The buttock or gluteal muscles are extremely important in providing pelvic stability when walking. Every time you step on your right foot, your right gluteal muscles are vital in keeping your pelvis stable and preventing your left hip from dropping. The gluteal muscles insert into the outside of the hip via their tendons and these tendons can break down, particularly in middle aged athletes after twisting injuries, or in endurance athletes as a result of training load. Given the frequency with which they must act (every second stride), it is easy to understand how they can become overloaded. In order to load and strengthen the tendons:
The key exercise for treating proximal hamstring tendinopathy is an eccentric bridge. As you start this type of exercise you should have your feet on the ground with your knees flexed to about ninety degrees. As you get more confident extend you knees so your leg forms a longer lever. As you make more progress you may place your feet on a chair or a swiss ball. It is important to remember that the key component is the lowering phase of the exercise.
Remember these exercises are supposed to be uncomfortable. You should ideally aim for more than 90 repetitions a day. Start slowly and build up to this number. You do not have to do all of the exercises in one sitting. It is more manageable to do a number of smaller sets over the course of a day.
Hamstring injuries are one of the most common injuries seen in recreational and professional sport. They can significantly affect an athletes season partly because they take a long time time to recover and also because they have a very high rate of recurrence. Approximately one third of all athletes who sustain a hamstring injury will go on to have a second injury - many of these happen in the first week back. Very frustrating!
A recent study in the American Journal of Sports Medicine has shown that the incidence of hamstring injuries in football (soccer) players can be reduced by about 60% by adopting a simple strengthening program. The study involved more than 900 professional and semi-professional football players based in Denmark. Players were either asked to complete a hamstring strengthening program or to continue with their normal training and warm-up routine. The strengthening regime involved a single exercise a 'nordic drop' - and was completed during a normal training session. Those who completed the strengthening program had a marked reduction in the incidence of hamstring injuries. The reduction was greatest for those who had previously injured their hamstring. There was an 85% reduction in the risk of injury in this group.
The nordic drop does not require any equipment and can be quickly and easily done on the training field. The exercise generally requires a partner. To do a nordic drop:
|Week||Sessions/week||Sets and Repetitions|
|1||1||2 x 5 reps|
|2||2||2 x 6 reps|
|3||3||3 x 6-8 reps|
|4||3||3 x 8-10 reps|
|5-10||3||3 sets of 12-10-8 reps|
|10+||1||3 sets of 12-10-8 reps|
If you have any other questions about hamstring injury prevention - or the management of an acute or chronic hamstring injury - please book in to see one of our expert clinicians.