Hamstring injuries are common in sports involving sprinting and rapid acceleration. They can range from mild to severe tears of the muscle fibers. Rehabilitation follows phases from acute injury management to return to sport, and involves stretching, strengthening, and sport-specific drills. Prevention strategies aim to address risk factors like poor flexibility, muscle imbalances, and fatigue through proper warm-ups and training.
Bicipital tendonitis is inflammation of long head of the biceps tendon under the bicipital groove.
In early stage, tendon becomes red and swollen, as tendonitis develops the tendon sheath can thicken.
In late stage, often become dark red in color due to inflammation.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Sports injuries and Physiotherapy management.pptxkajal sansoya
Sport injuries refer to kind of injury that occur to a player during sports or exercise.
In other words, the situation which occurs accidently during physical activity or when the player does not remain in the position of participating in the game or his physical ability decreases is also referred to sports injuries.
Direct injury is caused by an external blow or force.
Indirect injury caused by an internal force as over stretching a ligament in sudden change direction.
Overuse injury any repetitive activity can lead to overuse injury, can occur over a period of time, usually due to excessive and repetitive leading of the tissue, with symptoms presenting gradually
Muscle pull
Tennis elbow/ golfer’s elbow
Rotator cuff injury
Frozen shoulder
Tendonitis
Bursitis
Runner’s knee
Achilles tendonitis
Foot arch sprain
Pulled hamstrings
Plantar fascitis
Iliotibial band syndrome
Carpel tunnel syndrome
Lower back pain A contusion is another way to say bruise and is the bleeding in the brain due to localized trauma.
A concussion refers to more widespread brain trauma from a blow to the head or swift shaking
Laceration is the tearing of skin with a sharp object or by impact injury from a blunt object or force that results in an irregular wounds.Warm up and cool down
Stretching before and after activity
Cross –train activity
Dress right
Use proper technique
Improve posture
Avoiding DOMS( delayed onset muscle soreness)
Early-stage rehabilitation is gentle exercise allowing for the damaged tissue to heal. This stage is often rushed and will result in poor quality healing and will be prone to re-injury.
Mid-stage rehabilitation involves progressively loading the muscles/tendons/bones or ligaments to develop tensile strength producing a healed tissue that will be able to withstand the stresses and strains of everyday life and exercise.
Late – the final stage (late) of rehabilitation is where the tissue adapts and is stressed using functional exercises and drills to ensure the body is ready to return to play.
Pilates is a system of repetitive exercises performed on a yoga mat or other equipment to promote strength, stability, and flexibility. Pilates exercises develop the body through muscular effort that stems from the core. The technique cultivates awareness of the body to support everyday movements that are efficient and graceful.Centering
Concentration
Control
Precision
Breath
Flow
Taping is a form of strapping. It is the procedure that uses tape, attached to the skin, to physically keep in place muscle or bone at a certain position to reduce pain and aids recovery.
It is a form of partial immobilization of joint. which allow for a certain level of functional mobility.There are a number of different types of stretching exercises which can be done to improve flexibility. The most appropriate technique will depend on your specific aims and include:
Static stretching
Dynamic stretching
PNF
Ballistic stretching
Neural stretching
Dry needling
Cupping
Gait
The four hamstrings muscles are: the biceps femoris (long head), the biceps
femoris (short head), the semitendinosus, and the semimembranosus. The
two biceps femoris muscles are located on the lateral part of the thigh.
The semitendinosus and the semimembranosus are located on the medial
part of the thigh.
Bicipital tendonitis is inflammation of long head of the biceps tendon under the bicipital groove.
In early stage, tendon becomes red and swollen, as tendonitis develops the tendon sheath can thicken.
In late stage, often become dark red in color due to inflammation.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Sports injuries and Physiotherapy management.pptxkajal sansoya
Sport injuries refer to kind of injury that occur to a player during sports or exercise.
In other words, the situation which occurs accidently during physical activity or when the player does not remain in the position of participating in the game or his physical ability decreases is also referred to sports injuries.
Direct injury is caused by an external blow or force.
Indirect injury caused by an internal force as over stretching a ligament in sudden change direction.
Overuse injury any repetitive activity can lead to overuse injury, can occur over a period of time, usually due to excessive and repetitive leading of the tissue, with symptoms presenting gradually
Muscle pull
Tennis elbow/ golfer’s elbow
Rotator cuff injury
Frozen shoulder
Tendonitis
Bursitis
Runner’s knee
Achilles tendonitis
Foot arch sprain
Pulled hamstrings
Plantar fascitis
Iliotibial band syndrome
Carpel tunnel syndrome
Lower back pain A contusion is another way to say bruise and is the bleeding in the brain due to localized trauma.
A concussion refers to more widespread brain trauma from a blow to the head or swift shaking
Laceration is the tearing of skin with a sharp object or by impact injury from a blunt object or force that results in an irregular wounds.Warm up and cool down
Stretching before and after activity
Cross –train activity
Dress right
Use proper technique
Improve posture
Avoiding DOMS( delayed onset muscle soreness)
Early-stage rehabilitation is gentle exercise allowing for the damaged tissue to heal. This stage is often rushed and will result in poor quality healing and will be prone to re-injury.
Mid-stage rehabilitation involves progressively loading the muscles/tendons/bones or ligaments to develop tensile strength producing a healed tissue that will be able to withstand the stresses and strains of everyday life and exercise.
Late – the final stage (late) of rehabilitation is where the tissue adapts and is stressed using functional exercises and drills to ensure the body is ready to return to play.
Pilates is a system of repetitive exercises performed on a yoga mat or other equipment to promote strength, stability, and flexibility. Pilates exercises develop the body through muscular effort that stems from the core. The technique cultivates awareness of the body to support everyday movements that are efficient and graceful.Centering
Concentration
Control
Precision
Breath
Flow
Taping is a form of strapping. It is the procedure that uses tape, attached to the skin, to physically keep in place muscle or bone at a certain position to reduce pain and aids recovery.
It is a form of partial immobilization of joint. which allow for a certain level of functional mobility.There are a number of different types of stretching exercises which can be done to improve flexibility. The most appropriate technique will depend on your specific aims and include:
Static stretching
Dynamic stretching
PNF
Ballistic stretching
Neural stretching
Dry needling
Cupping
Gait
The four hamstrings muscles are: the biceps femoris (long head), the biceps
femoris (short head), the semitendinosus, and the semimembranosus. The
two biceps femoris muscles are located on the lateral part of the thigh.
The semitendinosus and the semimembranosus are located on the medial
part of the thigh.
Whiplash describes a range of injuries to the neck caused by or related to a sudden distortion of the neck. The typical clinical picture in whiplash injury is that following the injury there is no obvious immediate pain.
Also visit: http://www.ineuro.be/Welcome.html - A must have for every osteopath and health care provider. Simple to use and no unnecessary information. It keeps your knowledge sharp for daily patient care!
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the PPT Describes about various types of dysfunction in mechanical pattern as described by Janda's. it also describes about normal muscle slings prresent within the body and its compensation and decompensation patterns towards the adaptations of the body
In this presentation I’m going to inform you briefly about a novel arthroscopic technique for athletic pubalgia. You may have heard it as “sports hernia or groin injury………” but in fact is a groin pain syndrome, particularly common in sports that require athletes to perform repetitive kicking..
Muscles,
Faculty of Medicine,
Alexandria University,
Medical Student: Mohammed Yasir Taha Alkhammas,
Under Supervision: Professor Dr. Nancy Mohamed El Sekily
Acromioclavicular (AC) joint injury is a term used to describe an injury to the top of the shoulder, where the front of the shoulder blade (acromion) attaches to the collarbone (clavicle).
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
1. Hamstring
Strain Injuries
3003PES – Injury Prevention and Management
By DION OBST
2. Table of Contents
• Introduction • Mechanism of Injury
• Definitions • Clinical Diagnosis
• Aetiology • Differential Diagnosis
• Anatomy of the Hamstring • Phases of Injury and Treatment
• Physiology of the Hamstring • Rehabilitation
• Muscle Physiology • Rehabilitation and Injury Prevention
•Young athletes and Hamstring Strains • Literature Review
• Biomechanics of the Hamstring • References
3. Introduction
• A variety of studies have found that hamstring injuries are the
most common injury in AFL, athletics (sprinting), soccer, cricket and
touch football (Hoskins, 2005).
•Hamstring strain injuries typically occur in sports that involve rapid
high speed activity, rapid acceleration and/or strenuous stretching
manoeuvres.
• Brockett et.al (2004) investigated AFL injuries and estimated
approximately 16% of all injuries cases are hamstring strains.
• The evidence suggests that the chance of re-injury to the
hamstring occurs in 34% of cases (Brockett, 2004).
Source: http://www.fotosearch.com/ Source: http://mm.afl.com.au/
4. Definitions
A muscle strain can be defined as excessive stretching or
tearing (complete or partial) of the muscle fibres and is
graded according to the severity.
Common names for a hamstring strain injury include:
• Biceps Femoris strain
• Torn ‘Hammy’
• Pulled hamstring
A hamstring strain involves stretching and/or partial tearing
of one or more of the 4 hamstring muscle groups
Source: http://www.return2fitness.co.uk
5. Aetiology
Hamstring strain injuries are graded according to their severity:
Grading Severity
Grade 1 (Mild) Small % of fibres are stretched or torn, mild pain,
minimal to no loss of strength.
Grade 2 (Mod) Significant % of torn fibres, swelling, pain with
active ROM, loss of strength, palpable deformity.
Grade 3 (Severe) Complete tearing of fibres and/or MT junction,
gross impairment, severe initial pain.
Source: http://www.sportsinjuryclinic.net
Muscles that are most susceptible to strains are those in which their
origin and insertion points span over two joints (Noonan,1999).
Untrained athletes are more prone to hamstring-related injuries
during exercise that involves eccentric muscle contraction.
6. Aetiology
The most common causal factors of Normal
hamstring strain injuries are:
• Poor flexibility and strength
• Strength imbalance between
quadriceps and hamstring muscle
groups
• Strength imbalance between gluteals
and abdominal muscle groups
• Inadequate warm-up techniques
• Previous hamstring injuries
• Over exertion or excessive stretching
• Muscle fatigue
• Differences in leg length (Increased
tension on shorter leg)
Poor flexibility Great flexibility
7. Anatomy of the
Hamstring
The hamstring comprises of 3 major muscles:
1) Biceps Femoris (long and short head)
2) Semitendinosis
3) Semimembranosis
The hamstrings span over two joints - the hip and
the knee joint
Muscle Origin Insertion
1. Ischial Tuberosity Head of Fibula (lateral side)
(long)
(short) Linea Aspera Head of Fibula (lateral side)
2. Ischial Tuberosity Tibia (medial surface)
3. Ischial Tuberosity Tibial Condyle (medial)
(Hoskins & Pollard, 2005)
Source: http://www.fotosearch.com/
8. Physiology of the
Hamstring
• Eccentric contractions of the hamstring are believed to result
in microscopic muscle damage to the muscle fibres (Brockett,
2004).
• A local inflammatory response is initiated following injury.
• This mechanism is believed to have a role in sensitizing muscle
nocioreceptors and mechanoreceptors (Morgan, 1999).
• Untrained individuals are more prone to muscle strain injuries
which may result in reductions in muscle tension and the
optimal length to generate tension is increased (Morgan, 1999).
9. Muscle Physiology
• Muscle fatigue is thought to play a major role in contributing to
muscle damage.
• Muscles that commonly experience strain type injuries are composed
of Type II (Fast-twitch) fibres (i.e. Hamstring).
• An strength imbalance may also exist between the quadriceps and the
hamstring. The quadriceps are typically stronger and therefore the
hamstrings often fatigue much faster (Petersen & Holmich, 2005).
•This results in the inability of the hamstring muscles to adequately
relax during contraction of the quadriceps, therefore strains occur
(Petersen & Holmich, 2005).
• Other causal mechanisms include changes in excitation-contraction
coupling, Ca2+ sensitivity and sarcomere recruitment (Morgan, 1999).
10. Young Athletes and
Hamstring Strains
• During growing periods, muscles and
bones have the tendency to grow at
different rates.
•Young athletes may be subjective to
hamstring strain injuries if their bones Source: https://console.clubsonline.com.au/
grow at a faster rate than their muscles.
• This causes greater stretch on the
muscle fibres and therefore a sudden
motion such as jumping may lead to
exaggerated stretch or muscle tearing
from the bone (Brockett, 2004).
Source: http://images.conquestchronicles.com/
11. Biomechanics of
the Hamstring
The biomechanical role of the hamstrings include:
• Knee Flexion (heel towards gluts)
• Hip Extension (backwards movement of leg)
• Deceleration of the knee ( quadriceps antagonist)
Source: http://www.albionrundoctor.com/
12. Biomechanics of
the Hamstring
During gait, injuries most commonly occur at the end stage of
the swing phase (Hoskins & Pollard, 2005).
MUSCLE ACTION
Semitendinosis/ Predominantly involved in hip extension. Also knee flexion
Semitendinosis and internal rotation of lower leg.
Biceps Femoris (long) Hip extension at beginning of gait cycle
Biceps Femoris Knee flexion and external rotation of the lower leg.
(Long & Short Head)
Mechanoreceptors in the ACL provide proprioceptive information
to the hamstring muscles, causing them to activate at the end of
the swing phase of gait (Hoskins & Pollard, 2005).
This may explain the reason why those who previous experienced
knee injuries are prone to hamstring strain injuries.
13. Biomechanics of
the Hamstring
A study by Askling et.al (2006), examined the differences in
the recovery period of two types of acute hamstring strains.
• A group of 18 elite sprinters an 15 dancers diagnosed with
hamstring strains were examined
• The sprinters experienced the injury during high speed
running, whereas the dancers developed the strain via slow
stretching exercises
RESULTS: Initially, the sprinters experienced the greatest loss
of function, however the dancers required significantly
greater time to return to pre-injury level:-
Median (Sprinters) – 16 weeks (range 6-50)
Median (Dancers) – 50 weeks (range 30-76)
14. Mechanisms of Injury
The evidence strongly suggests that athletes who have experienced
hamstring injuries previously, are most susceptible to recurring
hamstring strains (Orchard, 1997).
Eccentric contraction of the hamstrings is known to cause microscopic
damage to the muscle fibres. Tearing of fibres begins when the force
applied exceed 80% of the force required to agitate the muscle
(Malliaropoulos et.al,2004).
Poor technique or muscle weakness may result in a hamstring strain
during the initial stance phase of gait (Hoskins & Pollard, 2005)
It is proposed that microscopic damage is caused by the lengthening
of sarcomeres in a non-uniform manner (Brockett, 2004).
• Muscle fibres that exhibit short optimal
length capabilities are more at risk of
microscopic damage (Brockett, 2004).
15. Clinical Diagnosis
Referral of any hamstring distress is vital for
establishing correct treatment options and
preventing further injury.
Diagnosis involves an evaluation of past
history, type of action/activity performed and
physical examination.
MRI scans may be conducted to establish deep-
intramuscular strains or tearing of the
hamstring .
These scans are only performed if a negative
response to treatment occurs or the
mechanisms of injury are unknown (Hoskins &
Pollard, 2005).
*Partial tear of right hamstring tendon (red arrows)
Source: http://3.bp.blogspot.com/
16. Clinical Diagnosis
The following physical examination techniques are
commonly performed when diagnosing hamstring injuries
Straight Leg Raise – Passive leg raise with straight
knee.
Normal ROM is 80 – 90 .
Pain may be reproduced.
Comparisons are made between opposite limbs.
Source: http://bjsm.bmj.com/
Resisted Knee Flexion – Passive resistance as
patient bends knee.
Causes hamstring contraction and pain
Strength of movement is compared to opposite limb
(http://www.sportsinjuryclinic.net/)
Source: http:// http://www.chiroandosteo.com/
17. Clinical Diagnosis
Slump Test – Determines if any neural
involvement is present.
Patient straightens out one leg, bends head
downwards and points toes upwards.
Stretch is enhanced by pushing patient forward.
Symptoms such as pain shooting down the leg is a
positive indication of neural involvement.
Source: http://www.ihcatl.com/
Palpitation – Physician will touch or palpitate the
muscle to detect any deformity, pain, tension or
hole within the muscle belly and associated
structures.
(http://www.sportsinjuryclinic.net/)
Source: http://thump01.pbase.com/
18. Differential
Source: http://www.fotosearch.com/ Diagnosis
• Misdiagnosis of hamstring strain injuries is common, leading to
incorrect management techniques that can exacerbate the injury or
prolong the recovery period (Hoskins, 2005).
• Preventative techniques to decrease the chance of a hamstring
strain are imperative in professional sport.
• The sciatic nerve passes through the hamstring muscle group and
therefore an injury to the lower back may refer pain to the hamstring
region (Noonan, 1999).
• Delayed-onset muscle soreness is commonly mistaken as a strain
however the symptoms develop 24-72 hours post-exercise then
disappear. A strain results in immediate pain and functional
deterioration (Noonan, 1999).
• Hamstring pain may also be a symptom of other injuries such as
adductor strains, sacroiliac joint, gluteal trigger points and bursitis. Source: http://sussexphysio.co.uk/
19. Phases of Injury and Treatment
The following table summarises the 5 phases of injury proposed by
Petersen & Holmich (2005) and the appropriate actions to aid recovery
Phases of Injury Signs/treatment
Phase 1 (acute): • RICER treatment is important
1 - 7days Goal: Minimise swelling, pain and control haemorrhaging.
• Use of NSAIDs for short period after injury.
• Light movement techniques prevent adhesions.
Phase 2 (subacute): • Inflammatory symptoms begin to resolve.
3days – 3weeks • Basic exercise techniques promote healing and prevent
muscle atrophy. Concentric exercises introduced.
• Cardiovascular fitness should be maintained.
Phase 3 (remodelling): • Loss of flexibility due to scar tissue formation and pain.
1 – 6 weeks • Stretching performed to maintain flexibility.
• Eccentric exercise introduced (light to avoid re-injury)
Phase 4 (functional): Goal: Decrease the risk of re-injury during sport.
2wks – 6months • Sport specific strength and flexibility protocols initiated.
Phase 5 (return to comp): Goal: Maintain strength and flexibility of muscle to avoid
3wks – 6mths recurring injury.
20. Rehabilitation
Once a qualified physician has established a correct diagnosis,
there are a variety of techniques used to enhance recovery and
prevent further injury. Stretching techniques are outlined below:
STATIC STRETCHING CONTRACT – RELAX
Internal rotation External rotation STRETCHING
DYNAMIC STRETCHING
Source: Swinging of leg forward and backwards with gradual
(http://www.sportsinjuryclinic.net/) increases in height
21. Rehabilitation
A study by Malliaropoulos et.al (2004), examined two different
rehabilitation protocols to determine effectiveness of each.
80 athletes with acute hamstring strain injuries were assessed, with
rehabilitation occurring 48hrs post-injury.
One group performed one session daily and the other participated in four
per day.
Each session involved a static hamstring muscle stretch that was
sustained for 30 seconds. This was performed 4 times per session.
The results indicated that the group which participated in the greater
number of sessions (4 per day) were able to regain ROM in a shorter
period of time and therefore spend less time away from competition.
22. Rehabilitation and
Injury Prevention
Other forms of rehabilitation and injury prevention for
hamstring injuries include:
• Sports Massage
• Acupuncture
• Taping techniques
• Compression Shorts
• Bracing
•Yoga and Pilates
23. Literature Review
(Evidence based prevention of hamstring injuries in sport.
Petersen & Holmich, 2005)
• Age, physical status, type of sport, exercise techniques and warm-
up strategies are important elements used to predict the likelihood
of a hamstring injury.
• A lack of clinical evidence exists regarding the effectiveness of
hamstring rehabilitation methods. However immobilization
throughout the recovery phase of injury is known to have a negative
impact on healing (Morgan & Allen, 1999).
• There is a high incidence of recurring hamstring injuries especially
if inadequate rehabilitation and/or an appropriate warm-up is not
performed before physical activity.
• In the AFL, research suggests that each club experiences 5-6
hamstring related injuries per year. This amounts to 15-21 games
missed per season (Brockett, 2004).
24. Literature Review
• The biarticular arrangement of the hamstring muscle group
provides a substantial risk of injury especially due to poor
biomechanical techniques and/or muscle weakness.
• Studies suggest that the period of change from an eccentric to a
concentric contraction is most susceptible to strain injuries.
• Studies have shown that fatigue has a major influence regarding
injury risk. An investigation into English professional football
showed that a significant number of hamstring injuries occurred in
the latter stages of each half (Askling et.al, 2006).
• Hamstring strength , flexibility exercises and the presence of pain
should be used to determine when an athlete can return to
competition.
25. References
Askling, C., Saartok, T., & Thorstensson, A. (2006). Type of acute
hamstring strain affects flexibility, strength, and time to
return to pre-injury level. British Journal of Sports Medicine,
40(1):40-44.
Brockett, C., Morgan, D., & Proske, U. (2004). Predicting hamstring
strain injury in elite athletes. Medicine and Science in Sports
and Exercise, 36(3): 379-387.
Hoskins, W., & Pollard, H. (2005). The management of hamstring
injuries – part 1: Issues in diagnosis. Manual Therapy, 10(1):
96-107.
Malliaropoulos, N., Papalexandris, S., Papalada, A., & Papacostas, E.
(2004). The role of stretching in rehabilitation of hamstring
injuries: 80 athletes follow-up. Medicine and Science in Sports
and Exercise, 37(1): 756-759.
26. References
Morgan, D., & Allen, G. (1999). Early events in stretched-induced
muscle damage. Journal of Applied Physiology, 87(1): 2007-
2015.
Noonan, T., & Garrett, W. (1999). Muscle strain injury: Diagnosis and
treatment. Journal of American Academy of Orthopaedic
Surgery, 7(1): 262-269.
Orchard, J., Marsden, S., & Garlick, D. (1997). Preseason hamstring
muscle weakness associated with hamstring muscle injury in
Australian footballers. American Journal of Sport Medicine,
25(1):81-85.
Petersen, J., & Holmich, P. (2005). Evidence based prevention of
hamstring injuries in sport. British Journal of Sports Medicine,
39(1): 319-323.
Sports Injury Clinic. (2009). Hamstring Strain Rehabilitation. Retrieved
April 29, 2009, from
http://www.sportsinjuryclinic.net/cybertherapist/back/hams
trings/hamstringstrain.htm