Tuesday, May 20, 2008

Anatomy of a potential hamstring injury.


Recently I have had 3 of my athletes experience a dull aching pain in their upper hamstring (all 3 were on the right side).. The common link between the 3 were that they started increasing intensity and were starting track sessions. Intuition tells me that because they were all 3 experiencing the pain in their right hamstring that the stress of running on a track and running fast around the left hand turns is causing this. Duh.
The potential injury is caused (possibly) by inflammation of the ischial tuberosity (circled in the picture above). The what? The ischial tuberosity turns out to be a critical little place that can be a real pain in the ass.. it is the site of attachment of the sacrotuberous ligament; the site of origin of the inferior gemellus, quadratus femoris and the hamstring group- semitendinosus, semimembranosus, and long head of biceps femoris. Injure this site and you are actually affecting many different muscles and tendons.
There could be argument for strengthening exercises like walking lunges (one of the better hamstring exercises), straight leg dead lifts if you know how to do them correctly, hamstring curls, straight leg "paw back" or glute exercises that mimic your run form (use a cable or stretch cord attached to your ankle). Gentle stretching of the glutes and hamstrings could help keep the site more resilient but only stretch after the pain in 100% gone.
I suspect that the track and the added intensity is to blame- so step one is to eliminate the track and perform harder run sessions on a trail with few turns.

3 comments:

Matt said...

Tim,
I just want to see if I'm on the right track: my zone breakdown from the test a month or so ago goes:
Z1 - 125 to 141
Z2 - 142 to 159
Z3 - 160 to 169 and so on.

I think he told me and you seemed to agree that 150 is my Aet. Is that right?

Today I ran 6 miles pretty hilly, very comfortably. Of course my HR went up and down; I ended up avg. HR 152. Does that mean that this work-out is beyond my Aet and therefore too "hard"? According to my zones, it doesn't look bad, but I'm trying to remember where 150 came from. Perhaps I should finish with a longer flat section to bring these workouts to 150 or below.

thanks.

McDuff said...

Tim:

As an aging runner, I have been plagued lately with injury due to the repetitive nature of our sport. Particularly my knees, hamstring, and hips.

A simple adjustment to the track repeats, that the group I train with has found effective, is to reverse our direction occasionally to go clockwise even though years of track running has made counter-clockwise feel intuitive.

But as you suggest, my best solution has been to train more exclusively on trails.

Lucho said...

McDuff- If you have access to a gym then you may want to try an elliptical trainer.. they are brilliant! I find that as a cross training exercise it stimulates running fitness extremely effectively.. maybe better than a treadmill. You will get a huge boost in hamstring strength and hip strength. Maybe then sit in the dry sauna for 20:00 and do some gentle massage for your troubled muscles and stretch very gently..
I love the track and I enjoy running on it but I do limit my time there and try to stick to less technical trails for health reasons.