I had my own business for providing training plans for teams and athletes. 
I was one of the Irish National Coaches for Powerlifting, and have attained two 3rd places at the first World University Championships, 
in Belarus in July 2016.Feel free to email me or call me as I am always looking for the next challenge. 



Contact details below; 

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