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 Post subject: Hamstring cures
PostPosted: Wed Nov 04, 1998 4:19 pm 
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Joined: Thu Sep 17, 1998 6:01 am
Posts: 157
Location: Evansville, IN, USA
On the old forums there was a thread about
various cures for a pulled hamstring other
than the old RICE principle. Whoever had
those cures please let me know, a student
here pulled her hamstring. Thanks greatly.

Osu!
Jason


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 Post subject: Hamstring cures
PostPosted: Wed Nov 04, 1998 9:55 pm 
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Joined: Thu Mar 11, 1999 6:01 am
Posts: 17136
Location: Richmond, VA --- Louisville, KY
Jason

RICE (acronym for Rest, Ice, Compression, Elevation) is the first stage of any injury. It's important to take a day or two off, as usually an injury like this is a tear that may be associated with internal bleeding. You need to first make the swelling and internal bleeding stop. Once you've had a good 2 days of RICE, you can carefully proceed to rehab.

The piece I wrote was for Van Canna, and it was targeted for his situation. He pulled a muscle a few weeks before his dan test, and needed to be as close to 100% as possible in a very short period of time. I recommended things for him that one should not do if you have the time to rehab in an optimal fashion.

First, I always tell people that they must have a relationship with their doctor. In very rare circumstances what seems like an injury may be something much more serious. One of my professors once "strained his back" while cutting wood. He was an M.D., and thought nothing of it. Turned out that he had bone cancer in his spine that was secondary to a huge tumor in his lung. He died 2 months after this was detected. But....ignore any doctor that wants to give you muscle relaxers and other nasty drugs. There is no short cut to real rehab. The best doctors are former athletes or those that "like" athletes (sometimes referred to as "jock docs").

REHAB:
Your friend needs to find a leg extension and leg curl machine. In many health clubs, these are two separate machines. You can pay a couple hundred at your local department store to get a cheap machine that has a lot of basic exercises, and these two should be on it. She needs to do 3 sets of ten repetitions of leg extension and leg curls, on BOTH legs, every other day. The "good" leg can tell you a lot about why the injury may have happened in the first place. Ideally the quadriceps (front of leg exercised in leg extension) and hamstring (back of leg exercised in leg curl) should have a 3 to 2 strength ratio. If that ratio is any higher then you are an injury waiting to happen. This happens a lot in karate, particularly when people exercise with a lot of squatting and low stances but then don't work on their hampstrings. The weight room is a great place to get this complimentary muscle pair back in balance.

The WAY you do these isotonic (same force) exercises is important in rehab. It's best in the beginning to leave the ego at home. Dial the weight way down, and get the agony of exercise from very, very slow contraction and relaxation of the muscle. If it aches afterwards (lactic acid buildup), then that's good. That will be associated with subsequent hyperemia (increased blood flow) which will bring in the good stuff and carry out the bad.

Pain is a very important tool in rehab. Best to take nothing more than a decent Over The Counter antiinflammatory/analgesic. Remember that acetaminohen (Tylenol) is a great analgesic (pain reliever), but not an antiinflammatory. Aspirin is good at both, but it changes your clotting time pretty dramatically. While that will keep grandpa from having a heart attack, it'll make you bruise too easily in the dojo. Ibuprophen (Motrin, Advil, Nuprin) works very well for this purpose. Naproxen also is good. I prefer the former. But back to the pain....you NEED this in the weight room. It'll tell you if you are overdoing it, or if you just tore something. There is a big difference between good pain (meaning there will be growth tomorrow) and bad pain (meaning you just tore something). The experienced athlete learns the difference. Getting drugged up by a couch-potato doctor will make you lose touch with this important sense. There's a reason why nature gave us pain! On the other hand....too much pain can indeed slow the healing process. There is a right dose of pain to work with to achieve optimal healing conditions.

If you don't like using even OTC drugs for pain relief, acupuncture is an excellent non-drug way to achieve an analgesic effect.

Heat vs ice is always a controversy during rehab for those who don't understand what is going on. Basically you use ice during the first 24 to 48 hours to stop swelling, bleeding, and arrest the onset of inflammation. Once you've accomplished that, you want to go to heat. This stimulates circulation which promotes healing. Best thing is to use MOIST heat for about 20 minutes or so before doing the exercises. Then alternate between the weight exercises and light stretching. If you feel like you might be overdoing it a bit in the beginning, it won't hurt to ice it afterwards. But once you are well into the recovery phase, stick with heat only.

Lots of people use various creams and majic ointments. Almost all of them have camphor, the stinky part of Ben Gay. It irritates the skin which brings blood to that point of the skin which creates a LITTLE bit of wamth. Some of the newer non-stinky creams have capsaicin in them, the active ingredient in chili peppers. And some of these creams/ointments also have an analgesic effect via a counterirritant mechanism (overload the pain circuits). If you can get someone to massage the creams, ointments, or oils on the injury, then that brings the benefits to another level. Personally I use other means to achieve all these benefits.

And in a perfect world, you will have access to a whirlpool at a rehab center. This simultaneously gives you heat and massage to the injured area. Once again, the idea is to promote circulation and cause clearance of fluids which contain all the nasty byproducts of an injury.

A quick note about something that most of us take for granted...make sure to get plenty of restful sleep and eat a well balanced diet. If you are looking for suplements, go for multivitamin/multiminerals that have (among other things), beta carotene, C, E, selenium, and other antioxidants like the phytonutrients found in fresh vegetables. And there are certain fatty acids (ecosapentanoic acid, gamma linoleic acid, linoleic acid, linolenic acid, etc) found in oily fish, flax oil, borage oil, etc that have an antiinflammatory effect. Be careful - overdosing on the good fatty acids (like taking too many fish oil capsules) can give you a similar "aspirin" effect of slower clotting time. Ideally you just have a diet rich in fresh fruits and vegetables, and get all your fats from gentle baking (NOT frying) of fresh fish like salmon, tuna, etc. Better yet, eat sushi! Remember that supplements are just that. And stay away from the other animal fats - they contain arachadonic acid which is pro-inflammatory.

Finally, a positive mental attitude is most important. There are many, many ways to achieve this: prayer, ANY cure that you BELIEVE in, humor, bowing to Mecca, etc, etc, etc. I cannot overstate this! Most people who claim majical cures using techniques that have no measurable "efficacy" are achieving their results by taking advantage of this phenomenon. In science we call it the placebo effect. Bottom line - it works, but has nothing to do with anything but your own mind. Your own mind is very powerful in medicine - IF you know how to use it.

I'll chant a few mantras for your friend.

Bill

[This message has been edited by Bill Glasheen (edited 11-04-98).]

[This message has been edited by Bill Glasheen (edited 11-04-98).]

[This message has been edited by Bill Glasheen (edited 11-04-98).]


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