How to stay injury free…

Assess Treat Rehabilitate

Though I mention runners, the following points applies to anyone who trains and is looking to enhance performance with the inclusion of interval training, specifically sprints.

Why do runners start interval training?

Usually, to increase running speed and aerobic fitness delivering a greater stimulus to your heart, lungs and muscles. (1)

(An easy read article can be found here: American College of Sports Medicine-

How does the running stride differ between long distance runners and sprinting?

Quite a lot really, but we’ll just take note of one major point, a longer stride, this requires a fuller range of motion through the hamstring muscles and joints (knees and hips).

Unfortunately, the body does not instantly adapt to changes in exercise, this takes time, needing the right load at the right time with a progressive approach to development, something which becomes less efficient as we age.

One of the most prevalent injuries in runners is the hamstring strain, also common in football and many other sports (2).

Why do we get hamstring injuries?

Outside of ankle, knee, hip and spinal issues, hamstring muscle injuries are from overload which can happen when the muscle is stretched beyond its capacity or challenged with a sudden excessive load.

How can you maximise the muscle length?

Maximising the hamstring length allows for a fuller range of motion, when muscles are tight/tense they have an effectively a shorter range. Stretching, provided its regular and over a period of time can help you maintain a fuller range of motion (3).

How can you maximise the resilience and capacity to withstand the load placed on it?

Strength and conditioning (7), a structured approach to developing the capacity of the body to generate and withstand the loads applied to it through actions, based on physiology (tissue response) and research.

What is the best recovery and rehabilitation action plan?

A Cochrane systematic review 2020 (8) reported that no single approach demonstrated the prevention of a re-injury to Hamstring muscles, and outside of Manual therapy (treatment inclusive of manipulation, soft-tissues and specific interventions) did not show a clinical difference. We can hypothesis that altered mechanics and function once corrected minimised altered adaptations, however this doesn’t address the reason for the mal-adaptation and compensation patterns which negatively effecting the body movements.

The hamstring muscles are part of a complex musculoskeletal system which requires a global approach.

Muscle recovery will follow tissue response. Depending on the phase of repair- proliferation, regeneration or remodelling, will require the right load applied at the right time, this may include strength and conditioning exercises, stretching- isometric/PNF/static. But note the last thing you want to do with a pulled hamstring is stretch the life out of it… (4)

What is the best prevention plan?

We need to maximise muscle and joint performance-





Combined with.

-Assessment and treatment with a rehabilitation plan for prevention

-Gait Analysis, a way of identifying how you run or walk, examining the movement pattern as your feet contact the floor, looking for any deviations from normal/optimum movement, and any dysfunction.  

-custom made orthotics- using data from the Gait Analysis these will optimise ground contact, combining custom orthotics provided greater improvements in stability and performance. (6) providing improved sensory feedback needed for a more accurate foot positioning.

-Technique, a good technique is more efficient, less energy consuming and places a more balance load through the joints. (5) 

-Work with a coach, have a training plan that’s personal to you.  A good coach can minimise the risks, improve your technique and performance whilst identifying issues that need addressing.

Hamstring injuries plague amateurs and the professionals, even with the latest research and resources, to facilitate a successful recovery and prevent reinjury you need a multifaceted approach.

If you are experiencing a hamstring injury or any other injury contact Deansgate Osteopathic Clinic, we offer a complete rehab solution from ground contact to injury recovery with prevention strategies.  

“Assess – Treat – Rehabilitate – Strength & Condition – Integration”


1-Effects of Two High-intensity Interval Training Concepts in Recreational Runners (Faelli et al 2019). Research suggests that in recreational runners the 10-20-30 training is effective in improving aerobic fitness and performance.

2-Common Running Injuries: Evaluation and Management (Arnold, Michael J, Moody, Aaron L 2018) Running is a common form of exercise but predisposes athletes to several running-related injuries..

3-The research has demonstrated that when simple static stretching is executed regularly over a minimum of 6 weeks, flexibility is significantly increased (Bandy & Irion, 1994; Thacker et al., 2003).

4-Prevention of Hamstring Injuries in Collegiate Sprinters  (Yusaku Sugiura et al,. 2017). The incidence of hamstring injuries in sprinters decreased as agility and flexibility were added to strength training.

 5-Running Technique is an Important Component of Running Economy and Performance  (FOLLAND et al 2017).This study provides novel and robust evidence that technique explains a substantial proportion of the variance in RE and performance. We recommend that runners and coaches are attentive to specific aspects of stride parameters and lower limb angles in part to optimize pelvis movement, and ultimately enhance performance.

 6-Barton CJ, Munteanu SE, Menz HB, et al.2010. The efficacy of foot orthoses in the treatment of individuals with patellofemoral pain syndrome: a systematic review.

7- Swart NM, van Linschoten R, Bierma-Zeinstra SM, et al. 2012. The additional effect of orthotic devices on exercise therapy for patients with patellofemoral pain syndrome: a systematic review.

8- Effects of Strength Training on Running Economy in Highly Trained Runners: A Systematic Review With Meta-Analysis of Controlled Trials, C. Balsalobre-Fernández et al,. 2016

 9- Interventions for preventing hamstring injuries: Systematic review. Elliott F Goldman, Diana E Jones, 20 January 2010

 10- G Waddington, R Adams, and  S Bartold 2010. Football boot insoles and sensitivity to extent of ankle inversion movement.





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