Rehab Exercises (Charlie and others, please help!)

I’ve just been to a physiotherapist about my hamstring strain which I aggravated last Saturday. It has been 3 days, still no good.

My physio and my coach both said that I will not be playing for the next 2 weeks. The coach was pissed off!

I’m going to the physio every 2 - 5 days and stretching the hamstrings every day. Going to start heat treatment in a couple of days time.

What I really am clueless about now is how I would ease myself back into training.

The strain is not too bad, I was able to go for a very slow jog on Sunday (1 day after it happened) although that was probably the wrong thing to do. Although sprinting at this stage is impossible and I can’t see myself being able to do 10m accels in two days time as suggested in another thread.

At what stage can I begin doing weight training for legs again? What exercises can I use which will not involve too much hip extension (will not do further damage to the hamstring?)

Can I start doing vertical plyos soon? (depth jumps) to maintain speed and strength? Should I up the volume to compensate for the fact that there is no speed being done? (normal volume is around 30 foot contacts per session)

I’m currently just doing a large volume of upper body lifting plus aerobic work in the form of stationary cycle, hand crank and rower.

Please help me form a plan for the next 2 weeks while I try to get my season back on track. Thanks.

Thanks for the advice.

By the way, this is the 5th day now and it doesn’t bother me to run at about tempo speed (although I haven’t tried doing a full tempo session yet, just went for a few quick strides when I was watching the team train). However, despite this level of recovery, the affected area still feels painful if I press down on it. Is this normal or is this a sign of bruising?

David can you tell us how exactly you damaged it? Eccentric phase? Location of site? Middle/top etc.?
What running phase, How is flex?
How is strength? Brusing? Swelling?
Is the spot warm? History of injuries?

It’s almost always best to stay off for the first 3 days and stretching should be monitored extremely carefully after a full evaluation. Provide the details requested including if any bruising appeared so far and perhaps we can make some suggestions.

There is no question that you should be totally of ot for next couple days, but the best for of therapy to maintain aerobic fitness and meet risistance training is hydrotherapy. First few days just go in and swin normally to see how it feels and when things are better you can move to the next phase which will be doing exercises that mimic your sport. Hopes this helps.

Originally posted by no23
David can you tell us how exactly you damaged it? Eccentric phase? Location of site? Middle/top etc.?
What running phase, How is flex?
How is strength? Brusing? Swelling?
Is the spot warm? History of injuries?

I first injured it while kicking a rugby ball, and reinjured it a week later doing the same thing. The location is the middle of the hamstring.

There is no real bruising or swelling (I can flex my knee joint with no problems, only feel pain when the hamstring is put under a stretch (eg. kicking or running). If I try to run quickly, I feel pain as soon as the foot strikes the ground.

If I press down on the affected area with my fingers, the muscle definately feels a little painful (I’m not sure if that is a sign of bruising).

The spot is not warm. I do not have a history of hamstring injuries, in fact this is the first time I have ever had an injury to this area.

I’ll give my advice first some of it I got from other posts most is sadly from experience …

Charlie Gives a good example of the recovery for Ben in both Speed Trap and in CFTS, but as there are few people with such options open to them you’ll have to use the same principles in a slightly different approach.

The fact the site seems to be in the belly of the muscle is a good thing (in a funny way).
These are only guidelines - see a qualififed Therapist and use their advice.

First 3-4 Days-
Rest, as little movement or stress to muscle as possible.
Can use Ice to keep inflamation down following any movement.
No heat for first 3 days
Pulsed EMS can be applied now ABOVE the injury site to promote blood flow/drainage.

After first 3-5 Days
Professional Treatment: Therapy to Loosen hip flexor and groin muslces to reduce tension on hammer.
Stretching, Release of Muscular tension at insertions and other muscles e.g. Hip flexors etc.
Self Treatment: Light Self Massage after 3 days in direction of heart to encourage blood flow to remove waste from site etc. - follow all treatment with ice.
All Icing for max 20 mins
Anti-inflams may be reccomended by some people - personally I find them of little use and can be hard on the stomach.

After first 5 Days:
More a agressive therapy from a skilled therapist to treat the injured site and prevent accumulation of tissue at site.
Two key areas of rehab: Strengthening and Flexibility.
Strengthing :
Using a light Theraband begin with 3 sets reps of 10 progressing to 15 reps ham curls
Progress to heavier bands and lower reps - 5 sets - 6-8 reps
In your case concetrate on the eccentric phase where the injury seems to have been caused
Flexibility :
Starting with light stretching to stretch muscle gently - microstretching to start.

After first 5-7 Days:
Begin back with 15 mins jog.
Start with weights, again concentrate on RDLs, Lunges.
The jury is out on Hamstring curl machines - My opinion - Good for 1-3 sessions at start but once you don’t go banannas with machines you’ll be ok.
As though I need say it - Free Weights are best

Charlie has also reccomended the following in other posts
Recovery begins with on fourth day (with the affected leg in a tensor), start one leg drills raising the healthy leg only.
Depending on the level of recovery by day 5, you might be able to start with some easy 10 m accels.
For these drills, always stand on the mark and accel only to the designated mark,
to ensure that you don’t over-extend the affected muscle, with a walk back recovery.
Start with 2 to 3 sets of 10 x 10 m accels, and advance the distance by 2m increments, as able.

Use ice for 15-20 mins post ALL exercise.

You should avoid creatine which encourages water retention and reducing carbs also (which I only learned recently)
Charlie has reccomended taking ZMA to help reduce muscle tonus and maybe B vits also.
Glucosamine or a Glucosamine-Chondroitin combination supplement might help - personally I have no experience of any improvement and am not convinced
There should be no need to increase your protein intake - but don’t let it slip either.

The days are just rough guidelines.

I’ve just jotted down a few things here - and I’m sure I’ve left a few bits out - but someone else will be able to fill in the blanks …
Hope this is a help.


[Charlie - you’ll probably have some corrections to make to this …]

I would be guessing this is a grade 2 strain - if you can still feel pain on touch.
Someone else will be able to tell you if there is brusing or discolouration on the site/area or discoloration gathering below the site maybe around the back of the knee joint.
At this stage only a properly qualified therapist will be able to diagnose the injury correctly - I’m only giving pointers (i.e. guessing!).
The ability to running or stride such as maybe tempo is very misleading for team sports - be careful.
Turning, sprinting and jumping (especiailly landing in your case - I would imagine) is where the hammer will be tested the most.

How you doing now David?

I feel able to sprint today, although I will not be risking it unneccessarily. I will see the physiotherapist again on Monday morning.

I feel no real problems when I had a few quick strides after my gym session, still a little bit of tightness and still feel a little discomfort when I press hard on the affected area with my hand.

I will do a light tempo session tomorrow (Sunday) and train with the team on Tuesday.

I expect to have full recovery (in terms of sprinting and mobility) by the middle of next week (although I do not expect to be able to exert sharp eccentric force such as kicking the ball). The coach wants me to sit out one more week but due to a seriously depleted backline with many injuries, I may get my lucky break and make it back on the field by next Saturday.

Thanks for your help, cheers.

Take it easy man - and take no chances.
Glad to hear it’s coming on good.

AHHH NO!!! #$&@^#@!!!