Without a doubt the muscle injury It is one of the most common in people who practice sport and, among them, it has been observed that the muscle group hamstring It is the most prone to injury. This is because it is a polyarticular muscle, that is, it governs several joints such as the knee and the pelvis. It is also a muscle very long with a tendon intramuscular (Septum), around which the tear usually occurs.
Within this set, it is the biceps femoris the one that takes the worst part (80% of breaks), since it has greater activation in the moments of greatest risk of injury (braking and/or landing).
There are different ways to classify a muscle injury But perhaps what interests us most is to know the degree (0, I, II, III and IV) and the location of this (myofascial, myotendinous or infratendinous); because it will be, in part, what determines the duration of the recovery.
Among the risk factors that can cause it, there are some of them that we cannot control, such as age; however, most of them, such as strength deficit, the lack of flexibility for the sporting gesture, inadequate pelvic stabilization (core), he stress, the hydration, he rest and even the fatigue They are totally trainable; and at Evolution Madrid we can help you improve them.
Finally, we must say that we are not very fond of the protocols facing the treatment of a injury since there are many variants during the rehabilitation that we must modify based on the behavior of the tissue, from the experience we have lived with patients previous and of the individual that we have before us. However, we are going to offer you a possible guide to be able to take a look and know in which phase of the injury the subject can be found and how we should approach it at all times until complete recovery and return to sport.
Acute phase (0-48 hours)
Regulate the inflammation (Ice, cold water dives).
Working on lumbopelvic mobility active way.
Working on lumbopelvic mobility passive way (Physiotherapist).
If there is a lot of pain, use painkillers (Paracetamol).
Forbidden:
Massage the injured muscles. If possible, work on the adjacent muscles (e.g. calves).
NSAIDs – Non-Steroidal Anti-Inflammatory Drugs (e.g. Ibuprofen).
Work the injured muscles during the first 3 days (up to 6 days for major tears).
Compression (Reduces vascular supply to the muscle).
IF AFTER 5 DAYS THERE IS NO OBVIOUS IMPROVEMENT IN SYMPTOMS, YOU SHOULD BE CHECKED BY A DOCTOR TO ASSESS INTRAMUSCULAR EDEMA.
To move on to the next phase, walking must be painless as well as the contraction at 50% of the affected muscle.
Subacute or regeneration phase (After 48 hours-14 days)
Painless electrotherapy for increase blood flow.
Strengthening injured muscles by isometric contraction in position of maximum possible elongation.
Strengthening the muscles synergist (gluteus maximus).
Generate pelvic stability – CORE.
Flexibility work of active way of the affected muscle (hamstring).
Flexibility work of the muscles antagonist (psoas).
Forbidden:
Passive flexibility of the affected muscle. Avoid neural tension.
Eccentric exercise and explosive gestures.
Fibrogenesis Phase (From the 2nd week. Day 14-28)
Muscle enhancement electrotherapy in elongation position.
Cardiovascular exercise (Light jogging).
Strengthening injured muscles by eccentric work.
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Progress to maximum loads.
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Progress in speed.
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Search for functionality.
Precautions:
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In case of pain do not shorten the muscle length (do not decrease joint range); it is preferable decrease the intensity.
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This is a phase that can make us believe that we are going backwards, which is normal, due to the process of cicatrization (greater deposits of fibrosis).
Functional Readaptation Phase
Correct imbalances.
Explosive work (plyometrics, changes of rhythm and direction, single leg receptions).
Increased cardiovascular capacity.
Incorporation into regular training.
Return to sport (Competition)
- No pain.
- Full strength with the muscle in the lengthened position.
- Full range of motion without pain.
- Painless sporting gesture at any speed.
- Subjective feeling of recovery. No fear or apprehension.
