Embed Size (px)
DESCRIPTION
Hamstring injuries
Citation preview
“Problems cannot be solved by the same level of thinking that created them” A.E.
Mathieu Gram
Hamstrings
Mathieu Gram
Most common injury in
Mathieu Gram
Hamstring – Incidence & Severity
• Approximately 6 players/squad/season
• Miss approximately 3 matches or weeks of play
Woods et al., 2004 – Hoskins et al., 2005
Mathieu Gram
Risk factors
• Previous hamstring injury >2x risk• Age• ACL injury (altered proprioceptive feedback)
• Reduced flexibility ???• Low hamstring strength ???• Strength deficits or imbalances ???
Isokinetic testing – specificity?Engebretsen et al., 2010Arnason et al., 2004Tsuda et al., 2001Verrall et al., 2001Christensen et al., 2000Mathieu Gram
Mathieu Gram
Clinical reasoning
+ Psychosocial
Mathieu Gram
Anatomical links
TibFib joint
SI Joint
m. Romboidei
ACL
Tsuda et al., 2001Beltran et al., 2003Hoskins et al., 2005
m. Popliteus
Mathieu Gram
Strong framework?
Mathieu Gram
Strong framework?
Tension TLF
Hodges et al., 1997Barker et al., 2004
Mathieu Gram
Strong framework?
Tension TLF
Hodges et al., 1997Barker et al., 2004
Mathieu Gram
Strong framework?
Tension TLF
Hodges et al., 1997Barker et al., 2004
Mathieu Gram
Strong framework?
Tension TLFHodges et al., 1997Barker et al., 2004
SIJ
Lx
Mathieu Gram
Articular
When evaluating hamstring pain,Evaluate biomechanics of:
“Problems cannot be solved by the same level of thinking that created them” A.E.
Mathieu Gram
Articular
When evaluating hamstring pain,Evaluate biomechanics of:
TibFib Joint
Mathieu Gram
Articular
When evaluating hamstring pain,Evaluate biomechanics of:
TibFib Joint
SI Joint
Mathieu Gram
Articular
When evaluating hamstring pain,Evaluate biomechanics of:
TibFib Joint
SI Joint
Lx
Woods et al., 2004
Mathieu Gram
Muscular
When evaluating hamstring pain,Evaluate:
- Framework Lumbar-Pelvic dysfunction?
- Tension Trigger Points?
- Strength
- Length
Vogt et al., 2003
Mathieu Gram
Muscular
When evaluating hamstring pain,Evaluate:
- Framework Lumbar-Pelvic dysfunction?
- Tension Trigger Points?
- Strength
- Length
Vogt et al., 2003
Gluteus Maximusvs
Hamstrings
Mathieu Gram
Neural
When evaluating hamstring pain,Evaluate neurodynamics:
Piriformis syndrome
Mathieu Gram
“Problems cannot be solved by the same level of thinking that created them” A.E.
Treatment of hamstring injuries should also be directed at non-local hamstring factors.
Hoskins & Pollard, 2005
Mathieu Gram
