Core Healthcare Group January Newsletter
Pre & Postnatal Pilates Program & Hamstring Injuries
Prenatal and Postnatal Pilates Program- Article by Physiotherapist Elizabeth Ciranni
During pregnancy your body undergoes many adaptations as your baby grows. Common changes include the pelvis and lower back pulling forwards, upper back becoming rounded, and the neck poking forwards. Activating pelvic floor and postural muscles help to maintain a neutral spine position and protect your body against pain and dysfunction.
Pelvic floor strengthening supports our abdominal organs and internally holds our pelvis together.
Power Contractions are useful to practice to build up tolerance of the pelvic floor when the bladder is under stress, for example when we cough or sneeze. A power contraction is a maximal squeeze on and off. A maximum of 10 contractions should be practiced at any time.
Low and slow pelvic floor contractions (30% contractions) help with every day pelvic floor support and postural endurance. These contractions should be at 30% of the maximal contraction that power contractions reach, and you should work up to doing a 30 second hold at 30%. Initially, you may only be able to do 3 -5 seconds. This will improve with practice.
Both Power Contractions and 30% contractions should be practiced in the following positions at least 1-3 times per day.
Try to incorporate these things into your regular routine for ongoing maintenance:
• Inclined Supine
• Sitting on the ball
• 4 point kneel
The Role of the Hamstring in Hamstring Injuries – The culprit or victim? Article by Physiotherapist Robert Walsh
Hamstring injuries are one of the most common musculoskeletal injuries in athletes. They are the most common complaint in (McLennan and McLennan, 1990; Bennell and Crossley,1996) soccer (Woods et al., 2004), Australian Rules football (Orchard and Seward, 2002), cricket (Orchard et al., 2002a; Stretch, 2003), touch football (Neumann et al., 1998) and hurling (Watson, 1996). They are also very common in rugby league and union. Strains usually occur during the late phase of gait when stretching out or initial push off phase during running.
Not only are they common first time injuries but also as recurrent injuries. So why is this? A review of the literature has taken into account injury location, with relation to the hamstring anatomy and how they relate of overall body function, providing insight into how core stability could contribute to hamstring injuries.
There are three muscles that make up the hamstring group: The semimembranosus and semitendinosus medially and the biceps femoris laterally, with the biceps femoris being the most commonly injured of the three. The main role of the hamstirngs during running is transmitting force from the knee to the pelvis, where the musc large and powerful gluteus maximus drives the hip into extension for a powerful push off. The biceps femoris in particular also has an important attachment to the sacrotuberous ligament which has attachments to the thoracolumbar fascia. This fascia is extremely important to the stability and control of the spine and pelvis. The biceps femoris contributes to stability of the pelvis by pulling the fascia inferiorly.
Other important muscles that attach to the thoracolumbar fascia and contribute to spinal and pelvic stability include: The Gluteus Maximus which compresses the pelvis, Transverse abdominis, Internal and External Obliques which tension the fascia in a horizontal direction and Latissimus dorsi which tensions the fascia in a superior direction.
Research into hamstring injuries have shown decreased strength and delayed timing of transverse abdominis and gluteus maximus. When this occurs the latissimus dorsi can take a more dominant stability role and pull the fascia superiorly. This places increased tension on the biceps femoris which is a muscle smaller muscle. The authors indicated that increased stability and force producing role leads to increased activation levels in the biceps femoris can predispose to first time and recurrent hamstring strains.
This provides important insight into hamstring strain rehabilitation and prevention. Specific assessment into core and gluteal strength needs to be completed as part of rehab/prevention.
Of course, it is important to note that hamstring injuries are multi-factorial and other factors also need to be considered include: Sport type, training levels, running technique, appropriate warm up and cool down.