Tag Archives: Return to Play

The Most Effective Hamstring Injury Prevention Program

Hamstring injuries have been reported as one of the most common injuries across a variety of sports that involve repetitive kicking and/or high speed running, such as soccer, track and field, football, and rugby. Re-injury rates are also an issue affecting many athletes long term, with roughly 30% of athletes suffering a re-injury to the hamstring within the first year. In order to prevent hamstring injuries it is important to understand WHY they occur, and to develop a prevention program which targets these risk factors.

The hamstrings are a group of 3 muscles, the biceps femoris, the semitendinosus, and the semimembranosus. Their main purpose is to bring the hip back and bend the knee. The majority of injuries to the hamstrings are strains to the biceps femoris long head muscle. Injury occurs mainly during sprinting, as the muscles contract eccentrically to decelerate the leg.

What are the Risk Factors?

Age
Unfortunately, the older you get, the higher your chance for hamstring injury. The age when the risk starts to significantly increase is 25 years old, with research suggesting a 30% increase in risk annually thereafter.

Decreased flexibility
Tight hamstrings aren’t the only problem; tight hip flexors and/or quads are also problematic.

Muscle Imbalance/weakness
Muscle imbalance within the lumbopelvic region and/or weakness in the hamstrings;

Previous injury
Previous injury to the hamstring, groin and/or knee.

The Most Effective Hamstring Prevention Program

Eccentric Strengthening Program
The majority of hamstring injuries occur during sprinting when the muscle is working eccentrically. As such, eccentric strengthening programs have been shown to decrease the risk of hamstring injury by 65-70%. The most popular and widely studied exercise for hamstring injury prevention is The Nordic Hamstring Exercise. We strongly encourage all athletes to add this exercise to their strengthening regime. However, it shouldn’t be the only hamstring exercise you do. While it has been shown to decrease the risk of hamstring injury significantly, it only activates part of the hamstring muscles (specifically the semitendinosus and short head of the biceps femoris). 80% of hamstring injuries occur to the long head of the biceps femoris, which is better activated with a hip extension exercise such as deadlifts. The most effective hamstring injury prevention program should focus on targeting all the hamstring muscles with both knee and hip dominant movements. Below you will find 2 different exercises: the nordic hamstring exercise and straight leg weighted deadlifts. We recommend doing both for the greatest benefit. See a progressive 12 week schedule below:

Frequency 2x/week x 12 weeks.
Week 1-3: 3 sets of 5-6 reps
Week 4-6: 4 sets of 6-7 reps
Week 7-9: 4 sets of 8-9 reps
Week 10-12: 4 sets of 10-12 reps

Nordic Hamstring Exercise: Can be completed with a partner holding your legs or hooking feet under something heavy. Lower yourself forward, keeping your back and hips straight. Once you cannot go any further push yourself back into start position.

 

Weighted Deadlifts:

Work on your core
While strengthening the hamstrings is important, you can’t forget about everything else that helps support, align and coordinate the hips. If there is an imbalance around the hip such as tight hip flexors, weak glutes, etc., the hamstrings will be more susceptible to injury. In addition, exercise programs that focus on trunk stabilization and agility vs. a traditional program of ONLY hamstring stretching and strengthening post injury results in a quicker return to sport and significantly much lower reoccurrence rate (7% vs. 70%).

Running Program
Most hamstring injuries occur during sprinting, especially later in the game when fatigue sets in. Therefore, strengthening and isolating the hamstrings in the gym is essential, but you must also include interval speed training to improve coordination, large hip/knee joint torques, and explosive strength. Weekly sprint workouts have been shown to prevent hamstring injuries. Like all training loads, ensure the sprinting load (distance, reps and speed) is progressed gradually.

Where to go from here?

If you currently are suffering from a hamstring injury it is best to book an appointment with a therapist and get on an individualized rehab plan. If you are currently injury free and would like to stay that way, then add the above hamstring exercises to your current strengthening program following the 12-week plan. If you want more bang for your buck, then add some core and hip stability exercises as well. If you still have questions or want more guidance on injury prevention book an appointment with one of the Sheddon Physiotherapy and Sports Medicine therapists at 905-849-4576.

Heiderscheit et al., (2010). Hamstring strain injuries: Recommendations for Diagnosis, Rehabilitation and Injury Prevention. Journal of Sports Physical Therapy. 67-81.
Liu et al., (2012). Injury rate, mechanism, and risk factors of hamstring strain injuriesin sports. A review of the literature. Journal of Sport and Health Science. 92-101.
Prior et al., (2009). An evidence based approach to hamstring strain injury. A systematic review of the literature. Sports Health. 154-164.

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Questions? Contact us

concussion management clinic Oakville Mississauga

SPECIAL EVENT Concussion Baseline Testing

Have you completed your Concussion Baseline Testing? Don’t wait any longer, we are having a one day event where you save 40% from individual testing. Continue reading below for details:

WHAT
Concussion Baseline Testing open to all athletes (Cost is $70/athlete)

WHEN
Saturday April 6th, 2019
8:00-2:00pm
Please book in advance this is NOT a drop in

WHERE
Sheddon Physiotherapy and Sports Clinic
1300 Cornwall Unit 103
Oakville Ontario

HOW to book
Call at 905-849-4576 or
Email at admin@sheddonphysio.com

WHY
The multimodal testing that we go through is a series of physical and cognitive tests that provide a pre-injury overview of healthy brain function. This offers an objective benchmark on which to compare should an athlete sustain a concussion. Which also takes the guess work out of return to play decisions. Many organizations may use a single test or a small group of tests as a baseline but we will be using the Complete Concussion Management (CCMI) approach, which uses a variety of tests offering more objective insights, data and improved accuracy and reliability. 

Important notes:

  • Testing time is roughly 30 minutes, there may be a home portion depending on age. No extra fees apply

Frequently Asked Questions:

  • The season has already started, are we too late for concussion baseline tests?
    • NO! Preseason is the ideal time for testing, but anytime during the year prior to a concussion is better than no baseline.
  • WIll the cost be covered through my insurance?
    • The cost of the baseline is covered under most Extended Health Plans since it is administered by a physiotherapist.
  • My child had a baseline done over a year ago, why should we do it again?
    • As young athletes mature, their baseline scores can change greatly from one year to the next. Therefore, it is recommended that athletes get a baseline at the beginning of each season.
  • My hockey team did the impact test preseason, isn’t that good enough?
    • No! Computerized neuropsychological tests, such as the ImPACT test are only assessing one aspect of concussions, neurocognitive function. In order to properly manage concussions a baseline test must be multidimensional, assessing the full spectrum of concussion outcomes (i.e., balance, reaction time, visual processing, physical capacity AND neurocognitive function). In order to know when an athlete has fully recovered, the different areas of the brain that could potentially be affected with a concussion must be assessed prior to and after a concussion.
  •  It’s not mandatory for my childs team.
    • Concussion baseline tests are becoming widely used in many sports at all levels. Although not mandatory (yet) in all high-risk sports, it is one of the most important and effective tools for concussion management. Without a baseline test there is no way to accurately know when an athlete has fully recovered from a concussion. Research has shown that concussion symptoms improve much sooner than brain recovery, which may put athletes at risk for returning to sport too quickly, especially if sport clearance is based solely on symptoms.
  •  Those dates don’t work for my child or team?
    • If you are part of a team or an individual who would like to participate in Concussion Baseline Testing but you cannot fit these dates into your schedule, please contact us and we will try to arrange for another date and time.

Book Your Appointment

Questions? Contact us

concussion management baseline test Oakville Mississauga 6

SPECIAL EVENT Concussion Baseline Testing

Have you completed your Concussion Baseline Testing? Don’t wait any longer, we are having a one day event where you save 40% from individual testing. Continue reading below for details:

WHAT
Concussion Baseline Testing open to all athletes (Cost is $70/athlete)

WHEN
Saturday September 8th, 2018
8-12pm (noon)
Please book in advance this is NOT a drop in

WHERE
Sheddon Physiotherapy and Sports Clinic
1300 Cornwall Unit 103
Oakville Ontario

HOW to book
Call at 905-849-4576 or
Email at admin@sheddonphysio.com

WHY
Baseline testing is the key to effective concussion management.

Read more about the importance of baseline testing here.

*****************Only 6 spots left – book now if interested************************

 

Important notes:

  • Testing time is roughly 30 minutes, there may be a home portion depending on age. No extra fees apply

Frequently Asked Questions:

  • The season has already started, are we too late for concussion baseline tests?
    • NO! Preseason is the ideal time for testing, but anytime during the year prior to a concussion is better than no baseline.
  • WIll the cost be covered through my insurance?
    • The cost of the baseline is covered under most Extended Health Plans since it is administered by a physiotherapist.
  • My child had a baseline done over a year ago, why should we do it again?
    • As young athletes mature, their baseline scores can change greatly from one year to the next. Therefore, it is recommended that athletes get a baseline at the beginning of each season.
  • My hockey team did the impact test preseason, isn’t that good enough?
    • No! Computerized neuropsychological tests, such as the ImPACT test are only assessing one aspect of concussions, neurocognitive function. In order to properly manage concussions a baseline test must be multidimensional, assessing the full spectrum of concussion outcomes (i.e., balance, reaction time, visual processing, physical capacity AND neurocognitive function). In order to know when an athlete has fully recovered, the different areas of the brain that could potentially be affected with a concussion must be assessed prior to and after a concussion.
  •  It’s not mandatory for my childs team.
    • Concussion baseline tests are becoming widely used in many sports at all levels. Although not mandatory (yet) in all high-risk sports, it is one of the most important and effective tools for concussion management. Without a baseline test there is no way to accurately know when an athlete has fully recovered from a concussion. Research has shown that concussion symptoms improve much sooner than brain recovery, which may put athletes at risk for returning to sport too quickly, especially if sport clearance is based solely on symptoms.
  •  Those dates don’t work for my child or team?
    • If you are part of a team or an individual who would like to participate in Concussion Baseline Testing but you cannot fit these dates into your schedule, please contact us and we will try to arrange for another date and time.

Book Your Appointment

Questions? Contact us

Baseline test concussion Sheddon Physioyherapy Sports Clinic Oakville Mississauga

Baseline Testing: The Key to Effective Concussion Management

Concussion management programs have become a major focus in sports medicine clinics due to the increased public awareness and recognition of concussions. One of the biggest concerns following a concussion is the possibility that an athlete returns to sport before the brain has fully healed and sustains a second concussion, which has the potential to cause irreversible brain damage. Unfortunately, there is no single clinical test that can be done to know when an athlete has fully recovered from a concussion. Furthermore, research has shown that symptom resolution occurs much sooner than brain recovery, which may put athletes at risk for returning to sport too quickly, especially if sport clearance is based solely on symptoms. How are health practitioners, coaches and parents supposed to know when an athlete is ready to return to sport? In order to know when an athlete has fully recovered, the different areas of the brain that could potentially be affected with a concussion must be assessed, including:

  • Balance;
  • Strength;
  • Reaction time;
  • Neurocognitive performance;
  • and visual processing.

These different test results need be compared to pre-injury values in order to know when an athlete has returned to their normal pre-concussion baseline values. As such, the best way to ensure that you return to sport safely following a concussion is to get baseline tested before a concussion even occurs. At Sheddon Physiotherapy and Sports Clinic we offer the most comprehensive concussion baseline testing of any sports medicine clinic in the Mississauga and Oakville area.

Why choose us for baseline testing?

Most clinics will tell you that they provide concussion baseline testing, but that doesn’t mean they do it properly. Traditional baseline programs focus solely on computerized neuropsychological tests, such as the ImPACT test. Although vital for assessing neurocognitive function, research has shown that neuropsychological tests should not be used in isolation, since they only address one aspect of concussion. In order to properly manage concussions a baseline test must be multidimensional, assessing the full spectrum of concussion outcomes (i.e., balance, reaction time, visual processing, physical capacity). All of the therapists at Sheddon Physiotherapy and Sports Clinic have undergone extensive training with the Complete Concussion Management program in order to be educated with the most recent research-proven concussion management strategies.

How often should an athlete undergo baseline testing?

As young athletes mature, their baseline scores can change greatly from one year to the next. Therefore, it is recommended that athletes get a baseline at the beginning of each season. Also, if an athlete sustains a concussion during the season, a new baseline will be done following full recovery from the concussion, in case a second concussion occurs during the year.

We are one of the top private clinics in Canada in volume of concussion baseline testing through Complete Concussion Management. In addition, we have successfully treated hundreds of sports-related concussions and have an extensive network of specialists, including a sports medicine physician, vestibular physiotherapists, chiropractors and athletic therapists. We offer the highest quality of concussion testing and management in the Mississauga and Oakville area. If you are interested in learning more about our baseline testing for individual athletes or teams, please contact us at 905-849-4576

 

Book Your Appointment

Questions? Contact us

The Secret to a Quicker Recovery

There is a secret to healing faster and returning to sport quicker post injury, and it doesn’t involve controversial therapy or loads of money. It’s simple, effective and one of the main reasons professional athletes recover much more quickly than the Average Joe. Here’s the secret:

Get your injuries assessed and treated ASAP!

Research has shown that early intervention for an injury will help prevent it from getting worse, prevent muscle loss, weakening and compensation, as well as result in a quicker return to sport and activity.

Supporting Research:

  • Karlsson et al., (2007) showed that early functional treatment (during the first week) following an acute ankle sprain resulted in a significantly earlier return to sport, compared to a group of subjects given crutches and compression wrapping until pain subsided;
  • Studies have shown that following a concussion, athletes who were seen for an assessment by a therapist within the first week had a significantly quicker recovery and return to play, compared to athletes who delayed their initial post-injury evaluation (Bock et al., 2015);
  • Early intervention following lower back injuries has also been heavily researched and showed that treatment soon after injury helps prevent lower back pain from becoming a chronic issue, resulting in less time loss off work, and decreased medication use (Gatchel et al., 2003).

Whether you twisted your ankle or hit your head, being assessed and treated early on has been associated with a quicker recovery and return to sport. At Sheddon Physiotherapy and Sports Clinic, between our team of physiotherapists, chiropractors, massage therapists, athletic therapists and sports medicine doctors, there is no reason for an injury to be left unattended.

Bock et al., (2015). Factors associated with delayed recovery in atheltes with concussion treated at a pediatric neurology concussion clinic. Childs Nervous System. 2111-2116.

Gatchel et al., (2003). Treatment and cost effectiveness of early intervention for acute low back pain patients: A one year propective study. Journal of Occupational Rehabilitation. 1-9.

Karlsson et al., (2007). Early functional treatment for acute ligament injuries of the ankle joint. Scandinavian Journal of Medicine and Science in Sports. 341-345.