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Carl Askling - Lengthening type of exercises are effective
The document presents findings from two clinical trials on rehabilitation protocols for acute hamstring injuries in Swedish elite athletes, comparing the effectiveness of a lengthening protocol (l-protocol) and a control protocol (c-protocol). Results indicate that the l-protocol leads to a shorter average time to return to full participation and fewer re-injuries compared to the c-protocol. Overall, the lengthening exercises are emphasized as beneficial for restoring strength and preventing future injuries.
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Carl Askling - Lengthening type of exercises are effective
- 1. Lengthening type ofexercises is effective? mail:carl.askling@gih.se twitter:@CAskling
- 2. L-PROTOCOL Askling 2014 THE LENGTHENING PROTOCOL
- 3. Acute hamstring injuriesin Swedish elite football: a prospective randomized controlled clinical trial comparing two rehabilitation protocols. Askling C, Tengvar M, Thorstensson A Br J Sports Med, 2013 75 Swedish elite football players included Askling 2014
- 4. STUDY DESIGN •clinical examination - MRI to confirm • stratify - type of injury • randomized – L-protocol or C-protocol • repeated clinical examinations • before return – Askling H-test Askling 2014
- 5. Askling H-test Askling2014 Askling C, Nilsson J, Thorstensson A Knee Surg Sports Traumatol Arthrosc, 2010
- 6. Askling H-test •clinical examination – no signs of remaining injury • knee brace to keep the leg in extension • straps stabilizing the upper body/contralateral leg • perform SLR as fast as possible to the highest point • 3 trials per leg/uninjured leg first/no warm-up • if experienced any insecurety (VAS) – extended rehab. Askling 2014
- 7. OUTCOME • Timeto return: full participation in team training and aviailability for match selektion • Re-injuries: was registered during 12 months after return Askling et al. 2014
- 8. L-PROTOCOL THE LENGTHENINGPROTOCOL 1. THE EXTENDER 2. THE DIVER 3. THE GLIDER twice every day every other day every 3rd day 3 set X 12 reps 3 set x 6 reps 3 set x 4 reps AsklinAgs ektl ianlg. 22001124
- 9. Askling H-test •13 players (35%) in L-protocol - insecurity •27 players (71%) in C-protocol - insecurity •ext. of rehab. – mean 7d (range 3-14d) Askling Aest kalli.n 2g0 2120 14
- 10. 100 80 60 40 20 0 Min Min Max Time to return (days) *** Max L - group C - group Askling et al. 2014
- 11. Max Sprinting-type Stretching-typeSprinting-type Stretching-type 100 80 60 40 20 0 C-group *** *** *** *** Min Min Min Min Max Max Max Time to return (days) L-group Askling et al. 2014
- 12. Max PT notinvolved PT involved PT not involved PT involved 100 80 60 40 20 0 C-group *** ** ** *** Min Min Min Min Max Max Max Time to return (days) L-group Askling et al. 2014
- 13. SPRINTING-TYPE L-PROTOCOL •time to return: mean 23 days • longitudinal length edema: mean 17cm Askling 2014
- 14. RE-INJURIES • 1re-injury – C-protocol • location: BFlh Askling 2014
- 15. Acute hamstring injuriesin Swedish elite sprinters and jumpers: a prospective randomized controlled clinical trial comparing two rehabilitation protocols. Askling C, Tengvar M, Tarassova O, Thorstensson A Br J Sports Med, 2014 56 Swedish elite sprinters & jumpers included Askling 2014
- 16. 160 140 120 100 80 60 40 20 0 Min L-protocol Min Max C-protocol Time to return (days) *** Max Askling et al. BJSM 2014
- 17. Askling H-test •8 athletes (29%) in L-protocol - insecurity •19 players (68%) in C-protocol - insecurity •ext. of rehab. – mean 10d (range 3-20d) AsklingA estk aliln. g2 021021 4
- 18. RE-INJURIES • 2re-injuries – C-protocol • location: BFlh Askling 2014
- 19. LENGTHENING EXERCISES? •mirror injury situation • difficult to restore eccentric strength • increase strength at longer muscle lengths Askling 2014