Jan 29, 2015Sizing Up Hamstring Injuries
By Vern Gambetta
Vern Gambetta, MA, is President of Gambetta Sports Training Systems in Sarasota, Fla. The former Director of Conditioning for the Chicago White Sox, he has also worked extensively with basketball, soccer, and track and field athletes. He is a frequent contributor to Training & Conditioning. Vern also maintains his own blog at www.functionalpathtraining.blogspot.com
I am amazed and astounded at the number of hamstring pulls and oblique pulls in Major League Baseball. I also find it appalling and alarming that players miss months with a hamstring pull. I do not have any first hand knowledge of specific injury situations, but I base my opinions on the many years I spent immersed in the training culture of the sport.
To me, the increase in hamstring pulls and the exaggerated return-to-play times is the result of either negligence, incompetence, or flawed rehab and training methodologies. In many cases, I suspect it is a combination of the three. Based on my experiences in track and field, I expect an athlete with a hamstring pull to miss three weeks at the most.
Here are some reasons why I think the number of hamstring pulls in baseball is on the rise and why the rehabs are taking so long:
• Players do not sprint enough during practices and workouts. They only go all out during the games. They save themselves.
• When they do run, they only sprint straight ahead and do not run in curves and arcs. The hamstrings are under greatest stress coming out of a turn.
• There is a general lack of understanding of hamstring function and a lack of understanding of the mechanism of injury–hamstring pulls are deceleration injuries.
• Poor choice in strength training exercises. For example, too many athletes do hamstring curls and strengthening exercises that focus on the hamstring in non-functional positions.
• Over-reliance on machines for conditioning. Elliptical machines and stair stepper machines lock an athlete into a limited range of motion and high-speed treadmills foster incorrect running mechanics.
• There is a lack of understanding of correct sprint mechanics and how they should be adapted to the sport.
Once an athlete injures a hamstring, rehab must immediately emphasize getting their feet back on the ground with walking and extensive work on the non-involved leg. They should be jogging in two days! During my time with the New York Mets, when there was an over-reliance on a new therapy pool, the players lost coordination and did not get a “feel” for the ground. Therapy pools are okay, but should not be the main focus of treatment.
Oblique strains, however, are a much different from hamstring pulls. Oblique strains take a much longer time to rehab because once injured, the muscle has a tough time healing. Basically, they never rest due to their involvement in breathing and other everyday activities. Here is my two cents on why we are seeing more and more of them:
• Excessive amounts of non-functional abdominal work done in seated, prone, or supine positions.
• Over-emphasis on flexion/extension movements and not enough rotation exercises.
• With medicine ball work, there is too much emphasis on the throw and not enough on the catch.
• As with hamstring pulls, there is a general lack of understanding of the mechanism of injury, and that it is in fact a deceleration injury.
I am not very optimistic that we will see these injuries controlled in the near future. Baseball is a monkey-see-monkey-do sport. There are way too many fads in training and not enough good training methodology. There are too many egos and not enough teamwork and the front office types rely way too much on doctors who have no understanding of function or training.