Friday, June 28, 2013

Long Live Repetitive Eccentric Loading!

Got a call from my buddy, who injured his hamstring hurling (check out the Seattle Gaels website for some details about this awesome sport - http://seattlegaels.com/new/gaelic-sports/hurling).

With hamstring injuries, there are two subtypes- proximal (near the buttock), and more distal.

Like with all tendon injuries, I recommend early icing and compression as mainstays of management.  There are different ways to ice, but my favorite is to use a gallon-sized ziplock bag, fill it 1/3 with ice, press out the air, and fold it back on itself with the redundant plastic.  I then slip it inside a compression short, so that you have both ice and compression.

Once the acute phase has been treated, the mainstay from an exercise standpoint is repetitive eccentric loading.  Eccentric strengthening exercises are exercises where the muscle is getting longer while you contract it- think of lowering a dumbbell after doing a biceps curl.  The hamstring is a particularly hard muscle to eccentrically load, so these are some Youtube links highlighting some good choices.




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What should you do if you don't get better?  Well, that's obvious - come see Lake Washington Sports & Spine!  
- Diagnostically, we would do a thorough examination to make sure you don't have another injury (e.g., a lumbar radiculopathy, or SI joint arthropathy)
- If needed, we could look at the hamstring under ultrasound to assess the injury (3 times higher resolution than MRI!)
-Some patients benefit from ultrasound-guided injections, which we could do in the office.  We love the use of ultrasound- it hurts less, more accurate, more likely to work, and cool to see.  We're all about the patient experience at Lake Washington Sports & Spine.

Heal up buddy!

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