Hind leg injuries in football

Nicklas Pedersen

Nicklas Pedersen

Physiotherapist Protreatment and co-founder & co-owner of Liiteguard.

Share posts

Physiotherapist and co-founder of Liiteguard, Nicklas Falkesgaard Pedersen, gives an insight into hamstring injuries in this post.
Hind leg injuries football

Physiotherapist's experience

The hamstring injury is a common injury in football - both in elite and amateur football.

A study was done on professional footballers and it was shown that a squad could expect to have 5 hamstring injuries each season on average and that this meant that in 15 games of the season a player would be out due to a hamstring injury!

In all the years I've worked with footballers, this has been the most common muscle injury I've seen, so in this post I'll look at how the injury occurs and what you can do to prevent it.

The post will be about the acute hamstring injury, where the pain comes now and then, and feels like a significant stretch/stick in the hamstring that makes you stop activity. This is called an overload injury, and differs from the overuse-related injuries (overuse) where the pain comes gradually, and at first can be quite mild. Drawing again on my own experience, I would estimate that over 90% of the hamstring injuries I have seen, treated and rehabilitated belong to overload injuries, and that only a very small proportion are related to overuse.

How does a hamstring injury occur

There are three different muscles in the thigh, all of which attach around the saddle bone under the buttock, and run down the thigh and attach under the knee. A muscle injury in the thigh most commonly occurs in the outermost of these three muscles, called the biceps femoris, which around the knee forms the outermost part of the kneecap.

The muscles of the thigh are responsible for stretching the hip (bringing the leg backwards) and bending the knee, and they perform these movements by shortening the muscles. When you perform the opposite movement, bending your hip and extending your knee, as you do when you powerfully advance your leg in a sprint, for example, your hamstring muscles are maximally lengthened, and it is actually in this movement (called the extensor phase, when the muscles must hold back) that hamstring injury typically occurs.

The degree of injury can vary from a minor strain to a total tear of muscle fibres. The strain is the most common injury in the hamstring, and it is a minor injury in which the fibres of the muscle are stretched but not torn. The pain, as mentioned earlier, will be acute and so bad that you cannot continue playing, but no worse than walking without major problems afterwards.

It is an injury that can be recovered from relatively quickly, and typically requires no more than 2-3 weeks off the pitch.

The fibre rupture is a more serious injury, where the impact on the muscle fibres is so great that some fibres are torn. This injury is more prolonged and painful. Often, after the injury has occurred, it will be difficult to even walk because of the pain, and in the hours afterwards there will be bleeding in the skin, indicating that some fibres have been torn, causing bleeding in the tissue. The fibre tear takes longer to recover from and it is not unusual for it to take 6-8 weeks or more to be back on the pitch.

There are several risk factors that can increase your risk of getting a hamstring injury, and I will discuss the most important ones below, as well as what you can do to reduce your risk of a hamstring injury.

Lack of strength

Weak muscles are more prone to injury, and the hamstrings are no exception. Weak muscles find it difficult to cope with the demands placed on them, especially when they become fatigued. Studies have shown that most hamstring injuries occur during matches, and that they most frequently occur in the dying minutes of each half, when the muscles have been under strain for a long time and therefore begin to tire more.

As mentioned earlier, the injury to the hamstring most often occurs when the muscles are extended, either during a kick or when the leg is forcefully moved forward during a sprint. It is in these situations where the muscle is lengthened that it is weakest, and it is therefore a good idea to work on the strength of this particular function of the muscle's work if you want to prevent an injury.

If you want to do preventive training yourself, I would recommend these two exercises, which strengthen the muscle at the stage of the movement when it is most exposed.

Nordic Hamstring: Hare on mats with bending/stretching of hip and knee.

Lack of heating

It probably comes as no surprise, but warming up before you load maximum in battle and training is important!

The right warm-up stimulates muscles, tendons, joints and nervous tissue, making your body more ready for the load ahead, improving your performance and minimising the risk of injury.

In relation to muscles and tendons, the warm-up will increase blood circulation, making the muscles warmer and more flexible, which is important before the muscles go out to make explosive movements in external positions. A warm and flexible muscle is significantly less prone to injury than a cold and stiff muscle.

You probably have a set warm-up routine with your team, but I'd like to add a single exercise to your programme that you can do as part of your warm-up.

Lack of mobility

In addition to strong muscles and optimal warm-up, there is another area that can help prevent a hamstring muscle injury: mobility.

Mobility refers to the degree of movement of your joint muscles and tendons. This is also an important area of focus as reduced mobility in joints will affect how you can use your muscles, and mobility, or lack of it, is a frequent cause of injury, as the lack of mobility in the joints causes the muscles to load incorrectly and excessively.

When it comes to a hamstring injury, mobility around the lower back and pelvis is particularly important.

It is therefore a good idea to do exercises that ensure your mobility is optimal in these particular joints, so that muscles and tendons have the best conditions to do their job and are not exposed to unnecessary risk of injury.

Mobility training doesn't take long, and it's a good idea to do some simple exercises before each workout as part of your normal warm-up routine, but you can also do them daily.

I would recommend the following mobility exercises for the lower back, pelvis and hips: Lumbar Mobility - SI Mobility

Have fun and good training!

Click and read more about Liiteguard's sensory feedback compression stockings here.

References:

  1. C. Woods. The Football Association Medical Research Programme: an audit of injuries in professional football-analysis of hamstring injuries. Read it here: https://bjsm.bmj.com/content/38/1/36 

Popular posts