HAMSTRING REHABILITATION

REHABILITATION PROGRAMME PART 2

A MODEL HAMSTRING

DEFINITIONS (load is expressed in kilograms) Defined load A defined load is 3 sets, with 6, 5 or 4 reps per set and a load of 8, 9 and 10 kgs. For example: Set 1 = 6 reps, with 8kgs; Set 2 = 5 reps, with 9 kgs and Set 3 = 4 reps with 10 kgs.

Max load

(+2 or +3 or +4 or +5), for the duration of the prescribed rep- etitions of the set For example: Max +3 means use as much resistance that allows you to just complete the required sets (ie. your max). If you can do three extra repetitions (ie. 15 instead of 12) on the last set, increase the resistance next time so that you can just complete the prescribed sets and reps.

%1RM % load of a one repetition maximum lift For example: 80%1RM, of a 200kg maximum load, is 160kg (ie. 200 x 80/100)

Speed of movement This is defined in second counts for each ‘part action’ of the repetition. For example: 2-1-2 -1 = push to the count of two, hold for the count of one, return to the count of two, pause for the count of one. 1-0-2-0 = push 1, no hold, return 2, no pause. 2-2-2-2 = push 2, hold 2, return 2, pause 2.

By Don Gatherer, MCSP and Kerry Peek, MCSP

A rehabilitation programme must be objective and consist of a structured programme with clear progression criteria. It is not sufficient to say ‘if it is too hard or painful – stop’ or ‘don’t work as hard if the load is too heavy’. It is important to try to work within a structure that has clear guidelines, precise instructions and achievable aims that are appropriate to the injury.

Rehabilitation protocols The rehabilitation protocols for exercise progression and load assignment are based on the following principles and are ranked in the following order of priority: 1) Borg CR10 (pain scale) 2) Borg RPE (rating of perceived exertion scale) 3) Exercise set and repetition prescription variation - uniform load

4) Exercise set, repetition and load prescription variation 5) 1RM% loading (1 repetition maximum percentage assignment loading eg. 60%1RM)

12 SportEX

The Borg scales are reproduced at the end of the article for your reference (9).

Rehabilitation phase 1 (acute) This phase has been completed and covered by previous articles and is mainly comprised of the PRICE protocol (protection, rest, ice, compression, elevation) (see SportEX Health Issue 10).

Rehabilitation phase 2 (ROM) Entry criteria 1) Completion of Phase 1 2) Able to perform pain free voluntary contraction of the hamstrings (Borg CR10 (pain scale) 0-1) a) Isometric hamstring contraction - inner and middle range. b) Concentric/eccentric hamstring contraction - against gravity - inner and middle range

3) Full weight-bearing 4) Partial outer range active stretch

Rehabilitation objectives 1) Regain hamstring flexibility 2) Maintain hamstring vascularization/endurance