This paper was submitted by the Liverpool FC medical team. It describes the rehab of a player who had suffered 5 hamstring strains in 5 months.
Whilst I applaud their honesty and openness in sharing this information, it does however show where the medical profession is at in terms of hamstring rehabilitation.
If you don’t have time to read the full paper, here are the highlights.
Following the 5th injury to the same hamstring in as many months, the medical team decide to give the player an epidural. This was because he complained of tightness and neurological sensations in the right leg. They repeat the injection when his symptoms return after a long car drive.
As you probably know, epidurals are given to women in labour.
Intense stretching is used in an attempt to mobilise nerves. The team think these nerves could be responsible for the player’s reported restriction on the injured leg. The lead doctor has this to say about the intervention “as these techniques were components of the previous failed rehabilitations, a more aggressive neural mobilisation approach was started”.
If something doesn’t work 5 times, doing it again more aggressively is not usually helpful.
The player was also diagnosed as having a leg length discrepancy and prescribed orthotics. This despite the fact that the discrepancy was well within ‘acceptable norms’. The doctor comments “their (the orthotics) specific effect is incalculable’.
What is certain is that the orthotics will change how the player’s feet move and impact every joint in his body. Regardless, the player wears them for the rest of the season.
The outcome of all these interventions (and many more) is that the player is able to play out the rest of the season without further hamstring issues. He does however rupture his plantaris, a small muscle in the back of the lower leg that shares the same knee flexion role as the hamstring.
A coincidence? Surely not.
If your rehab is looking anything like this, take a step back and think.
Past injuries for this player included;
A left adductor strain 18 months prior.
A left soleus strain 18 months prior.
A left proximal hamstring tendinopathy 17 months prior.
A right knee grade 3 medial collateral ligament (MCL) tear 16 months prior.
A right Achilles reactive tendinopathy, onset 8 months prior.
A left adductor strain 6 months prior.
All of these previous injuries will have had an impact on the problematic hamstring. None were considered in his rehab programme.
Muscle Activation Techniques (MAT) is the only process that I’m aware of that is able to both find and resolve the muscular inhibition that will have occured after each and every one of these injuries. I doubt whether the hamstring was the problem for this player, but rather the victim of everything that had gone before it.