Monday, October 16, 2017

Hamstring/ Calf Pain? Treat Your Back

Now here's a nasty hamstring injury
I was looking through some of our past articles in our Physio Solutions blog and came across this article on how treating the lower back helps with hamstring injuries.

Here's a good reason why this is so. This article written way back in 2004 addressed the issue of hamstring and calf strains in older footballers in particular (but can also be in runners, triathletes etc).

I came across many of Dr John Orchard's articles back when I was doing my post graduate physiotherapy studies in 2003. This particular article suggested that a possible mechanism of higher occurrences of hamstring/ calf strains in older athletes may be due to your lumbar spine (or lower back) issues.
See where L5 nerve root is, (disc is next to it in white)
He suggested that the L5/ S1 neve root segment may be more prone to irritation and compression under the lumbosacral ligament due to disc degenerative changes. Dr Orchard notes that the L5 nerve root has the "most tortured path through the lumbosacral canal" before going over the sacrum to join the sacral plexus (or nerve roots).
The lumbosacral ligament further lessens the L5 space 

He suggested that it is likely that the location of a larger lumbosacral ligament is clinically more significant in older athletes due to degenerative disc changes (or slipped discs).

Due to possible L5 nerve root entrapment, some older athletes may have regular hamstring/ calf  and nerve muscle and tendon injuries. This happens when the L5/ S1 segment loses disc height (due to a slipped disc).

Space for the L5 nerve root is thus reduced (under the lumbosacral ligament) and may cause back pain and/ or hamstring and calf muscle/ tendon injuries.

So now you know why we treat your lower back when you have a hamstring or calf injury, especially when treating just the hamstring or calf doesn't improve your condition.

This is especially so when you saw from last week's post on how the hamstrings are closely related to the thoracolumbar fascia.


Reference

Orchard JW, Farhart P et al (2004). Lumbar Spine Region Pathology And Hamstring And Calf Injuries In Athletes: Is There A Connection? BJSM. 38(4): 502-504.


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