Injuries in the game of AFL are increasingly common year after year, and can be the difference between a win and a loss. Last week I wrote about one of the most common injuries hamstrings and in particular overstretched hamstrings. (read it here) This week i’ll explain to you a popular exercise that aims to tackle and reduce this common injury.
THE SUPPLE ‘POSTERIOR CHAIN’
The ‘posterior chain’ is comprised of some of the powerhouse muscles which are critical to movement; Lower back muscles, glutes, hamstrings and calves. Whether it be at the start of the season or coming into finals time, you want strong, supple hamstrings and calves that won’t let you down. As mentioned in our previous post, eccentric exercises are the gold standard in order to achieve this. Why are they gold standard? Whether you’re watching AFL on TV or standing at the other end of the ground because the ball is in the opposing 50m, hamstring strains occur when players are running and/or getting ready to jump. Slow motion studies conducted by Schache (et. al. 2010) showed that when running, during the late-swing phase, the hamstrings are acting eccentrically to slow the lower leg. This is proven to be the point where most hamstring strains occur, hence the reasoning why eccentrically strengthening out hamstrings is beneficial to preventing hamstring strains. A brief overview of the physiology of eccentric exercises was covered in our previous post. Well, how do I ‘eccentrically strengthen’ my hamstrings then? The Nordic Hamstring Exercise (NHE) is the most popular exercise, as well as best researched. You may have seen a video or two of this being done by athletes, as it’s a good measure of overall hamstring strength. What the high quality studies have shown is that by performing the NHE, you can achieve an 11% increase in eccentric hamstring strength, a 65% reduction in hamstring strains, as well as an 85% lower rate of recurrent hamstring strains compared to a control group following their usual training program. 1 2 3 This link will take you to a few variations of the Nordic Hamstring Exercise:
Is that it? Do this and I won’t have to worry about my hamstrings again?
Long answer short, not exactly. The Nordic Hamstring Exercise will target both hamstrings, whereas one leg may need it more than the other. Kicking off your preferred leg constantly uses a group of muscles on one side of the lower extremity, there as the non-preferred leg doesn’t get the same attention. This can vary the flexibility and strength of either hamstring muscle group. If you are really dominant on one side, whilst doing the NHE, the dominant muscle may be doing the bulk of the work, as it is able to compensate for the opposing hamstring. An Osteopath is able to assess your hamstrings and any compensatory strains/patterns going on in your body, in order for you to get the most out of exercise you do. What about calves? Your calves are another important muscle making up your ‘posterior chain’. The calf muscle responds really well to eccentric exercise like the hamstring does. One of the best ways to eccentrically strengthen your calves involves standing on your tiptoes and letting your heel drop down below the forefoot. This is the eccentric part. After lowering your foot past the step, take the weight off the ankle with the opposing foot and continue doing the lengthening of the calf. This is great as it can give you a larger range of motion in the ankle. Dr Chris Fielder – Osteopath (B. Clin. Sc, M. Osteo)Chris is an Osteopath practicing at MOVE Osteopathy in Brisbane CBD. He has an interest in all things AFL and loves to help people playing AFL at all levels to perform better and enjoy their sport. If you love playing your footy have an injury or want to avoid injury and perform better make an appointment to see Chris ph: 3229 3661 and stay tuned for more great posts from Chris on this topic.
References: 1.Mjølsnes R, Arnason A, Østhagen T, et al. A 10-week randomized trial comparing eccentric vs. concentric hamstring strength training in well-trained soccer players. Scand J Med Sci Sports 2004;14(5):311-317. 2.Arnason A, Andersen TE, Holme I, et al. Prevention of hamstring strains in elite soccer: an intervention study. Scand J Med Sci Sports 2008;18(1):40-48. 3.Petersen J, Thorborg K, Nielsen MB, et al. Preventive effect of eccentric training on acute hamstring injuries in men’s soccer: a cluster-randomized controlled trial. Am J Sports Med 2011;39(11):2296-2303.
1. Back pain from spinal joint sprains and strains
There are hundreds of joints extending from your neck to tailbone and rib cage. Movements during training that overstretch or overload joints can cause joint sprains and strains. These are common and can range from the mild irritation to debilitating pain. Most patients can make a complete recovery from most these when treated. Untreated they can remain problematic for long periods. Without treatment they can become areas of reoccurring injury and pain 2. Pelvic (Sacroiliac) joint sprain and strain
Like spinal joints, the two large joints either side of your tail bone in your pelvis can be sprained. The job of the sacroiliac joints can be very complex. They must bear weight and control movement. In my experience, they often become an area of repeated problems when left untreated. 3. Overuse injuries and tendonitis
As the name implies overuse and repetitive movements can cause injury almost any tendon. Repetitive use causes rubbing and irritation that can cause inflammation. In some cases this leads to bursitis which can easily become chronic. Tendonitis with bursitis almost always requires rest and specific rehabilitation. 4. Shoulder sprains and strains
The shoulder has a large range of motion but it generally not a very stable joint. This large range of motion makes it susceptible to chronic muscle strains, tendonitis’s, bursitis. These conditions in this area can often become chronic and can be difficult to manage. 5. Ankle sprains
These are a common traumatic sports injury. Rolling an ankle can be just bad luck but ankles need specific rehabilitation. Bad sprains can leave ankles week and susceptible to re-injury with simple activities. Many ankle strains over a period of time need specialized rehab.
6. Groin and hamstring strains
Are common sports complains and can often be the result of problems with form and technique. Tight and inflexible muscles, improper warm up can also be the cause. Overloaded weights training are another way these strains can occur. Simple examination and rehabilitation often gives excellent results. 7. Knee injuries
Poor techniques, physical trauma and overstrain of muscles around the knee can lead to many different knee injuries. Some such as patella (knee cap) tracking disorders can respond well to rehabilitation. More severe knee injuries need surgery and extensive rehabilitation to return to exercise. Knee injuries need thorough examination and investigation to be property diagnosed and treated.
So to avoid many of these common injuries we have put together a list of Our top tips for avoiding injury 1. Get professional advice
This is all about GOOD TECHNIQUE and knowing your body! As an Osteopath I have an excellent understanding of peoples individual body biomechanics. It is easy for us to see what is and what isn’t good for people to do. This combined with a trainer can put you in the best possible position train in the safest way possible way. This is when you can gain maximal results.
Knowing any limitations from previous injuries and concentrating on posture, technique and form. Getting advice from trainers no matter what your level is so important. Not only will it decrease your risk of injury but it also improves results. As you increase distance or weight you should be striving for improvement in technique. Not only does it present intrinsic challenges but it prevents injury.’ 2. Don’t do too much too fast.
Most of the time training is challenging yourself and pushing yourself harder. No matter what the challenge you need to allow your body time to get used to new movements or increased demand. Building things up steadily will always give you the best chance of avoiding injury. People become disheartened when they don’t see results from training sessions quickly
You would think this is most common to beginners but that is not always true. Sometimes more experienced exercisers misjudge where they are with strength and fitness. I often see very fit people underestimating the core strength required to get them to the next level in their training. Too much weight or distance too quickly can set you back severely. Overtraining and not allowing the body adequate rest periods can exhaust the body. Draining the body’s energy and not allowing time to recover and repair after can set you up for injury. 3. Warm up
Most people are guilty of not doing this one at some point. Warm up exercises are usually done with the aim of increasing the blood flow to the muscles. The increased blood flow makes them more “pliable” and adaptable to exercise without injury. Warm up exercises are generally high-rep, low-intensity – a light jog, cycle etc. Lifting weights without a warm up is putting you at a much higher risk of injury no matter how fit you are. 4. Don’t ignore pain
If it hurts, STOP! Pushing through pain (especially sharp or pain you have not had before) is not good. Pushing through fatigue for resistance training is how you progress. After an intense weights session a stretch or a foam roller can ease minor soft tissue strains. A good trainer can help you identify the difference between pushing yourself to the next level and pain due to tissues being injured. I often see patients who have been pushing through the pain not realising the damage they are doing. Continuing training with tendon injuries can cause tendonitis that can be difficult to rehabilitate. It is a similar story for stress fractures. Often the body has been trying to tell them for quite sometime that it cannot deal with the loads being applied. These injuries are far more common than people realise. If identified early they have much better outcomes. 5. Stretch
Ok so there’s lots of different schools of thought on this one. One minute it’s essential before and after all exercise. Next minute a researcher will claim there are no beneficial outcomes. What I do know from years of treating injuries is that not stretching at all will not help your performance. Not Stretching at all will probably put you at a much greater risk of hurting yourself.
Properly performed, a stretch helps to elongate, increase circulation and warm up a muscle. Warmed up muscles are more pliable and ‘alert’. in my experience this makes it far more injury-resistant. Post exercise muscle soreness is reported less when muscles are stretched after a workout.
Yep I’ve come across body builders that don’t stretch ….. like ever!! I often find not only do they have injuries but they can be very unbalanced with their strength and flexibility. They may be able to lift very heavy weights but some simple activities can easily cause strain in them. In my experience, the best performing bodies have a perfect combination of strength and flexibility. These bodies tend to recover well from injuries.
Make sure you get advice and guidance from a trained professional on what stretches are best for you and how to do them properly before you start. 6. Optimal nutrition
Ive seen countless people wanting to lose weight who consume too little or the wrong type of food. They continue to try to train hard and frequently. This is a great way to get injured. If you want to perform better or gain muscle bulk diet is important. Getting advice from a sports nutritionalist on what to eat is worthwhile. You need to provide your body with the best fuel possible if you want it to perform well. If you are doing resistance training you need to ‘feed’ your muscles. Optimal nutrition can feed your muscles and help them recover from a work-out.
Get the right advice from the beginning. Have a team around you to know exactly what your body can (and probably should not) do and how to do it correctly. At the first sign of injury get it assessed and treated. Follow the proper management from the beginning to avoid injuries setting you back.
A serious problem in your hip joint – like damage to your cartilage. It’s not that common particularly in young people and it is usually painful.
Tight tendons or muscles ‘snapping’ ‘flicking’ and ‘clicking’ over the boney parts of your hip joint. – This is really common and is often painless. The two biggest offenders are your psoas muscle in your groin or your ITB (illiotibial band) on the outside of your hip.
So is it bad?
If you have a serious problem in your hip joint then yes the reparative ‘clicking’ could be bad and causing further damage. If it is caused by ‘tight’ muscles snapping over boney bits ….. while it’s not that bad or necessary painful, it can lead to inflammation, bursitis and other problems at the hip in some people
The people who get “snapping hip syndrome’ the most are often dancers, athletes and people doing a lot of exercise or people that are using their hip flexors a lot in some way.
To know exactly what is going on in your hip and the cause of the ‘snap’ you need your hip properly assessed and diagnosed. Once we have examined your hip then we can work out exactly what is casing it and what to do about it.
In the majority of cases that we see the ‘clicking’ or ‘snapping’ is being caused by tight muscles. Osteopathy takes a global look at your body and movement to see how and why certain muscles have become this way …. Is it a repetitive movement you’re doing? Is it to do with your posture at work or when you are exercising?. Has your psoas become overly tight due to stiffness in your lower back? And so on…
Once we figure out how and why your muscles have become this way be can work out the best way to treat it.
We might release the tension in the muscles and use techniques to improve range of motion in parts of your body that are being affected by the increased tension in these muscles.
We will often prescribe you specific stretches or techniques designed to release tension in the problematic muscles. Foam rollers and massage balls can be very helpful with this
Help you understand and improve your technique or posture with a particular exercise or activity that you are doing
Sometimes no matter what the patient does they will never get rid of it. So long as they have had it investigated and ensure that there is no damage being caused to their joints by the activity that they are doing then they continue to move and ‘clunk’ ‘snap’ and ‘click’ their way through a yoga class. Have you got a snapping hip? Or know someone who does? If you need to be moving better then come see us and we’ll get you moving again! Call one of our clinics for an appointment
This month we asked trainer Matt from “The Results Room” in Newstead to give us some insight into how to keep up with your fitness goals even if you have an injury. An injury, pains, niggles and other ailments can really derail our focus and commitment to regular exercise and training. It can happen to anyone from high-level athletes to office workers to stay-at-home mums. If this is you, I want you to know that it’s not the end of the world or the end of your health and fitness goals, but a mere setback to learn from and overcome. Sometimes these things can take a long time to manage and frustrations can set in, but if you ensure there is a plan in place to fix it, perseverance is the key to seeing it through and coming out millhouse!
The following are a few strategies that you can implement in your training to keep you on track:
Train the uninjured body parts
If you injure your ankle for example, you still have all of your upper body that you can train and the other leg! Don’t be scared of creating an imbalance, as you will get a cross-education effect to the injured side that will help maintain the strength you do have and help to speed recovery.
Do your rehab exercises!
It helps your injury if you do these every day in most cases, they help to keep the injured limb mobile and provide some stimulus for either a healing or strengthening adaptation to occur. If you train with a trainer, get them to work with your clinician to monitor and coach you through your rehab exercises.
Prevention is better than a cure
Some injuries are clearly unavoidable; in those cases implementing the first two points will keep you on track. However, many injuries come about for a variety of reasons and can be avoided. To ensure you stay injury free find yourself a reputable coach who can give you a structured plan to fit your needs, knows and coaches you to perform exemplary form on big multi-joint exercises and has a working knowledge of exercise modifications should you need to change something to suit you better. If you have an injury, check with your Osteopath and seek their advice on training. If you have any questions or are interested in some more information about training feel free to pop in and Matt at The Results Room or send him an email to email@example.com.
Preparation before you hit the slopes No matter if you plan to ski or ride from first to last lift or just do a couple of runs between Apres ski sessions in a cosy bar it’s worth doing some preparation before you go to enjoy your holiday. Obviously you need strength and flexibility and an Osteopathic assessment and treatment before you go on your holiday will ensure that you have your best possible bio mechanical alignment before you go on your holiday. We can help improve your flexibility and show you exactly what you exactly what stretches and exercises you will benefit most from Whether you are a complete beginners or expert black run skier or snowboarder you will need some leg strength. Anyone who has ever done the ski lesson will be familiar with being told (at least 100 times in a lesson) “bend the knees”. Both skiing and snowboarding require you to keep your knees bent (flexed) so that you are able to use your body weight and move it over the edge of your skis or snowboard. If you don’t have some strength and endurance in your quads (the muscle in the front of your thigh!) you will certainly be feeling the burn pretty quickly which might mean you may not get so much use out of that 5 day lift pass! Try the following simple exercises to help prepare the legs
Simple quats and lunges using your body weight
If you go to the gym and have a bit of existing leg strength try squats in the “smith machine” with weight or a walking lunge with holding some weight in your hands
If you have not much existing strength and are not a gym junkie you could also try running up flights of stairs.
Look for the stairs everywhere you go start walking up them 2 steps at a time! (you could even put in a lunge or two on the steps while no one’s looking 🙂
as well as leg strength, make sure you have good flexibility – you will definitely benefit from stretches to your Glutes, quads, hamstrings and calves If you already know how to ski or snowboard well, you will already know it’s all about shifting your body weight over your edges Osteopathic treatment can help you achieve the best possible range of motion and freedom of movement to ski at your best. Giulian Di Venuto has treated many skiers that ski at an elite level and says the following
“Mechanical restriction in certain parts of the spine, pelvis and lower limb limits the technique and performance of the skier. I have found that when treating elite skiers there are some predictable areas of the body that if treated will correct difficulties within their style or technique and leads to improved confidence, performance and reduces the risk of injury” Dr Giulian Di Venuto – Osteopath
To help maintain great technique, strength and not burn your legs out you will also need to engage good abdominal and core strength. Brush up by doing the following.
traditional crunches and sit-up will help the abdominal strength
The squats and lunges also help to engage the core
Traditional Pilates and Swiss ball exercises that engage the core abdominal muscles
Avoiding Injury Ski injuries are common and let’s face it you can pretty much hurt any and every area of you body if you have a spectacular stack or tumble. Bruises, cuts sprains, strains and of course fractures. You can strain muscles you didn’t even know you had! Knees are the most commonly strained when legs and skis don’t co-operate! Take a few of these simple tips
Take lessons, learn and progress
Take note of and follow the ski slope rules
Warm up with some simple stretches (especially hamstrings, quads, calves and glutes)
Use good equipment – and properly fitted boots. Poorly fitting boots can give you some VERY sore feet and boots that are too big can cause you to fall
Stay with-in your limits and in control on slopes that you know you can handle
If you focus on it ….. you are likely to run into it – so keep looking to the open space where you want to go …. and not trees or ski schools!
Keep your knees bent and lean your weight down the slope
If you start to fall try not to fall on an outstretched hand – it commonly causes serious strains and fractures
If you fall to the side – falling onto ski stocks hurts too ….and will give you some pretty impressive leg bruises
If you do fall get your skis etc untwisted and organised before you try to get back up
Ski stock straps around your thumbs can cause serious strains if you fall – fit them correctly over your wrists
Remember trees are hard and hurt if you hit them! and the best safety advice I can give you on the snow wear a helmet!
What to do if you do injury yourself. If you have fallen and it feels serious don’t try to ski off the mountain – get help from the ski patrol to avoid making your injury worse. Get someone to check it out – but not your mate unless they happen to be a Doctor, radiologist, Osteopath or Physio. There is always a well equipped sports medicine clinic at the mountain with professionals that are used to seeing and assessing ski injuries, snowboarding injuries and the like. If it’s just a mild joint strain when you get back to your hotel get some ice (crushed in a plastic bag – wrapped in a wet towel) on your injury if there is any swelling it needs some elevation and light compression. Do not apply heat it will make it worse! Your ski injury really should be rested or you run the risk of making it 10 times worse, but if you get the all clear to keep skiing you may want to consider supporting or bracing the joint. Bruises will also benefit from the same ice treatment. Don’t hit the Apres Ski bar to tell your spectacular fall story unless you plan on only drinking hot chocolate – Alcohol will sadly only make the swelling and injury worse. Save Hot tubs, spas and saunas for simply overworked sore muscles at the end of the trip, the heat will only increase any swelling you might have sustained. Make an appointment to see us when you get home – falling down on the snow a few times even if you don’t sustain a major sports injury will usually “jam” things up and should be ‘freed up” before it becomes the catalyst for some other set of problems! If you didn’t actually fall and hurt yourself but you wake up the next morning feeling like you have been hit by a truck – better do some pre-ski stretching, plan a day with lots of breaks (maybe at the closest day spa) and start planning next years pre-ski trip fitness regime 🙂 Dr Kellie Rawlings – Osteopath (B.Sc. M.H.Sc) Principal Osteopath & Co-Director – MOVE Osteopathy