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I think you must of mis understood my reply Chris. I would agree with you re.rehab hamstrings and the time element, usually their back playing 6-8 weeks, if not sooner. What i wished to put forward was that if the player was experiencing symptoms whilst carrying out fast paced running at 5 weeks i would be confident in labelling it adaptive "useful" pain (pain i would say is strill protective in nature). Secondary hyperalgesia could well be a possible cause of this footballers pain. Acknowledging this could well diffuse what could be a frustrating time. >>> "Barrett, Chris" <[log in to unmask]> 03/16/00 11:48PM >>> Paul I have to disagree with you regarding your comments about how long a hamstring should take to be rehabilitated. I too work for a professional sporting club and I don't think our coach would be happy to hear that a hamstring injury can take 12 weeks to get back to playing! Seriously I think that as long as the physical tests are satisfactory and the player has got through full training on at least one occasion then they can play. I guess if in doubt, then the old "give it one more week" may be applicable. Occasionally we get caught out a player has retear but not often compared to those we get back as quickly as possible. In this case it all comes down to the diagnosis of the proximal stiffness, if it is not relevant or likely to cause problems then I think he should play. I thought he may have proximal hamstring tendonitis, and if that is the problem, because it is minor I would probably encourage them to play as soon as possible. Regards Chris Barrett Perth, WA -----Original Message----- From: Paul Sumner [mailto:[log in to unmask]] Sent: Thursday, 16 March 2000 5:05 PM To: Paul Sumner; [log in to unmask] Subject: Re: Hamstring Rehab. >>> Paul Sumner 03/15/00 10:51AM >>> Having worked in a pro-soccer club for 4 seasons I appreciate the pressure you may have in returning this player. Have you thought that 5 weeks is still early days in the rehab of a 2 joint musle. Think of Stan Collymore at Nottm Forest and Michael Owen's recent on - off return and re-injury. I believe you would be better reassuring the player that healing can take up to 12 weeks? and that this secondary pain could well be a secondary hyperalgesia, warning that things are going too fast. With the recent debate on spinal pschology in mind it is important to reassure the player that he will get better but to "push the rehab" too soon may well be detrimental, increase the risk of secondary problems and further frustration and most of all blaming of the physio!! PAUL SUMNER Cornwall uk >>> <[log in to unmask]> 03/13/00 08:39PM >>> I have a semi-pro footballer who is returning to full training after approximately 5 weeks out with a strain to the Biceps Femoris. We have gone through all the necessary extensibility and strength exercises, together with an amount of functional work. When we have asked the player to step his training up to include three-quarter and full pace running, he feels a tightness close to the origin of his hamstring. The original injury was mid-belly. All the signs of extensibility and strength are good. Could anybody suggest what the problem may be and how it can best be addressed? ********************************************************************** This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the system manager. This footnote also confirms that this email message has been swept by MIMEsweeper for the presence of computer viruses. ********************************************************************** %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%