Sunday, April 7, 2019

How To Reduce Your Injury Risk By Half

Starting position
Want to reduce your risk getting a running injury by half with no equipment needed? It takes less than ten minutes a week. It also helps you become a stronger and faster runner. What's the catch? Some of you will already be asking.

It almost sounds to good to be true, but this has well documented research to back it up. Researchers reviewed 15 studies (8459 male and female subjects) across different sports with subjects ranging from 18 to 40 years old. Those that did the Nordic hamstring exercises (also know as Icelandic curls) decreased their injury rates by 51 percent.
Lean forward and hold
My patients often struggle when I show them how to do it. We get the patient to kneel at the edge of our treatment bed with both ankles secured. The patient then progressively leans forward from the knees while keeping their back straight. When they can't hold the position any longer, they just use the hands to catch themselves as they fall forward.

Please bear in mind that the Nordic hamstring exercise (NHE) is extremely difficult to do. Some of my patients who had their anterior cruciate ligament (ACL) reconstructed can barely manage one rep before their hamstrings start to fatigue/ cramp. It's also quite common to get delayed onset of muscle soreness (DOMs) after attempting the NHE.

To progress, you can slowly increase the number of repetitions over two to three months. You can also lean forward further and hold that position longer before you fall forward.

For patients who struggle to do a single repetition, I'll get them to start with another similar exercise to the NHE that lengthens the hamstring at the same time while it's contracting. I get my patients to do the Arabesque first. The patient stands on one straight leg with the other leg behind while attempting to reach forward to touch a bottle or a cone etc. This movement is repeated until fatigue sets in.

When the Arabesque becomes easy, they can progress to doing the NHE.

The above two exercises are also very useful in Australian Rules football, soccer and rugby since the hamstrings are commonly injured in these sports too.

One last tip, if you can't find anyone to hold your ankles while doing the NHE, try putting your feet under a couch with a mat in front to cushion your landing.


van Dyk N, Behan FP et al (2019). Including The Nordic Hamstring Hamstring Exercise In Injury Prevention Programmes Halves The Rate Of Hamstring Injuries: A Systematic Review And Meta-analysis Of 8459 Athletes. BJSM. DOI: 10.1136/bjsports-2018-100045.

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