Hamstring injuries (Part IV) 

By Dr. D. Atukorale

Why is early and vigorous rehabilitation important?

Following hamstring the opposite quadriceps become weaker, light to balance the forces in the hamstring. 

If neglected the weak quadriceps take this as normal and with time a week tight quadriceps results, in addition to weak tight hamstring. Following a hams injury one must look at the knee, leg and the foot because problems in these places can cause a hams pull which will be in tight spasms at times making the knee 'locked'.

It is important to correct abnormalities such as anterior tilting of pelvis by strengthening muscle of the abdomen and ileopsoas and loosening glutial and rectus muscles.

How do you know the player is fit to return to sport?

Following full recovery of muscle strength and also stretch, it is advised to have a couple of weeks speed training.

In addition related activity such as jumping, direction changing etc. must be done. Running helps to strengthen the muscle and stretchability.

Dangers of poor rehabilitation

Repeated tears of scar follows recurrent injury. This gives weak spots in the muscle and tightness with activity. Inflammation and scarring results.

One reason for this is abnormal bio-mechanics. While muscle tears are the commonest injuries in sport, with mild tears, the player continues to play. In more severe cases more pain swelling, and less power is the rule. In the worst cases, muscle tears at the junction with the tendon. 

Is it a tear or a cramp?

At times it is difficult. Exact reason for a cramp is ill understood, low salts [sodium and potassium], inadequate water intake, tight muscles, are probably the culprits. A high carbohydrate meal 03 hours before a game is advisable. 

The reason for a cramp is a sudden muscle contraction without player's knowledge [but not a tear] and this is temporary. The treatment here is simple; stretching; hydration [+ salts], light massage, once the player is rested. 

How to prevent tears of muscles? 

To a great extent, they are preventable. In addition to what is mentioned, in [5] part [1] ; over-use can be avoided. 

Sports doctors have found that, during the last 20 yrs or so over-use has led to many injuries. About 2/3rds of lower injuries are due to four reasons. 

[1] Problems of training: Quick changes in volume; intensity; poor rest in between; poor stretching; using wrong technique. 

[2] Problems coming from birth: Bow legs; knock knees; abnormal foot surface; position of foot. Some of these are not correctable. 

[3] Bad Surface: Too hard/too soft. 

[4] Poor shoes. 

Preventing strategies are mentioned from time to time elsewhere. Physiotherapist will be able to help with stiff lower spine, tight muscles etc. One must also take a good diet, avoid very cold and hot conditions, gets psychological support from his trainer and getting another injury is less. 

Many who get hams pulls may have high oxygen cost [Oxygen used up per body mass]. A player walks at 80 meters/min [3 miles/hr] at higher we need more oxygen. Between 20 and 60 yrs, we need 12 times our body weight in kg of oxygen [for a 80 kg-80-12 ml of oxygen] every minute. Outside this age limit, we use more oxygen. 

I have an interesting story about a rugby player with hamstring injury. He had left hams multiple tears which took over one month to heel "thanks to oil". A second smaller tear on the other side took only a few days "thanks to ice". This 21-years-old boy from a less well-known school was seen playing even before recovering fully from the first injury. 

Although birth defects are a cause of muscle injuries, an efficient ruggerite with healing hams injury, was seen speeding, cutting down speed at will in addition to side stepping jumping, skipping, zig-zag movements, cutting at great angles and at times limping, until the try was scored. 

He is less than 23 years old. He has an athletic figure and in addition has played cricket, football and then 100M 200M 400M high jump, long jump, triple jump where he came first. 

He is cheerful and takes an average diet, which he could afford. It is quite possible that his past athletic qualities have given good cardiovascular fitness and very good lung function. Many have admired him playing. Before a game he appears quite relaxed.

Countdown to the Olympics - 81 days (14)

Chronicling the Olympics (Part 4)

By Annesley Ferreira 

1972 - Munich: a passel of exceptional and glittering performances at these games of the XXth Olympiad faded into insignificance with the horrifying events when international terrorism and politics entered the Olympics with shocking force. In its aftermath seventeen were dead - eleven Israelis, five terrorists and one German policeman - the world stood aghast and outraged. Though pressure mounted to abandon the games, the Israeli government urged that the games to continue - announced IOC president American Avery Brundage "the games must go on." So it did. The sensational performance of American swimmer Mark Spitz astonished the games with four golds erasing four world records in his swims, and the three relays also in world record time - an unbelievable whopping seven golds and seven world records, to become the most successful swimmer of all time. Australian Shane Gould picked three golds, one silver and a bronze. Soviet gymnast Olga Korbut became the "darling" of the crowds, the elfin who thrilled the audiences in an array of events. French policeman Lasse Viren won the 5000 meters in Olympic record time and the 10000 meters in world record time - doing so he emulated his compatriot Paavo Nurmi, American Frank Shorter won the gold in the marathon beating Mamo Wolde of Ethiopia into third place. The Olympic stadium and the adjacent theme parks for general sports and swimming set new architectural standards for the Olympic games.

1976 - Montreal: beset with multitudonous problems including a boycott even before the games commenced, saw that the city of Montreal was geared to displaying perfect organizational capability and enforcing strict security. All this left the Canadian taxpayers a massive debt that is being paid to this day. Politics took the centerstage when 24 of the 116 nations boycotted the games. The explanation given by majority of the black African countries was that New Zealand's rugby team had played in apartheid South Africa. Sri Lanka born, British swimmer David Wilkie powered to a gold in the 200 meters breast-stroke in world record time. Edwin Moses of the United States won the gold in a world record in his pet event - the 400 meters hurdles. Cuban Alberto Juantorena won the double: 400 and 800 meters beating the many favourites in these two events. John Naber of the US returned for the first time a sub-two-minute for the 200 meters back-stroke. East Germany's Kornelia Ender was the "queen of the pool" winning four golds and a silver, thus giving East Germany the second position in the swimming medal count with United States taking the top position. 

Contd. next week

Test matches of by-gone days: Jessop's Match (9)

Darling won the toss and in excellent weather Australia piled up 324. Trumble top scored with 64 and proved his all-round ability. England then went in and were bowled out for only 183 with Trumble doing the damage. He finished with 8 for 65.

Australia 324 (H.Trumble not out 64, Monty Noble 52, H.Hirst 5 for 77)and 121.

(W.H. Lookwood 5 for 45) 

England 183 ( H. Trumble 8 for 65) and 263 for 9 (G.L.Jessop 104 and George Hirst not out 58).

- Bruce Maurice 

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