Injury Prevention Techniques

IMPROVING SPRINT MECHANICS FOR HAMSTRING INJURY PREVENTION‼️(field research) Myself and Chris Bramah have collaborated to design and deliver tailored individualised programming consisting of sprint running mechanics and gym based drills and exercises. The aim was to determine the impact of specific interventions on sprint running mechanics and hamstring injury rates. WHAT WE DID: S-MAS screening was performed 10 weeks apart. Each movement category was assigned 3 different run mechanics drills and gym based supplementary work was included as part of their physical programme. The incorporation of this work across the training model consisted of pre training prep, on field warm ups, prior to speed exposure, and within gym based physical development sessions. RESULTS 📊 Movement quality improved: Across the group we demonstrated average group level decrease in S-MAS by 1.7 ⬇️ Previous research in this area demonstrated an S-MAS score increase by 1 was associated with 33% increase in incidence risk of hamstring injury. Across our group, the improvements have been impactful and contributed to improvements in player availability and injury incidence⬇️ - 0 hamstring injuries within intervention period - 100% player availability within intervention group - 51% reduction in days missed to soft tissue injury compared to same stage of previous season KEY MESSAGES - Average completion rate was 65% throughout the intervention period. Elite football poses chaotic schedules. This places a real challenge to determine when this work can be conducted, and places a paramount on the art of selecting certain training modalities. Listen to the athlete, work along continuums, adapt where necessary while not losing sight of long term objectives. - When looking to develop mechanics, you may not change how the athlete moves completely. Instead look to shift within bandwidths to optimise strategy and improve movement quality. - It may not directly improve how the player moves in matchplay. However, it subsequently develops the structure and capacities of the tissues in practice. Potentially reducing mechanical strain when performing high speed running/sprinting. - Assessing strategy can allow you to determine clear priorities to develop the required tissue capacity. - The use of this model addresses inadequate prescription of running mechanics. Moving to an individualised approach utilising various run mechanics drills and gym based exercises. - The model prescribed sits within a holistic approach for injury prevention strategies. While working through this process, we have been able to identify further methods that can be drawn upon to have physical transfer and develop movement in each of the three sub categories. Happy to discuss and share ideas with anyone who has done similar work in this area. Looking forward to more work in this space 🙌🏻

How Hamstring Contribute To Stability,   Looking past the knee flexion (one of the actions of hamstrings), this powerful muscle also helps in hip movement and delicate knee control. - Hip extension - Knee stability - Pelvic control Medial hamstrings like semimembranosus and semitendinosus help prevent medial condyle lift-off and excessive knee valgus—the mechanism in ACL injuries. Additionally, hamstring deficits impact knee internal rotation strength, particularly after hamstring graft ACLR, contributing to excessive external tibial rotation and dynamic knee valgus, which increases reinjury risk. Even at a muscular level, architectural changes post-ACLR increase injury risk. The biceps femoris long head, one of the main muscle in sprinting and high-intensity movements, often develops shorter fascicle lengths and greater pennation angles after ACLR when using the hamstring graft, similar to what’s seen in athletes with a history of hamstring strain injuries. These changes matter because shorter Bicep femoris (long head) fascicles (<10.56 cm) are associated with a fourfold increase in hamstring strain risk, while each additional centimeter in fascicle length reduces that risk by about 20%. Guys, 4 fold… 4 times more likely. Not 4% but 400%. Just think about this for a minute. Now, Given that shorter fascicles are more prone to eccentric-induced muscle damage, running-related hamstring injuries become a real concern for post-ACLR athletes. --- This is a snippet of my weekly newsletter where I break down sports medicine research & provide clinical tips Learn More --> https://lnkd.in/eeqWt2TF Study:  Buckthorpe, M., Danelon, F., La Rosa, G., Nanni, G., Stride, M. and Della Villa, F., 2021. Recommendations for hamstring function recovery after ACL reconstruction. Sports Medicine, 51(4), pp.607-624.

Our latest meta-analysis brings a compelling insight: incorporating plyometric exercises into structured injury prevention programs can reduce the risk of Anterior Cruciate Ligament (ACL) injury by a remarkable 60%. These exercises, which emphasize rapid muscle activation, neuromuscular control, and agility, have proven to be more than just physical drills, they are a science-backed strategy to mitigate the forces that lead to non-contact ACL injuries, especially in dynamic sports. https://lnkd.in/eUPEwciW But let’s take this to the next level. Pairing these proven methods with the real-time precision of tools like ForceDecks by VALD Performance. This state-of-the-art technology captures detailed force and power metrics, offering data-driven insights into an athlete’s performance. https://lnkd.in/e7HGtzTb Now, introduce AI algorithms that can process this data, detect subtle movement inefficiencies, and predict potential injury risks before they escalate. This convergence of sports science and technology offers a new frontier in athlete safety and performance. The future of sports medicine isn’t just about treating injuries—(it’s about staying ahead of them). By combining evidence-based training protocols with cutting-edge tech, we are setting a new standard for proactive athlete care. I’m excited to connect with innovators, sports scientists, and forward-thinking professionals who are passionate about redefining the boundaries of sports performance and injury prevention. #SportsScience #InjuryPrevention #VALDPerformance #AIInSportsMedicine #PlyometricTraining #AthleteCare #InnovationInSports

Hamstring injuries, especially to the biceps femoris long head, remain a leading cause of time-loss in elite soccer. Our understanding of how hamstrings behave across different running tasks and during targeted strength exercises provides critical insights for injury mitigation and rehabilitation strategies. Running Mechanics; Speed & Direction Matter: -       As running speed increases, hamstring EMG activity rises, especially in late swing, peaking over 120% MVIC in some individuals. -       The BFlh is highly active and susceptible to strain as it lengthens under load during late swing. -       Crucially, EMG patterns are highly individual yet consistent across speeds, highlighting the importance of personalized rehab and neuromuscular retraining. -       Turning at speed introduces asymmetrical hamstring loading. -       The outside leg exhibits more braking and greater horizontal forces; the inside leg produces more vertical force with altered joint kinematics. -       Curved sprinting increases lateral trunk lean, pelvic rotation, and ground contact time differences—factors that affect hamstring load distribution and injury risk. -       Rehab must include multiplanar, directionally specific sprint exposure. Exercise Selection Matters: Nordic Hamstring Curl - Produces the highest peak hamstring forces - Causes the greatest fascicle lengthening, especially in the semimembranosus and short head of the BFlh - Highly effective for eccentric strength and increasing fascicle length - Unmatched for eccentric overload and fascicle lengthening, making it ideal for fascicle remodeling. Single-leg Roman Chair - Produces moderate peak forces - Mimics quasi-isometric contraction during late swing phase - Targets BFlh long head and semimembranosus more effectively - Suitable for mid-stage rehab and controlled load progression (transition phases and load tolerance) Single-leg Deadlift - Produces lower peak forces, but with greater range of motion - Leads to the highest mean fascicle length, promoting hip-dominant adaptation - Engages the glutes more while still loading hamstrings - Ideal for late-stage rehab, reconditioning, and return-to-play prep - Support hip-dominant mechanics, useful for terminal rehab and reconditioning. Applied Takeaways: - Rehab Progressions Must Reflect Individual EMG Profiles: Each athlete displays unique activation patterns—assess and program accordingly - Introduce Running Early: Submaximal running can help restore neuromuscular patterns without overloading healing tissue - Don’t Neglect Curved Sprinting: Prepare hamstrings for multidirectional force vectors seen in match play—especially in fullbacks and wingers https://lnkd.in/g_9dxske https://lnkd.in/gyuGnCpv https://lnkd.in/gt23Enza

🏃♂️ Hamstring Progression #4: Single-Leg RDL to Step-Up The single-leg RDL is a powerhouse for the posterior chain, but this variation’s real value is how it enhances sprinting mechanics and hamstring resilience at long muscle lengths. 👉 Key evidence: Developing posterior pelvic tilt (PPT) control with gym-based eccentric exercises produces greater improvements in sprint kinematics than high-volume technique drills (Mendiguchia 2022; Alt 2021). 
This highlights the role of strength work that teaches dynamic pelvic control — not just cueing on the track. Why this variation?
✅ Mimics the 2-step sprint sequence (hinge → drive)
✅ Demands explosive PPT, which generates large hip joint forces and drives efficient power transfer (Sado 2017, 2019)
✅ PPT control counters excessive lengthening of the hamstrings and supports better proximal-to-distal sequencing (Sado 2017, 2019) ⚠️ Without good pelvic control, athletes slip into excessive anterior pelvic tilt during sprinting, which over-lengthens the hamstrings and raises their tension (≈ ST +13%, SM +26%, BF +31.5%; Nakamura 2016) — increasing both demand and injury risk. ➡️ The goal isn’t just a strong hamstring — it’s a hamstring that delivers explosive power in the right sequence, and under the right control for maximal sprint efficiency and resilience. What did you think of this 4-part progression series on hamstring (p)rehab and performance? 
I’d love to hear how you plan to integrate these exercises into your own training or rehab sessions — share your thoughts in the comments. Keiser Benelux Keiser Corporation  Location: Animo Studios   #BramSwinnenMethod #IntegratedPerformanceTraining #HamstringHealth #SprintingMechanics #AthleticDevelopment #StrengthToSpeed #PerformanceRehab #KeiserTraining #SingleLegRDL #PosteriorPelvicTilt #StepUpPower

Educational Deep‑Dive on Hamstring Strain for Rehab & Performance Pros > Hamstring Strains: Evidence‑Based Insights for Faster Recovery & Fewer Re‑injuries 🔍 Mechanism & Epidemiology - Accounts for ~12 % of all sports injuries; sprinting & kicking dominate mechanisms. - The long head of biceps femoris is involved in ≈ 80 % of cases due to high eccentric load during late swing phase of running. 🩺 Clinical Presentation & Grading - Hallmarks: sudden posterior‑thigh pain, “pop,” local tenderness/defect, pain on active knee flexion & passive straight‑leg raise. - Grade I = microscopic tearing (no strength loss); Grade II = partial tear with weakness/hematoma; Grade III = complete rupture or ischial tuberosity avulsion. ⏱ Acute Management (0–72 h) - POLICE (Protect + Optimal Load + Ice + Compress + Elevate). - Relative rest—avoid end‑range stretching; begin gentle pain‑free isometrics as tolerated. 🏋️♀️ Key Rehab Pillars 1. Eccentric Emphasis – Nordic hamstring curls, razor curls, diver touches: strongest evidence for healing & prophylaxis. 2. Lumbopelvic Stability – Plank variants, single‑leg bridges to reduce anterior pelvic tilt stress. 3. Progressive Loading Continuum – Isometrics → concentric/eccentric → energy‑storage drills → overspeed sprinting. 4. Criteria‑Based Progression – Pain‑free ROM, isokinetic or HHD hamstring strength ≥ 90–95 % contralateral, and unrestricted sprinting before clearance. 📈 Rehabilitation Timelines (ballpark) - Grade I: 1–3 weeks - Grade II: 4–8 weeks - Grade III (± surgery): ≥ 12 weeks Individual variance high—criterion beats calendar. 🚦 Return‑to‑Sport Checklist ✔️ Max‑effort sprint without pain/compensation ✔️ ≤ 5 % isokinetic torque deficit at 60 °/s & 180 °/s ✔️ Negative palpation & slump test ✔️ Athlete confidence score > 90 % 🔄 Re‑injury Prevention - Weekly eccentric hamstring program (Nordic protocol 1 × week in‑season, 2‑3 × pre‑season) can halve recurrence (Petersen 2011; van Dyk 2019). - Integrate sprint‑mechanics drills, adequate warm‑up, fatigue management, & sport‑specific conditioning. 📚 Key References Askling et al. BJSM, 2014 – Rehabilitation protocols. van Dyk et al. AJSM, 2019 – Nordic compliance & injury reduction. Brukner & Khan. Clinical Sports Medicine, 5th ed. IOC Consensus Statement on Muscle Injuries, 2022. 👉 Take‑home: Combining early optimal load with progressive eccentric‑focused rehab and objective RTS criteria yields quicker recovery and ~50 % fewer subsequent strains. Disclaimer ⚠️: Do not copy or use this content without permission !!! #SportsPhysiotherapy #Rehabilitation #HamstringStrain #EccentricTraining #ReturnToSport #EvidenceBasedPractice

Hunter Dobbins tore his ACL two days ago while making a play at first base. It was only the second inning of his first start back from an elbow injury. Many will call this a “freak” injury—a random, unavoidable stroke of bad luck. But that’s a misconception. Science shows ACL tears often stem from predictable gaps in training—gaps we can close. An athlete’s body is shaped by what it repeatedly practices. Pitchers like Dobbins train obsessively to perfect one refined, explosive arm motion. But baseball demands more than that box. Covering first base requires a sudden sprint, a sharp pivot, and controlled deceleration—movements rarely drilled with the same intensity. Without training your tissues, joints, and nervous system for these dynamic demands, you’re vulnerable. A 2020 systematic review in Sports Medicine found that multidirectional training—like agility drills, balance exercises, and practices like yoga—cuts ACL injury risk in sports requiring sudden directional changes, like covering first base in baseball. A 2005 study in The American Journal of Sports Medicine showed that neuromuscular training, including proprioceptive exercises, reduces ACL injuries by over 50% by preparing athletes for dynamic movements. Similarly, a 2013 study in the Journal of Orthopaedic & Sports Physical Therapy found that plyometrics and agility drills not only lower ACL injury risk but also boost explosive performance—like sprinting to cover a base. Yoga and mindfulness practices enhance this training by building bodily awareness and joint stability, critical for reacting to unexpected plays like Dobbins’ move toward first. A 2016 study in the International Journal of Yoga found that yoga improves balance and proprioception, reducing non-contact injuries like ACL tears. A 2018 study in BMC Sports Science, Medicine and Rehabilitation showed that mindfulness-based exercises, such as yoga or focused movement drills, improve motor control and lower injury risk by helping athletes adapt to dynamic game challenges. Pitching alone won’t protect you. Strength training alone won’t protect you. Repetition alone won’t protect you. True resilience comes from moving diversely—across planes, loads, and speeds—expanding your “movement vocabulary” to absorb surprises without breaking. Dobbins’ injury wasn’t just bad luck—it was a consequence of a body unprepared for the game’s unpredictable demands. With the right training, these risks can be slashed. This isn’t just about preventing injury. It’s about building a body that’s adaptable, intelligent, and responsive—a body ready for life, not just the highlight reel. Hunter’s injury is heartbreaking. But it’s a wake-up call. Expand your movement. Expand your resilience. — P.S. I train professional athletes and teams. I write and share stories about the intersection of somatics and performance. To follow along, ring the 🔔 for all my posts at the top of my profile. I'd love for you to be part of this growing community!

Tendon Loading Rule The Tendon Loading Rule describes how to load a tendon safely and effectively to stimulate healing, improve collagen alignment, and reduce pain—without overloading and causing irritation. It is based on three principles: ⸻ ✅ 1. Tendons Love Load — but Hate Sudden Change • Load must be progressive, not sudden. • Increase only 10–15% per week (weight, repetitions, or volume). • Tendons respond best to consistent, repeated mechanical stress. ⸻ ✅ 2. Pain-Guided Loading (The “Pain Monitoring Model”) During exercise: • 0–3/10 pain → Safe • 4–5/10 pain → Acceptable if it settles within 24 hours • 6–10/10 pain → Overload → Modify or reduce load This prevents flare-ups and allows optimal tendon adaptation. ⸻ ✅ 3. Loading Must Be Slow, Heavy, and Long-Term The most effective loading protocol for tendinopathy is: 🔸 Heavy Slow Resistance (HSR) Training • 3–4 sets • 6–8 reps • Slow tempo: 3 sec up + 3 sec down • 3 times/week • 8–12 weeks 💡 Works for: • Achilles tendinopathy • Patellar tendinopathy • Rotator cuff tendinopathy • Proximal hamstring tendinopathy • Lateral elbow tendinopathy HSR creates: • Increased tendon stiffness • Better collagen quality • Less pain • Stronger musculotendinous unit ⸻ 🔥 BONUS: The 4 Loading Phases for Tendon Rehab 1️⃣ Isometrics (Pain Reduction Phase) • 30–45 sec holds • 5 repetitions • Reduce pain by 30–40% 2️⃣ Isotonics (Strengthening Phase) • Controlled concentric + eccentric • Moderate to heavy load 3️⃣ Energy Storage (Plyometric Phase) • Hops, jumps, skipping • Focus on tendon elasticity 4️⃣ Return to Sport • Sport-specific drills • Monitoring pain & load ⸻ 📌 Summary The Tendon Loading Rule = ✔ Progressive load ✔ Pain-guided limits ✔ Slow & heavy long-term strengthening ✔ Build from isometrics → isotonic → plyometric → sport

Tennis elbow (lateral epicondylitis) is an overuse injury affecting the forearm extensor tendons, especially where they attach to the lateral epicondyle. It can affect anyone due to repetitive wrist and arm movements 🔬 Causes & Risk Factors ✔️ Overuse of wrist extensor muscles (esp. ECRB) ✔️ Microtrauma & Tendinopathy – Collagen degeneration, not inflammation ✔️ Angiofibroblastic Hyperplasia – Abnormal blood vessels & disorganized collagen 🔹 Risk Factors: 🔸 Repetitive activities (tennis, typing, painting, manual work) 🔸 Poor biomechanics & muscle imbalances 🔸 Improper equipment (wrong racket grip size) 🔸 Aging (35–50 years old) 📌 Physiotherapy Management ✅ Pain Management & Initial Treatment ✔️ Activity Modification – Avoid overuse ✔️ Cryotherapy & NSAIDs – Temporary pain relief ✔️ Bracing & Taping – Reduce tendon strain ✅ Exercise Therapy (Gold Standard) ✔️ Eccentric & Isometric Exercises – Promote tendon healing ✔️ Manual Therapy (Mulligan Mobilization) – Improves grip strength & reduces pain ✔️ Soft Tissue & Myofascial Techniques – Reduce tightness & improve blood flow ✔️ Cervical & Thoracic Mobilization – Addresses neural involvement ✅ Advanced Therapies (For Chronic Cases) ✔️ Shockwave Therapy – Stimulates collagen remodeling ✔️ Dry Needling & Acupuncture – Helps with pain modulation 🔥 Rehabilitation Protocol: 🔸 Phase 1 (Weeks 1–2): Pain Management & Early Activation 🎯 Reduce pain, protect tendon, introduce movement ✔️ Relative Rest & Activity Modification ✔️ Pain Relief: Ice packs (10–15 min,2–3× daily), bracing ✔️ Isometric Wrist Extension Holds: 30–45 sec × 5 reps, 3×/day 🔸 Phase 2 (Weeks 3–6): Tendon Loading & Strengthening 🎯 Strengthen tendon & improve endurance ✔️ Progressive Eccentric Loading (Key to Recovery) 🔹 Eccentric Wrist Extensions with Dumbbell – Slowly lower weight (3×15 reps) 🔹 Eccentric Radial Deviation Exercise – Strengthens stabilizers ✔️ Grip Strengthening: Soft ball squeeze, finger extension ✔️ Manual Therapy & Mobilization (Mulligan MWM, soft tissue release) 🔸 Phase 3 (Weeks 6–10): Functional Strengthening & Neuromuscular Control 🎯 Improve grip strength, endurance, return to activity ✔️ Advanced Strengthening: 🔹 Wrist Extensions (Resistance Band) –3×12 reps 🔹 Supination/Pronation (Dumbbell) –3×10 reps 🔹 Hammer Grip Eccentric Strengthening ✔️ Plyometric & Proprioceptive Training: Ball dribbles, elastic band punches ✔️ Return-to-Activity Drills 🔸 Phase 4 (Weeks 10–12+): Return to Sport/Work & Prevention 🎯 Full recovery & recurrence prevention ✔️ Gradual Overload & Maintenance Training (eccentric exercises 2–3× per week) ✔️ Shoulder & Scapular Stabilization (YTWL exercises) ✔️ Biomechanical & Ergonomic Adjustments: 🔹 Tennis players: Optimize racket grip & technique 🔹 Office workers: Adjust keyboard/mouse positioning ✔️ Gradual Return to Sport/Work ⏳ Expected Recovery Timeline 📌 Mild cases: 6–8 weeks 📌 Chronic cases (>3 months): 12+ weeks Eman Hekal, DPT Physiotherapist & Rehabilitation Specialist

Understanding Tennis Elbow: It’s Not Just for Athletes Post Body: Tennis Elbow (Lateral Epicondylalgia) is one of the most common upper limb tendinopathies — and surprisingly, many of those affected have never held a tennis racquet. It typically presents as lateral elbow pain, worsened by gripping, lifting, or wrist extension. Despite its name, this condition is more about tendon overload and degeneration than inflammation — which is why anti-inflammatory strategies alone often fail. 🔍 Key Clinical Findings: • Pain with Cozen’s, Mill’s, and Maudsley’s tests • Tenderness over lateral epicondyle • Weakness in grip strength • No neurological signs 📌 What Works in Evidence-Based Rehab? • Eccentric and isometric loading of wrist extensors • Manual therapy & Mobilization with Movement (MWM) • Myofascial release to forearm extensors • Addressing kinetic chain deficits (e.g., scapular stability) • Ergonomic corrections for desk workers or lifters As a physiotherapy student and content creator, I believe educating people early about tendon care and load management can prevent chronic disability and unnecessary injections or surgeries. ➡️ If you’re treating or experiencing Tennis Elbow — how do you structure your rehab approach? Let’s share and learn together. 👇 #TennisElbow #LateralEpicondylalgia #ElbowPain #GripPain #Tendinopathy #PhysiotherapyTips #RehabStrong #ManualTherapy #EvidenceBasedPhysio #WristPainRelief #GripStrength #MulliganTechnique #PainFreeLifting #TendonRehab #DeskJobPain