With the NTFL season just around the corner, former AFL physiotherapist and Director of Elite Physiotherapy, Joshua Tidswell looks at the most common injury in AFL football - hamstring tears.
Hamstring strains are common injuries in sports such as Australian Rules Football (AFL), which are characterised by maximal sprinting efforts, kicking and sudden accelerations.
Hamstring strains remain the most common injury in the AFL, with an incidence in 2018 of 6.3 new injuries per club. They are also the most common cause of matches missed (25.2 matches per club).
“These are the highest rates we have seen for a number of years” (Orchard et al. 2018).
Hamstring injury has been the single most common injury type in the AFL for many years, despite the increased focus on hamstring injury prevention. This figure has not changed significantly over the past decade. In the 2009 AFL season Orchard et al. reported 7.1 new hamstring injuries per club @ 21.8 games missed.
What causes hamstring injuries?
There has been several proposed causes and risk factors for hamstring injuries:
Previous hamstring injury
Poor eccentric hamstring strength
Poor hamstring flexibility
High training loads
Altered quadriceps/hamstring ratio
Yet injury rates continue to be high along with recurrence rates, which were up around 20% in 2018.
So, what’s the answer?
The bulk of research into hamstring injury prevention is conducted on soccer athletes. The common denominator over the past decade has been the Nordic hamstring (NH) exercise.
A systematic review published in 2017 by Al Attar et al. found teams using injury prevention programs that included the NH exercise reduced hamstring injury rates by up to 51%!!!
Despite this, Bahr et al. (2015), who studied 50 professional football (soccer) teams across 3 seasons reported over 80% of teams did not include Nordic hamstring exercises in their strength and conditioning programs.
What is the Nordic hamstring exercise?
Nordic hamstring exercises are a simple partner exercise which can be easily integrated into a teams training program without the need for specific equipment. The person performing the exercise kneels down, keeping their back straight, while their partner holds both their ankles firmly to the ground. The exercise participant then leans forward, pivoting at the knees to slowly lower themselves down as far as they can towards the ground. When they can no longer control the movement, the participant uses their arms to catch themselves in a push up position before returning to the start position and repeating.
The exercise itself is quite demanding on the hamstring muscle and can cause short term muscle soreness (DOMS) in less trained individuals. This is largely due to the high eccentric loading of the muscle. This soreness will gradually self-resolve within 48-72 hours.
As a result, it is recommended to keep the volume down to around 2-3 sets of 6-8 repetitions for the first few weeks. This load can then be progressively increased to 3 sets of 10-12 repetitions.
Below is a proposed training program.
Other common hamstring strengthening exercises:
Deadlift / Romanian deadlift
Back extensions (GHD machine)
Single leg arabesque (RDL)
Gym ball bridge/curl
At Elite Physio our Physiotherapists use a hand-held muscle dynamometer to test peak hamstring muscle strength. This gives us an objective measure and may help identify weaknesses as well as those potentially at risk of hamstring injury. It is also useful in gaining baseline testing scores (pre-season), comparing limbs and monitoring strength progressions.
Is your football team doing Nordic hamstring exercises?
Prevention is better than a cure!
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