Rehabilitation from injuries with help from Pilates is something often needed by my partner, Michael, when he arrives home following cycling accidents and surfing incidents. Our families are often the best sources of new material when it comes to working through injuries and rehabilitation issues. My most recent opportunity for Pilates growth involved Michael experiencing a Grade 2 hamstring injury when surfing.
This article is about working with the more mature weekend warrior suffering a hamstring injury. There is a lot of material about working with hamstring injuries, particularly for footballers of various codes, but working with someone in his early 60s is very different to working with an elite athlete in their teens or twenties. I certainly hope that you don’t hear the hamstring snap in a class setting, but you may see a client coming to see you after they have done this. You may also be seeing some passive overstretch hamstring injuries or tendinopathies, especially in dancers or after some barre classes, so it is best to be prepared.
Whenever you deal with an injury, whether it be a hamstring, shoulder or neck, it is important to understand the individual muscles and joints and their functional role in whole-body movement. When you understand these patterns and your client’s activities, the development of a movement plan can be quite simple. It’s getting the load right that is the challenge.
The Role Of Hamstrings
Hamstrings are part of the deep longitudinal sling. They work in conjunction with the tibialis anterior muscles for dorsiflexion and the erector spine muscles for a thoracic extension.
The specific joint movements facilitated by the hamstrings include hip extension and knee flexion in various stages of gait.
Understanding these slings and joint patterns helps understand what function has been lost because of the injury and what can be done to support functional return. In the case of hamstring injuries, the exercise choices require a focus on return to walking, running and spinal extension. The grading of your client’s program depends on the mechanism of injury stages of healing, their particular goals and their condition before the injury.
Mutually respectful work with a physiotherapist is also essential.
Mechanism Of Hamstring Injury
There are a few different ways you can damage a hamstring muscle, including:
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