AFL, Hamstring Strains and Pilates
By Susan Czyzo (Bachelor of Physical Education and Health, Master of Science in Physical Therapy)
Like it or not, winter is officially here (sniff, sniff, cough, cough). Footy is in full swing and doing its part to help soothe our winter blues, perhaps even if our club isn’t performing too well (sorry Essendon friends). At this point of the season, experts weigh in on team and individual performances thus far and make suggestions and predictions for the second half. Interweaved into their analysis of what’s worked and what hasn’t are comments regarding player injuries and how they’re impacting a team’s execution. According to the AFL’s official injury list, Gold Coast and Fremantle are currently (round 12) the most represented with 14 injuries each. Lower extremity injuries dominate both teams’ lists with knee (unspecified) and hamstring injuries plaguing the Suns while the calf seems to be the weakest link for the Dockers club.
The Stats
Historically, hamstring injuries have ranked as the most common injuries amongst AFL players. The stats from 1992 to 2012:- 6 per season per team (second most common – groin strains – 3)
- 26% recurrence rate (groin strains – 24%)
- 21 matches missed per club per season (ACL injuries/groin strains – 12)
Community AFL
At the community level, the most common injury sustained by AFL players is also a hamstring strain, followed by ACL/MCL tears, thigh haematomas and lateral ankle sprains.Risk Factors in Sport in General
The research on risk factors for hamstring injury in sport is inconsistent at best. The risk factors that are backed by the most (and best to date) research include:- older age
- hamstring injury
- quadriceps peak torque
- hamstring flexibility and strength
- quadriceps to hamstring ratio
- hamstring to hamstring ratio
Risk Factors in the AFL
In studies focusing solely on amateur and sub-elite AFL competition, consistent predictors of injury include:- older age (>24)
- previous hamstring injury in last 12 months
- hamstring flexibility
- hip joint ROM
- neural mobility
Interesting addition to the research
Freckleton, Cook and Pizzari (2014) published a study showing a connection between single leg bridge maximum repetitions and hamstring strains in sub-elite and amateur AFL players. Players who sustained a right hamstring strain demonstrated a significantly lower right single leg bridge mean score (20 reps) compared to their uninjured counterparts (26 reps). Take-home messages...so far- You’re at higher risk of sustaining a hamstring injury while playing AFL the older you are and if you’ve previously injured your hamstring.
- Hamstring strength, poor anterior hip/thigh flexibility, previous injuries to your knee and leg and ankle dorsiflexion ROM may increase the likelihood.
- You can decrease your focus on hamstring stretching at this stage as this factor has not shown to impact the risk of a hamstring strain.
- It couldn’t hurt to work on single leg bridge endurance.
How does Pilates fit in?
Most physiotherapists would agree that hamstring injuries often involve not only a lengthy recovery period but also a long phase of increased susceptibility to re-injury. As we wait for further research to clarify injury risk factors and document clearer prevention strategies, we must work with the current level of evidence and our best clinical judgement to both rehabilitate hamstring injuries and to attempt to reduce their occurrence in AFL players. Pilates training is one physiotherapy tool available to accomplish these goals. Pilates provides AFL players unique movement experiences where they can develop and challenge their coordination and body awareness, key to succeeding at a game that requires proficiency in these areas. Even if we just consider mat and reformer exercises, we have a large set of exercises to choose from to also work on:- regaining strength in the lower extremity post injury
- flexibility of the anterior hip/thigh/ankle (see above potential risk factors)
- quadriceps strength
- single leg bridge endurance
- global lumbopelvic control
Try these at home/clinic/studio
Reformer prone + Long Box: hamstring curls- vary spring tension to challenge postural control and eccentric strength
- vary spring tension to increase eccentric demands
- with single leg + curl variation, instruct athlete to perform single leg stretch motion with contralateral leg for coordination challenge
- keep one leg in long strap for duration of the set while the contralateral leg performs same motion (without resistance) in alternating fashion
- maintain well-aligned side-lying position while performing straight leg hip extensions with top leg
- facing footbar, standing leg lunge position while stretching contralateral hip flexors
- facing springs or facing straps, perform a set of lunges while carriage remains out and stationary