How to diagnose, treat and prevent Hamstring Strains

How to diagnose, treat and prevent Hamstring Strains

What is a hamstring strain? A strain is a stretch or tear of a muscle or tendon. People commonly call such an injury a “pulled” muscle. 

Your hamstring muscle group is in the back of your thigh and allows you to bend your knee and extend your hip. It is made up of three large muscles: biceps femoris, semimembranosus, and semitendinosus. 

How do hamstring strains occur? 

A hamstring muscle strain usually occurs when these muscles are contracted forcefully during activities such as running or jumping. 

What are the symptoms of hamstring strains

There is often a burning feeling or a popping when the injury occurs. You have pain when walking or when bending or straightening your leg. A few days after the injury, you may have bruising on your leg just below the injury. 

How are hamstring strains diagnosed? 

One of our Practitioners will examine your leg and find tenderness at the site of the injury. And they will usually perform a series of muscle tests to figure out the extent of the injury.

How are hamstring strains treated? 

Treatment may include: 

  • Applying ice packs to your hamstrings for 45 minutes every 3 to 4 hours for 2 to 3 days or until the pain goes away 
  • Elevating your leg by placing a pillow underneath it 
  • Using crutches if it is too painful to walk. 
  • Your practitioner will begin treatment to reduce unnecessary scarring of the injury and return muscle elasticity back as close to pre-injury
  • All body structures affecting the hamstring will be treated to maintain optimal function
  • Treatment will aim at stimulating blood flow to the area to increase the rate of healing
  • Strength exercises will be given to strengthening the muscle and tendon.

When can I return to my sport or activity? 

The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from an injury at a different rate. Return to your sport or activity will be determined by how soon your leg recovers, not by how many days or weeks it has been since your injury occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. 

You may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true: 

  • You have bought the strength capacity of the injured muscle to a level that can sustain your sports requirements
  • You can do basic running drills, including acceleration and deceleration without pain or discomfort
  • You have returned to pre-injury fitness
  • You can train with your team or sport without restriction

How can I prevent a hamstring strain? 

  • Preparing your muscles pre-training or pre-game by gradually increasing the intensity of activity until you reach a game-ready intensity
  • Moving your hips and pelvis through a rigorous range of motion without discomfort.

What is an ankle sprain?

ankle sprain ligament injury

An ankle sprain, or ligament injury, causes a stretch or tear of one or more ligaments in the ankle joint. Ligaments are strong bands of tissue that connect bones at the joint. 

What is an ankle ligament injury?

There are many ligaments in the ankle. The most common type of sprain involves the ligaments on the outside part of the ankle (lateral ankle sprain). Ligaments on the inside of the ankle may also be injured (medial ankle sprain) as well as ligaments that are high and in the middle of the ankle (high ankle sprains).

Ankle sprain grades

Sprains may be graded I, II, or III depending on their severity: 

  • Grade I sprain: pain with minimal damage to the ligaments 
  • Grade II sprain: more ligament damage and mild looseness of the joint 
  • Grade III sprain: complete tearing of the ligament and the joint is very loose or unstable

Sometimes sprains are just classified as mild or severe, depending on the amount of ligament damage. 

How do ankle sprains happen

A sprain is caused by twisting your ankle. Your foot usually turns in or under but may turn to the outside. This causes you to roll over your ankle and damaged ligaments.

What are the symptoms of a sprained ankle? 

Symptoms of a sprained ankle include: 

  • mild aching to sudden pain 
  • swelling 
  • discolouration 
  • inability to move the ankle properly 
  • pain in the ankle even when you are not putting any weight on it

How do are ankle sprains diagnosed? 

To diagnose a sprained ankle, a practitioner will review how the injury occurred and consider your symptoms. He will examine your ankle carefully. X-rays may be taken of your ankle but are not always necessary to make a diagnosis. 

How are ankle sprains treated? 

Treatment may include: 

  • Applying ice packs to your ankle for the first 2 to 3 days to begin to reduce swelling. Taking anti-inflammatory and tissue repair support.
  • Treatment can begin on the ankle to help improve blood flow and range of motion. You will be encouraged to begin putting weight on the ankle as soon as it’s tolerable.
  • Doing ankle exercises to improve your ankle strength and range of motion. The exercises will help you return to your normal activity or sports. 
  • Rarely, severe ankle sprains with complete tearing of the ligaments need surgery. After surgery, your ankle will be in a cast for 4 to 8 weeks. 

How long will the ankle sprain effects last? 

The length of recovery depends on many factors such as your age, health, and if you have had a previous ankle injury. Recovery time also depends on the severity of the sprain. A mild ankle sprain may recover within a few weeks, whereas a severe ankle sprain may take 6 weeks or longer to recover. Recovery also depends on which ligaments were torn. A lateral sprain (outside ligaments) takes less time to recover than a medial sprain (inside ligaments) or a high ankle sprain (high, middle ligaments). 

When can I return to my sport or activity? 

The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from an injury at a different rate. Return to your sport or activity will be determined by how soon your ankle recovers, not by how many days or weeks it has been since your injury occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. Practitioners at the clinic are well trained and suited to guide you in the return to sport process.

How can I help prevent an ankle sprain? 

To help prevent an ankle sprain, follow these guidelines: 

  • Wear proper, well-fitting shoes when you exercise
  • Practice proper warm-up techniques pre-performance
  • Strength training will help in maintaining strong ligaments and also rehabilitating weak ones

Treatment When You’re Feeling Good

Most people assume that they only need treatment when they have an injury, but what about treatment when you’re feeling good? Is there any use to this or is it just a waste of time? Let’s take a look at some of the criticisms and the advantages of this approach to treatment.

Most people will take the car to a mechanic and ask for a service when the car is generally in good condition, you wouldn’t take your car to a mechanic and ask for a service if the car’s broken down. The mechanic would first have to fix the problem, get your car back out of the road, and then resume your servicing schedule. You can see where this analogy is going.

Disclaimer: This is for Educational Purposes Only

Let me take a quick intercession to inform you as to the nature of our advice. We are experienced, healthcare clinicians. We wish to share our experience with you on topics to do with your health. We may be a little colourful in doing so, but at the heart of what we do is in-the-trenches experience. Whilst we have achieved academic success and understand the evidence, we are not solely evidence-based. We are, however, EVIDENCE INFORMED. 

We find that the evidence is usually 10-15years (at minimum) behind what we are seeing in the clinic. We see real people, with real problems, and we’ve made a great living out of offering real solutions. 

If all you’re after is the researched evidence, you can find some on Google Scholar, or you can very easily look for more on Google. We want to give you real-life advice, most of which you may not find in the research.

There is no way that this document can replicate or replace expert assessment and guidance given by a qualified registered healthcare practitioner who has seen you personally. I am sure you’re aware that I have no knowledge of your personal medical history or how you take care of your body. If you require care from a qualified practitioner, you would be best served by seeing someone who can empathise with your situation and treat you accordingly.

I’m sure you understand that I disclaim any and all responsibility for anything you do as a result of reading this document. And by reading this article, you accept 100% responsibility for the actions of you or anyone under your care.

But let’s take a step back here. The argument against this analogy is that the body has a self-healing capability, whereas a car doesn’t. Yes, the body can heal itself, and actually, it can do a whole lot more. It can also regulate and adapt itself so that any constant stress has less effect on the system. These stresses are not just physical, but mental and emotional also, but for our purposes today, our services are mainly concerned with the alleviation of physical stress.

The body’s self-regulation we discussed reduces the performance of the body because it has to account for consistent external stress. We don’t prefer this reduction in performance because well, it’s not optimal, and it can lead to injury when the stress is too high for regulation to occur.

But there are a couple of more criticisms to this approach. One, that it’s unnecessary. And two, that it’s unethical. Why would you take someone’s money and treat them when they aren’t in pain and they really don’t need it?

Let’s look at the first criticism of it being unnecessary. Whilst unnecessary can mean different things to different people, let’s try and be as objective as we can about the topic. To make the matter less complicated, the most up-to-date information we have about pain science is that the perception of pain by the brain can be looked at as a set of scales. On one side you have safety signals and on the other, you have danger signals. When the danger signals outweigh the safety signals, pain is perceived in the brain and quite simply, you feel pain.

The danger signals can be anything from trauma, constant mechanical loading, mental stress, and even poor habits and perceptions you’ve built over time. The question now becomes, how qualified is the therapist at identifying the physical danger signals and do they have a track record of actually doing what they claim to do? There’s no evidence other than our own anecdotal evidence to rely on to be able to answer this question, and if hardcore evidence is your measuring stick, you will probably feel that the treatment is unnecessary. 

But here’s the funny thing…we never question if the laws of gravity and the mechanical laws governing the universe exist. We assume they do. We quantify them. And we also have to assume that they act on the human body since we are a part of that universe. So movement can be identified and quantified. But can it be rectified or improved? Well, to the extent that mechanical laws can act equally on the relevant parts of the body, yes they can. Unequal distribution of force can be understood as asymmetry, and that is what we are specifically trained to identify and help correct. Pain science is telling us that these things affect danger signals and lead to pain. So by identifying and preventing them, there is a very valid argument that preventative treatment is necessary and in-fact desirable. 

So in summary, you can hide behind a lack of existing evidence for preventative treatment and claim it’s unnecessary. But you would also have to disregard the laws of the universe governing movement. You can’t have it both ways! 

What about the claim that it’s unethical to charge people money for treatment that can’t be substantiated to be necessary? Well, if you still feel that the treatment is not required or beneficial then you will continue to be convinced that treatment is unethical. But if you’ve come to the conclusion that preventative treatment is beneficial, then not only does treatment become ethical, it’s actually a disservice to the patient not to advise them of this strategy.

Without even considering the health benefits (of which we will get to) the time and cost savings alone are worth the investment. For treatment when pain sets in, a condition could take between 4-6 sessions to alleviate the pain. It might cost you anywhere between four to six hundred dollars over the space of about two to three weeks. Now if you spread that out over the year and you have say four to six treatments over the space of a year, well that time and money are now spread out and it becomes more time and cost-effective. 

From a health perspective, preventative treatment is win-win for everybody. The patient benefits from improving mobility and symmetry of movement, and not having to put up with debilitating pain. We are able to keep those danger signals at bay. At least the ones we can control. Good practitioners are able to do this because they have built up a skill set over time in identifying and correcting poor movement patterns. We appreciate doing this because, well for us, it’s easier on our bodies and brains. And like any profession, some are able to do it more effectively than others.

One of the other benefits from a health perspective is it allows you to shift your mindset from just managing and helping yourself with injuries to actually optimizing your health. We can start to help you with your diet, we can start to help you with your training so that you improve your strength and stop these mechanical strains from coming on in the first place.

Treatment, when you’re feeling good, is, in an ideal world, what we would like for all our patients. But that’s just going to happen. In reality, what really teaches a person most effectively to have preventative treatment is – unfortunately – pain and suffering. Most people are stubborn, and won’t buy-into preventative treatment until they’ve been floored by debilitating pain at least a few times. That’s the unfortunate truth.

We encourage you not to let pain smack you around for a few years before you have preventative treatment. We can never guarantee a pain-free life. But one thing we’re sure about is it’ll take a lot more to hurt you. If you understand how treatment can help you when you’re feeling good you can utilize this to your benefit. Stay Strong!

Dr. Sami Karam Osteopath

Author – Dr. Sami Karam

Dr. Sami Karam
Osteopath

A little extra about me. I’ve been a qualified Osteopath since 2004. I’ve been playing football ever since I could remember and I have a passion for it. I’ve played at the highest level in the NSW State League at both Youth and Senior levels, and have also been Head Physician at numerous State League Clubs. I’ve travelled internationally and consulted with Sports academies in Barcelona and Italy. I have a special interest in Strength and Conditioning for footballers, as I believe it gives them an edge in their physical competition. My passion involves bringing all of this knowledge into every single treatment that I provide for all athletes. If you feel that I can help you and want to reach out to me, contact me.

If you feel that any of the information we’ve given you here resonates with you and you feel we are in a position to help, please BOOK ONLINE as we would welcome the opportunity. If you feel that we can help you in any other way, please reach out to us via our CONTACT PAGE.

Can Exercise Cause Injury?

Can Exercise Cause Injury?

Many things affect motivation. Some people seem to have it all the time, for others, there are more ups and downs than a rollercoaster ride. What we dislike is when injury contributes to either the lack of motivation or the deterioration of health even when motivation is there. We want to squash any chance that your exercise can lead to injury.

Two kinds of exercisers 

I’m often discussing exercise and Injury with two types of people. The first kind of person goes up and down with their motivation and is going back to exercise after a lay-off from injury. The second person is the person who’s continuously exercising, is motivated, but can’t overcome nagging injuries. If you’re one of these people and want to find out more about the connection between exercise and injury, read on!

Disclaimer: This is for Educational Purposes Only

Let me take a quick intercession to inform you as to the nature of our advice. We are experienced, healthcare clinicians. We wish to share our experience with you on topics to do with your health. We may be a little colourful in doing so, but at the heart of what we do is in-the-trenches experience. Whilst we have achieved academic success and understand the evidence, we are not solely evidence-based. We are, however, EVIDENCE INFORMED. 

We find that the evidence is usually 10-15years (at minimum) behind what we are seeing in the clinic. We see real people, with real problems, and we’ve made a great living out of offering real solutions. 

If all you’re after is the researched evidence, you can find some on Google Scholar, or you can very easily look for more on Google. We want to give you real-life advice, most of which you may not find in the research.

There is no way that this document can replicate or replace expert assessment and guidance given by a qualified registered healthcare practitioner who has seen you personally. I am sure you’re aware that I have no knowledge of your personal medical history or how you take care of your body. If you require care from a qualified practitioner, you would be best served by seeing someone who can empathise with your situation and treat you accordingly.

I’m sure you understand that I disclaim any and all responsibility for anything you do as a result of reading this document. And by reading this article, you accept 100% responsibility for the actions of you or anyone under your care.

What is exercise?

In past articles, we defined exercise as a workout that’s done specially for the results of that day’s workout. You’re burning some calories, you’re getting your heart rate up, you’re getting your sweat on, but that’s generally where the results end! You’re not moving closer to any pre-defined goal you’ve set for yourself. When we see exercise in this light, we can start to understand a couple of problems that can emerge. The first problem is the problem of randomisation. 

Randomisation is you doing random exercises each and every time you go and do a workout. This means that your body doesn’t get adapted to anything specific and each and every time you perform a workout, you get sore. F45, CrossFit and Bootcamps are prime examples of this type of workout. 

This soreness is from the muscular damage you’ve created during your workout and because your muscles haven’t been adapted to anything specifically, they keep feeling sore! Now, if you accumulate too much muscular damage over time this leads to systemic inflammation and injury. 

Another issue with randomisation is that you don’t get to practice anything specifically. Your technique doesn’t improve and if you’re doing things that are reliant on good technique, under load, and under fatigue that is a precursor for injury.

Can Exercise Cause Injuries

How exercise can hurt you

Another problem that we can see with exercise is the problem of intensity modification or how hard you train. Most people want to train as hard as they can each time to maximise their results. And if you’re participating in a group type session, the trainer will push you as hard as you can, so that they can maximise your results! 

Whilst this might seem like a good idea on the surface it can lead to injury. The reason for this is if you go as hard as you can each time you train, you’re going to accumulate inflammation and that accumulation of inflammation over time will lead to injury! 

The common occurrence in the clinic is that we see many examples of participants in these group type classes performing movements like squats, deadlifts, and Olympic lifts that are technique dependant, under fatigue. These movements aren’t inherently bad, but when you push someone to do them when they’re already fatigued from 100 burpees, you’re pretty much forcing injury upon them. 

A common joke between allied health practitioners is that every time a CrossFit or a Bootcamp opens in your area, you can upgrade your car. Because the business will pick up! Most people can last about four to six weeks exercising in this fashion before they end up here in the clinic!

Exercise with minimised risk

So now we can start to see how these two different types of people emerge. The first person with waving motivation because they’re doing random sets of exercises and the second person who’s motivated but keeps getting nagging injuries due to the increase of inflammation in their body. 

Now, this means you can continue exercising but understand the risks and the benefits, there are benefits to good exercise but there are also risks. You can mitigate those risks! If your exercise is technique dependant, practice that technique so that you become good at it! If you’re going hard each time, understand how to modify your intensity so that you don’t accumulate too much fatigue. Maybe have a week off every seven or eight weeks. 

How to reduce your chance of injury

A great strategy is to spend 12 weeks per year getting yourself strong through good strength training. Some CrossFit boxes will actually support you in this endeavour and this can reduce your chance of injury because you get to practice good movement and you get stronger at the movements that are technique dependant. If you spend some energy on mitigating these risks you can continue exercising and enjoying your exercise, and if you do this, You’ll Stay Strong!

Dr. Sami Karam Osteopath

Author – Dr. Sami Karam

Dr. Sami Karam
Osteopath

A little extra about me. I’ve been a qualified Osteopath since 2004. I’ve been playing football ever since I could remember and I have a passion for it. I’ve played at the highest level in the NSW State League at both Youth and Senior levels, and have also been Head Physician at numerous State League Clubs. I’ve travelled internationally and consulted with Sports academies in Barcelona and Italy. I have a special interest in Strength and Conditioning for footballers, as I believe it gives them an edge in their physical competition. My passion involves bringing all of this knowledge into every single treatment that I provide for all athletes. If you feel that I can help you and want to reach out to me, contact me.

If you feel that any of the information we’ve given you here resonates with you and you feel we are in a position to help, please BOOK ONLINE as we would welcome the opportunity. If you feel that we can help you in any other way, please reach out to us via our CONTACT PAGE.

Physical Activity, Exercise & Training

Physical Activity, Exercise & Training

Physical Activity, Exercise, and Training are three very different things that are often confused as being the same thing. It’s important we understand the differences between those three when it comes to our purposes in the clinic and rehabilitation. Knowing the differences may mean you have a successful experience when dealing with health improvement.

History of physical activity, exercise and training

Our ancestors, even as little as 100 years ago, worked really hard physically. Outside of competitive athletic endeavours and warfare, there was no real need to have to think about adding any more stress to your body than what your daily life already asked of you. Both men and women were on average much more physically resilient, because their lives demanded it.

Today’s physical activity, exercise and training

Your life in 2020 whatever doesn’t physically demand much from you. So now you have to actually think about adding some physical stress to your life, so you don’t deteriorate into uselessness. Out of this necessity, came the need for physical stress that can be categorised into three distinct groups being physical activity, exercise, and training.

Disclaimer: This is for Educational Purposes Only

Let me take a quick intercession to inform you as to the nature of our advice. We are experienced, healthcare clinicians. We wish to share our experience with you on topics to do with your health. We may be a little colourful in doing so, but at the heart of what we do is in-the-trenches experience. Whilst we have achieved academic success and understand the evidence, we are not solely evidence-based. We are, however, EVIDENCE INFORMED. 

We find that the evidence is usually 10-15years (at minimum) behind what we are seeing in the clinic. We see real people, with real problems, and we’ve made a great living out of offering real solutions. 

If all you’re after is the researched evidence, you can find some on Google Scholar, or you can very easily look for more on Google. We want to give you real-life advice, most of which you may not find in the research.

There is no way that this document can replicate or replace expert assessment and guidance given by a qualified registered healthcare practitioner who has seen you personally. I am sure you’re aware that I have no knowledge of your personal medical history or how you take care of your body. If you require care from a qualified practitioner, you would be best served by seeing someone who can empathise with your situation and treat you accordingly.

I’m sure you understand that I disclaim any and all responsibility for anything you do as a result of reading this document. And by reading this article, you accept 100% responsibility for the actions of you or anyone under your care.

What is physical activity?

Physical Activity is the act of you surviving and being alive. When you get up in the morning and you brush your teeth, have a shower, go downstairs, have a cup of coffee, go to work, come home, have some dinner, go to the bathroom. You check your watch and you’ve done twelve thousand, maybe fifteen thousand steps. That’s great! That’s physical activity. That’s just you getting around for survival, we call that physical activity. It’s simple really and it’s the most basic form of movement. It takes very little thought and the minimum amount of effort on your part. But it also offers the minimum amount of return. That is not what we would classify as exercise.

What is exercise?

Exercise on the other hand is when you perform a set of movements or a workout for the sake of that workout on that particular day. The results of that workout lead to no specific place other than the physical stress and its consequences on that day. It’s generally random and is not programmed for any specific purpose other than performing that day’s exercise.

How you can exercise

You’ve burnt a few calories, you’ve jumped on the bike, and thrown the dumbbells around a little bit, but there’s no particular end goal or purpose. You’re just exercising. You’re moving around and you’re getting up a sweat. Now there are harder forms of exercise like maybe boot camp, or pump class, or F45 or CrossFit. These activities can be physically more demanding, but they’re random workouts none-the-less and therefore, EXERCISE! Now I can see all the CrossFitters going crazy,” oh I train bro.” NO! You don’t train, YOU EXERCISE! Your random workouts of the day are exercise. There are competitive cross-fitters who train for CrossFit competition, but they train to compete specifically in CrossFit events. They have specific things that they need to do that get them closer to their end goal for the CrossFit performance. And this brings me to my final point of what training is.

Physical Activity Exercise Training for rehabilitation

What is training?

Training is performing a workout that most efficiently brings you closer to a preconceived target or goal. This goal is usually quite specific and therefore requires specific programming of each workout. For example, if we set the goal of running a marathon, every time you perform a workout, it has to be done in the most efficient way to get you closer to the goal of you running the marathon. If you’re training to compete in a tennis tournament, your training each and every time you do it has to be done in the most efficient way to get you closer to that tennis performance.

If you’re just doing random sets of exercises you’re exercising, you’re not training! Now it’s important we understand the differences in the clinic with regards to injury, because we want you to have a training mindset, we want you to reach a specific goal with your rehabilitation, we program things for you so that every time you workout you get closer to that specific goal.

Rehabilitating your injuries

For our purposes when it comes to rehabilitating your injury in the clinic, physical activity is almost like asking us NOT to help you. You may as well resign yourself to the fact that you’re going to get hurt again because you’re not adapted to any added strain to your daily life.

How exercise can hurt your rehabilitation 

For most people, exercise is where they’re at, and it’s better than sitting on your ass all day. The problem with exercise is the randomness of it. If random exercise is also performed at high intensity, it can lead to injury and inflammation because there is little control over the stress you place on the body. If you think that the workout of the day (WOD) or the F45 class is programmed with you specifically in mind, think again! That’s why most people don’t last more than three months without some form of injury.

How training helps you recover from injury

Training on the other hand is where we see the best results when it comes to rehabilitation. We can control the movement, the load, the frequency, and the intensity so that it is not only suited to you personally, but done the right way, it can not only help you heal, but make you stronger and more useful than your pre-injury self. 

It’s really important you understand the differences between the three and not confuse them. It usually accounts for the difference between successful long-term resolution to injury, or frequent re-injury. Stay Strong!

Dr. Sami Karam Osteopath

Author – Dr. Sami Karam

Dr. Sami Karam
Osteopath

A little extra about me. I’ve been a qualified Osteopath since 2004. I’ve been playing football ever since I could remember and I have a passion for it. I’ve played at the highest level in the NSW State League at both Youth and Senior levels, and have also been Head Physician at numerous State League Clubs. I’ve travelled internationally and consulted with Sports academies in Barcelona and Italy. I have a special interest in Strength and Conditioning for footballers, as I believe it gives them an edge in their physical competition. My passion involves bringing all of this knowledge into every single treatment that I provide for all athletes. If you feel that I can help you and want to reach out to me, contact me.

If you feel that any of the information we’ve given you here resonates with you and you feel we are in a position to help, please BOOK ONLINE as we would welcome the opportunity. If you feel that we can help you in any other way, please reach out to us via our CONTACT PAGE.