Hamstring Injury

You are probably watching the World Cup 2014. Did you notice that there are several elite players injuring their hamstring muscle in a seemingly innocuous situation? In fact, hamstring injuries are very common. It is a tear in a fleshy muscle behind the thigh. Depending on severity of a tear, the injury classified from mild to severe using a grading system. The tear is caused by sudden acceleration in sports like running, soccer, tennis. It can also happen in a routine situation as in trying to catch your toddler, or running after a bus. There is a sudden, sharp pain behind your leg and the person cannot straighten his knee without pain.

I noticed in the early morning on my way to my office in Clinton Hill, groups and individual runners from Fort Greene and Prospect Heights are dashing toward Prospect Park dodging traffic on Atlantic Avenue and Grand Army Plaza. Sudden accelerations and stopping probably is not the most ideal way to start your work out.

There is no foolproof way to completely avoid hamstring injuries. However, the risks can be minimized by paying attention to the principles of muscle strength and flexibility. Individual flexibility should be maximized by a regular stretching program as well as a period of warm-up and stretching before the intended athletic activity. Park Sports Physical Therapists are experts in designing such a program. Our Clinton Hill location has space and equipment for assessment and rehabilitation of sports related injuries like a hamstring pull. Carefully designed individualized stretching routine will address imbalances that may lead to a hamstring pull. Optimal individual hamstring strength is at least half of the strength of the quadriceps muscle (muscle of the front of the thigh). Also, there should be minimal imbalance in strength between the right and left legs (the injured hamstrings should be about 90% as strong as the uninjured hamstrings). If necessary, a weight-training program should be instituted to optimally achieve these goals. In an evaluation of an injured athlete, particular attention is paid to the relative flexibility of opposing muscle groups, not just the hamstrings and quadriceps pair.

An additional aspect of recovery is proper nutrition. A well-balanced diet and appropriate fluid intake are essential to avoid electrolyte imbalance. It is even more important when exercising in a hot weather. Dehydration can lead to muscle cramping, thereby increasing the chance of muscle injury. Overweight people have a higher risk of muscle injuries in the lower extremities. Some experts have also advocated the use of nutritional supplements, such as antioxidants. Unfortunately, despite the best efforts at prevention and treatment, hamstring injuries will continue to be a common bane of the high-performance athlete as well as the “weekend warrior.”

Ankle Sprains

As a former competitive athlete, I sustained multiple ankle sprains. My personal experience and my knowledge acquired through my profession puts me in a good position to give an expert advice on ankle sprain. Ankle injuries has become one of the most common conditions we treat in our clinic.

Several factors contributed to such an occurrence. One of them is an increase in sports activities and sports participation. Ankle sprains in general by far the most common sports related injury.

In fact there are more than 30,000 ankle sprains in the US per day. Most of those sprains are mild GradeI type that will go away in 2-4 weeks. I am concerned about more severe sprains, approximately 25% of injured persons will go on to develop chronic ankle instability. Surgery may be appropriate in those cases.

There are several risk factors for developing ankle sprains. Probably the biggest factor is a history of a previous sprain. In an ankle that has been already sprained the ligaments are less taut, resulting in the ankle feeling less stable. A typical mechanism of an injury is "rolling" on the outer surface of the foot and causing quick and sudden stretch to the lateral ligaments. Other risk groups are people with stiff ankles, athletes in contact sports. Women are 25% more likely to sprain their ankle than man.

In more severe cases, Grade III sprains, the ligaments are completely torn. In some cases surgery is required. The person may have difficulties putting weight through their ankle, and in many instances this condition makes performing recreational activities impossible. It may lead to a development of premature arthritis, since the normal distribution of forces acting on the joint are disrupted, the articular cartilage wears out much faster.

MRI examination is the most useful tool in determining the degree of ligament injury.

For GradeI and GradeII sprains Physical Therapy is most helpful. The therapist cannot make your ligaments tighter, but he can teach you specific exercises to improve muscular support around the ankle joint, thus providing dynamic stability.

Physical Therapy for all ankle sprains will focus on balance training and proprioceptive control, that is an awareness of your ankle joint position in space.

Our goal is to decrease your chances of re-injury and return to your fun activities.