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Re: Can I Have tips involving a pulled hamstring?
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Re: Can I Have tips involving a pulled hamstring? - May 20, 2006 12:39:00 PM
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JLS_PT_OCS
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Well, steve, the person who cares will be looking when the answer comes up. The person who cares keeps their mind open and does not practice the same first year of experience over and over again. I'm not suggesting we search continuously for an answer we're not likely to find, but merely to think about it and see the question in the context of overall clinical life. That keeps us open-minded.
I think, in this case, we know why the hamstring lengthens, but those who don't seem to care to know such things remain ignorant even though the answer is available. Perfect example of this phenomenon.
J
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
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Re: Can I Have tips involving a pulled hamstring? - May 20, 2006 4:11:00 PM
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Shill
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This is a perfect spot for a "Whatever". It is useless to debate when you have already reiterated my main point.
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Re: Can I Have tips involving a pulled hamstring? - May 20, 2006 6:55:00 PM
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ginger
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Jeffre, thanks for the highlights of this SIJ study, I'd be interested to read the full piece, do you have a link I could use , I don't have access to pubmed here as yet.
I know of only two manipulation and three mobilisation methods used to restore SIJ function , I'd be interested in the method used here. I warrant however that it was not because the SIJ function improved directly that improved Hamstring strength. More likely that in the course of moving the sacrum ,that mobilisation effects were produced at L5S1 , which reduced inflammatory inhibition of hams recruitment.
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Re: Can I Have tips involving a pulled hamstring? - May 20, 2006 7:16:00 PM
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ginger
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Jason , apropo research and my somewhat impatient view of studies that yield ever greater amounts of interesting though useless data, I'm reminded of my own experiences when putting forward plans for research for a masters in the early nineties. I badly wanted to commit to a proposition that there was a proveable relationship between SIJ dysfunction and PFS, or retro patella arthralgia as we said then.
My willingness to go that road was fully doused by my supervisor, who pointed out the many variables between the sacrum and the knee. Best to reduce your study, to just a way to examine the knee he advised , or your results will be pulled to bits and made a nonsense of by all and sundry.
No matter the value of this as a powerful and usefull proposition , leading to ( hopefully) a change to the manner physios went about their treatment. The diligent application of best science demands lots of little roads to be travelled first.
I shudder to think of the number of good ideas that are shelved because the road is too hard, or variables too confused to allow RCT's to proceed.
I for one am willing to have my work examined and rejected by anyone who reads it , I ask only to be read.
I recognise the caution and sanguine propriety in your resonses , yet can't help wondering wether you too have a sense that some people ( PT's physios health professionals in general )may have to be dragged kicking into new levels of understanding.
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Re: Can I Have tips involving a pulled hamstring? - May 21, 2006 12:08:00 AM
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nari
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Ginger
I don't support the view that the SIJ directly affects anything, but work on the much maligned joint must affect the lower lumbar spine and its neural environment in some way. So I agree.
I also support your statement about lots of little roads being taken to understand what is going on.
Many of these roads aren't well defined as yet, but can lead to entirely different perspectives if one keeps going....and reading.
Nari
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Re: Can I Have tips involving a pulled hamstring? - May 21, 2006 6:03:00 AM
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dfjpt
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[QUOTE]I don't support the view that the SIJ directly affects anything, but work on the much maligned joint must affect the lower lumbar spine and its neural environment in some way.[/QUOTE]Well-said. :)
Let's name the layers on the way to the SIJ: skin, dorsal cutaneous nerves (superior and medial cluneal), numerous flat ligaments attached to numerous other aponeuroses and skeletal bits, all highly innervated, all of which lead to probability of much Ginger-induced mechanoreception spreading far and wide, out from the region of the (likely perfectly innocent) SIJ, and much neuromodulation echoing back into the region through eccentrically lengthening motor outflow mechanisms, as the CNS tries its best to both take advantage of and buffer itself against the barrage.
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Re: Can I Have tips involving a pulled hamstring? - May 30, 2006 7:03:00 AM
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anoopbal
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You guys never cease to confuse me (:-
Correct me if I am wrong. Wont it help stretching a muscle to correct faulty miovement patterns? For example, if I have a tight hams and tight calf, I find it difficult to squat down fully.But if I stretch it prior I have no problem. So wont it help in the long run with my squats.
Thanks
Anoop
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Re: Can I Have tips involving a pulled hamstring? - June 7, 2006 3:50:00 PM
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GUESTPROUSER
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THe majority of injuries are either from:
a. Inflexibility
b. week oppossing muscle
egs for flexibility
a a runner that did a 1 mile run. Rests. Goes to the gym, does 25 reps of seated ham raises, and then goes to sleep, cant ask for nothing less than a muscle spasm! So theyer body them forces them to stretch, stretch and strech some more.
b a gymnast can do a 180 degree leg raise easily, whereas the average human being who never pick up anything of the ground past 90 degrees and only bend that far.
egs for injuries
a 500lb bench, 225lb row. Injuries galore. The head of the delt dont lie, thats why any elite athlete would have or make sure they have or attain a proportainal deltoid head.
b Massive quad, and no hamstring, looking for injury right, Its stated that the quad to hamstring ratio must be at least 100:80, tested in any local gym.
Warmup, Stretch, Loosen and Strengthen, and at least for health sake for those proportions.
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Re: Can I Have tips involving a pulled hamstring? - June 8, 2006 4:29:00 AM
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JLS_PT_OCS
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Anoop-
Welcome back. Yes, stretching a muscle is one way to decrease it's resistance to passive stretch and one way to allow more ROM at a joint, especially if the ROM currently allowed is not permitting good biomechanics or producing excessive force on painful tissues.
However, "dynamic warmup" type repeated motions toward the restricted range can have a similar effect, without the inhibition of some of the active contraction properties of muscle. Some of the properties you need for your squat, for example. :)
J
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Can I Have tips involving a pulled hamstring? - June 8, 2006 5:51:00 AM
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PHSPT
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J,Im curious
if stretching doesnt do much for ms lenghtening, then the PFJS pnts i work with, should not be able to have an increase in ms ROM after 4-6 weeks of PT. (i may have misunderstood what your alluding to here)
Personally I have seen a permanent change in the ability of a pnt to stretch after performing a religious HEP. of 30-40 secs twice a day.So what are these permanent changes attributed to??
A good question would be how long do these changes last, and how often do pnts need to maintain/perform stretches, before the ms returns to its original state??
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Re: Can I Have tips involving a pulled hamstring? - June 8, 2006 7:24:00 AM
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JLS_PT_OCS
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PHS-
As we stated before, increases in ROM are attributable to a neurological phenomenon, it's reduced restriction to passive stretch.
I didn't say the ROM doesn't increase, but rather that we are not changing the length of the soft tissue, but decreasing it's resistance to elongation. Confusing these two things leads to much therapy aimed at the wrong areas, for the wrong reasons....that's why it's important to acknowledge a difference.
It's not a question of semantics or being argumentative, but an important principle of understanding physiology that drives our treatment approaches and rationales.
Thanks.
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Can I Have tips involving a pulled hamstring? - June 8, 2006 12:59:00 PM
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nari
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Instead of thinking that a stretch produces a longer muscle in a physical sense, try the concept that the brain *permits* lengthening to occur, ie a return to the muscle's usual state, by neurological means.
Nari
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Re: Can I Have tips involving a pulled hamstring? - June 9, 2006 8:32:00 AM
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Shill
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Nari,
Does the unconscious brain permit these things too? Such as a comatose patient recieving PROM? Could it be a peripheral mechanism without central input as well? Sorry for the barrage of questions on a Friday, and even more sorry as it is Saturday there.
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Steve Hill PT
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Re: Can I Have tips involving a pulled hamstring? - June 9, 2006 9:39:00 AM
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emadshehata
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Shill:
Do you mean the patient in an incomplete consiouss state/complete alertness ?
But , I think as the person ,s awarness /consciousnss improves ,the abilities of the cortex to conquer pain increase .
Emad
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Re: Can I Have tips involving a pulled hamstring? - June 9, 2006 11:07:00 AM
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nari
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Shill
I don't know...
That is a $64 question,(or two) and I don't think it has been investigated - would be most intriguing. Particularly in the semi-conscious patient, where there is some awareness going on.
We'll need to tell V S Ramachandran to have a look at this... ;)
Nari
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Re: Can I Have tips involving a pulled hamstring? - June 9, 2006 4:26:00 PM
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Shill
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Emad,
I mean the completely out of it patient who doesnt respond to a coma stim program. Who knows, maybe these patients dont actually make gains in ROM during a bout of stretching. Ive never seen it studied in this population.
Steve
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Steve Hill PT
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Re: Can I Have tips involving a pulled hamstring? - June 9, 2006 5:36:00 PM
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nari
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Stretches are sometimes done on comatose patients with the theory that it can nourish cartilages, etc. I don't think that has ever been shown, either.
As for ROM, passive movements do not alter ROM in the case of normal tone; aren't needed in the case of flaccidity; and can damage muscle in the case of hypertonicity. This was well established in the 80s by Carr and Shepherd (Aust) who then promoted positioning regimes. PMs have not been done for years in the ICU scene, but if the relatives and friends are desperate to "do" something, we advocated for them to dovery gentle middle range movement only, and that made them feel more useful.
But...passive movements and re-establishment of patterns in the brain..? Who knows.
Nari
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Re: Can I Have tips involving a pulled hamstring? - June 10, 2006 2:22:00 AM
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emadshehata
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Steve:
Seems i was unconscious when those studies regarding passive motions had been performed in 80s,to be honest i have not read any concerning stretching on semiconscious people , but i am sure applying just gentle motions is not dangerous at all ,on contrary it is useful as a feedback even in those unconscious people ,keeping the cortex up to date /knowladgeable /active is good ,i do not have studies or evidences support my view.
Emad
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Re: Can I Have tips involving a pulled hamstring? - August 29, 2006 4:20:00 PM
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anoopbal
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I have raed in shirley Sahrmanns book about how if the gluteus maximus is inactivated/not firing properly, the hamstrings usually comopensates for it and get over overworrked and injured. Has anyone came across this idea?
Anoop
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