This video highlights the hamstring rehab with Carter Henderson. Carter was a standout linebacker at Duquesne University, leading the team in tackles the last two seasons. Now he is in preparation for an NFL Pro Day.
Carter came to GP for rehab of a hamstring pull 12 days out from his Pro Day. His initial 5 days focused on manual therapy, eleetromuscular stimulation (EMS), with a primary emphasis on exercise progressions based on his tolerances and weaknesses. Focus was placed on exercise specificity to the stresses the hamstrings encounter during sprinting. We aimed to match joint angles, mechanics, and dynamics as they relate to his sprint form and lateral movement.
Days 6-8 on his rehab focused on tempo runs and flying 40s, keeping intensity below 75% effort. Gradually worked into higher intensities with specificity to pro day drills. Focus still on manual therapy, joint mobilizations and manipulation when indicated.
Effective treatment for a hamstring strain, and for any injury, must address not only the site of pain but ALL possible predisposing factors. There are essentially three ‘reasons’ as to why hamstring injuries occur. Sprinting is not the problem. Focusing on each predisposing factor through progressive treatment and training will best prepare the athlete for return to sport activities.
The act of ‘pulling’ a hamstring usually occurs at high speed running during the terminal swing phase of the gait cycle. As the hip is decelerating the forceful momentum as the leg swings forward, the hamstrings are loaded and lengthening as you are finishing the swing phase before foot strike. There are predisposing factors that ultimately cause the hamstring to be compromised such as:
- Poor neuromuscular control of the lumbopelvic region,
- Asymmetries in muscle length and/or hip range of motion, and
- Sacroiliac joint dysfunction
All of these factors need to be and should be considered when devising a treatment and rehab protocol to ultimately reduce the risk of re-injury and improve rehabilitation outcomes.
The utilization of manipulation, massage, soft tissue techniques, and nutritional considerations to support tissue healing become the foundation of early care and recovery from hamstring injury. Everything used to facilitate healing is based on examination and identification of the presence of any predisposing factor(s).
The transition from rehabilitation to return to sport then becomes dependent upon a process that addresses proper tissue healing and exercise progressions to improve structural balance, lumbopelvic control, strength, and coordination of movement required by sport specific demands in output and movement patterns.
This essentially sums up the process behind Carter's rehabilitation program.
Carter has turned around nicely and tons of credit to him. He wasn't able to walk without pain when we first started his rehab and was able to run a 4.75 sec 40 yard sprint on his pro day at Duquesne University. He did everything right in his rehab. Carter is extremely coachable and great to work with and we wish him all the best.
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