Dear Patrick,
Well I treated a man who had spent the entire warm season riding his
bike 18 miles each way to work. When he switched to driving to work
& cross-country skiing for exercise he promptly pulled a "hammy''. It
was threatening to turn chronic when I saw him. With straight-knee hip
extension, he had no activation of glutes, despite very good muscle bulk.
For treatment, I taught bent-knee hip extension in prone, for him to do
at home w/ ankle weights. I told him to get the muscle a little sore & then
make sure he always felt it working when he skied.
>From the info in recent posts, I guess I should have been hamstrung
myself for using such an approach. ;o) It worked, he said, the second &
last time I saw him.
I considered it a treat to see someone w/ such a classic, & so easily
treatable muscle imbalance, which I reasoned, was probably due to all
of his biking, during which he only activated hams. True, I never thought
his glutes were weak, yet working on them certainly prevented his
continued overuse of hams while skiing.
Sarah
Patrick Zerr wrote:
> I'm writing regarding the discussion on hamstrings which I highly doubt a
> seasoned athlete will pull a hammy because of spurious activity. If a false
> move could easily injure the athlete it would be so easy to have the athlete
> just avoid that movement, but they can't because these are essential
> movements that leading to the injury which has been waiting to happen.
>
> But, having said this specific diagnosis of the problem must be identified
> rather that pontificating about the role of Tr.Ab which may or may not be
> related.
>
> Knowing the mechanism of injury and correlating it to the following should
> provide the information needed to treat this patient.
>
> 1st, is the Biceps fem., the Semi-memb., or Semi-tend. the injured muscle.
> This can be tested by strength testing which is possible and not to
> difficult to isolate medial from lateral HS's. See Kendall's muscle testing
> book.
>
> 2 is this a distal or proximal HS injury. This can be determined by atleast
> palpation.
>
> If the lateral HS is injured it could also be a sciatic nerve injury or
> better labeled a nueral tension problem. I have rarely seen a medial hs
> injury and it is usually in a young adult where the mechanism of injury
> matches a spotaneous stretch in a way that would injure the medial hs such
> as slipping into a split type position.
>
> Furthermore there could be problems with the lumbar spine causing injury to
> the nerve roots as it exits the foramen. This is when spinal mobility
> testing is important. It is not surprising to find in athletes (or anyone
> else for that matter) hyper and hypomobile segments which contribute to this
> problem.
>
> And to make matters worse there probably are biomechanical imbalances of the
> whole lower chain into the spine which may contribute to this spine
> disorder.
>
> I look forward to further discussion from the list on this matter.
>
> Sincerely,
> Patrick Zerr
> www.apluspt.com
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