2002 Functional Design Systems

Transcription

1 1. Proprioceptive sensitivity has to do with not being too sensitive but being sensitive enough. 2. The hammies have a lot to do with all three planes of function. 3. In upright function, knee flexion is created by gravity. 4. The quadriceps and the hamstrings are not agonists and antagonists but synergists. 5. In function, the trunk is one of the drivers of the hamstrings. 6. Hamstring strains are not a result of bad hamstrings... they are a result of some thing causing the hamstrings to become bad. 7. The first thing to do to analyze the hamstrings is to ignore the hamstrings. 8. The golgi ligament endings in the collateral ligaments talk directly to the hamstrings. 9. Rehab is a functional extension of the analysis and the analysis is a functional extension of the rehab. 10.The key to rehabilitation is to attack the potential causes and then isolate out the hamstrings while integrated within pure function. 11.Rehabilitation and training and conditioning need to concurrently deal with mobility, stability, and proprioceptive reaction. 12. A hamstring will reform functionally if you do functional training. 13. In golf, effectively loading the hamstrings in all three planes helps create a powerful and consistent golf swing. 14. Functional exercises prepare one for functional activities Functional Design Systems

2 v3.5 HAMSTRINGS Eccentrically Powerful By: Gary Gray, PT OBJECTIVES FOR THE HAMSTRING FUNCTIONAL GUIDE To assimilate up-to-date information and knowledge about the hamstrings. To learn how to apply effective functional techniques when testing and training the hamstrings. To understand and appreciate the tri-plane Chain Reaction principles as they apply to the hamstrings. HOW TO USE THIS FUNCTIONAL GUIDE This functional guide can be used as a convenient summary of the program s contents to take with you after viewing. You can also use this guide as a notebook; space has been provided so that you can make notes on relevant tracts as you watch them.

3 Special thanks to the Michigan State University Equestrian Stable along with a special thanks to David and Jane. STRATEGY 1 Strategically revealing the analogy between the reigns on a horse and the hamstrings. STRATEGY 2 Strategically exploiting the myths relative to the function of the hamstrings. STRATEGY 3 Strategically intransformalizing by becoming the hamstrings. STRATEGY 4 Strategically appreciating all of the functional relationships of the hamstrings. STRATEGY 5 Strategically analyzing the body s relationships to the hamstrings and the hamstrings relationships to the body.

4 STRATEGY 6 Strategically rehabilitating the injured hamstring STRATEGY 7 Strategically preventing hamstring injuries through 3D Chain ReactionTM exercises. STRATEGY 8 Strategically transforming our understanding of the hamstrings into effective training and conditioning drills. STRATEGY 9 Strategically taking advantage of functional research to expand our understanding of function.

5 Oh, to be misunderstood Intransformalizing... becoming the part... becoming the hamstrings... during a hamstring knee flexion curl the hamstrings feel misunderstood. What the hamstrings do, what they do with everyone else, how they do it, who are their friends, how do they get done what they need to. Proprioceptive sensitivity has to do with not being too sensitive but being sensitive enough. The hamstrings have a huge origin on the ischial tuberosity with a criss-cross effect to their attachments across the knee medially with the semimembranosus and semitendinosus, and laterally with the long and short heads of the biceps femorus. The hammies have a lot to do with all three planes of function. In the sagittal plane, the hamstring s have relatively a lot of motion to give, not so in the frontal and transverse planes... therefore that motion in the frontal and transverse planes is more critical. In upright function, knee flexion is created by gravity. In ambulation, gravity, ground reaction forces, and momentum create knee flexion... the hamstrings immediately begin to decelerate hip flexion and knee flexion in the sagittal plane. Calling A Big Timeout In gait, with heel lift, the hip flexors create knee flexion during swing phase Invalid hamstring strength and flexibility testing During terminal swing phase the hamstrings get turned on. This occurs because of the hamstring s importance in decelerating the entire body in all three planes of motion. I need to have my electricity going. The quadriceps and the hamstrings are not agonists and antagonists but synergists. The hamstrings can set the body up good or the hamstrings can set the body up bad. The function of the hamstrings is complex, but understanding its complexity allows us to develop simple strategies and applications for effective analysis, rehabilitation, and training and conditioning programs.

6 The messages we are sending to the hamstring when we do a primary hamstring knee flexion training program Setting up the proprioceptive bias that will cause abnormal tightness Creates an inability to eccentrically lengthen effectively The butt is not important The foot is not important There is no importance for the three hamstrings There is no need to consider the transverse plane There is no importance to its eccentric capabilities at the hip, knee, foot and trunk Providing mixed messages Give artificial stimulation Maybe setting it up for injury Not synergizing with its friends Not taking advantage of hamstring dominance in all three planes Discussion of the hamstring s capabilities to decelerate in the frontal and transverse planes, especially with the change of direction. In function the trunk is one of the drivers of the hamstrings Taking a look at the hip flexors and their relationships to the hamstrings The bias of the opposite side and same side hamstrings due to dysfunctional hip flexors Influence of the foot in all three planes on the hamstrings Understanding the quads, hip rotators, abdominals, rhomboids and their relationships to the hamstrings Headaches and hamstrings... the dominance of the hamstrings throughout the entire body Because the hamstrings do so much we need to know them and their relationships inside and out

7 A special thanks to Doug Gray Analysis for prevention Hamstring strains are not a result of bad hamstrings... they are a result of something causing the hamstrings to become bad. Part of our analysis following injury is to determine what has been the warm up and training and conditioning program for that injured hamstring. The first thing to do to analyze the hamstrings is to ignore the hamstrings. Taking a look at the foot Single leg squats for ankle dorsiflexion Single leg squats with bilateral arm opposite and same side rotational reaches, at shoulder height Single leg balance with opposite leg medial reach Single leg balance with opposite leg same side and opposite side rotational reaches Description of foot function relative to the function of the hamstrings Gait analysis... description of the gait tweaks Taking a look at the knee Single leg squats... knee flexion excursion tests Single leg squats with bilateral arm anterior reach at waist height Single leg squats with bilateral arm anterior reach at waist height, with return to overhead posterior reach Single leg squats with bilateral arm anterior medial and anterior lateral reach at waist height, with return to overhead posterior reach Single leg squats with overhead bilateral arm medial and lateral overhead reaches Knee flexed, single leg balance, with opposite leg medial reach Description of the hips influence on the hamstrings Single leg squats with bilateral arm overhead posterior reaches Single leg squats with bilateral arm overhead posterior lateral and posterior medial reaches Single leg squats with bilateral arm opposite rotational and overhead posterior lateral reaches for a tri-plane tweak Taking a look at the hip Single leg balance with bilateral arm anterior, anterior lateral, anterior medial reaches at shoulder height Single leg balance without counter balance with bilateral arm anterior, anterior lateral and anterior medial reaches at shoulder height

8 We need to test and analyze what function demands Single leg balance with bilateral arm overhead posterior, posterior medial, and posterior lateral reaches Description of the iliopsoas relationship to the hamstrings The invagination of the hamstrings into the medial and lateral collateral ligaments... the golgi ligament endings in the collateral ligaments talking directly to the hamstrings. Single leg balance with opposite leg same side and opposite side rotational reaches The need for frontal driving through the hip as well. Taking a look at the trunk and arms Description of thoracic kyphosis posture and the thoracic spine influence on the hamstrings Single leg balance with same side arm and opposite side arm overhead posterior reaches Single leg balance with same side arm and opposite side arm same side and opposite side rotational reaches, at shoulder height Single leg balance with same side arm and opposite side arm overhead medial and lateral reaches Anterior lunges with exaggerated kick out Anterior lateral lunges with exaggerated kick out Anterior medial lunges with exaggerated kick out Anterior, anterior lateral, and anterior medial lunges with bilateral arm anterior reaches Anterior, anterior lateral, and anterior medial lunges with bilateral arm medial and lateral reaches Lateral lunges and posterior lateral rotational lunges with exaggerated kick out and with bilateral arm anterior, medial, and lateral reaches. Anterior lunges with bilateral arm overhead posterior reaches Anterior lateral and anterior medial lunges with bilateral arms, same side and opposite rotational reaches at shoulder height Single leg balance with bilateral arm anterior reaches at waist height with opposite leg posterior reach with drive return to overhead posterior reach with anterior knee drive. Single leg balance with bilateral arm anterior medial and anterior lateral reaches with opposite leg posterior lateral and posterior medial reaches with return drive to overhead posterior reach with anterior knee drive Adding the explosions to the loadings The rehab will smell a lot like the analysis... rehab is a functional extension of the analysis and the analysis is a functional extension of the rehab, because the test is the exercise and the exercise is the test.

9 Analysis and rehabilitation are a continuum... rehabilitation is ongoing analysis. Controlled 3D hamstring mobilization with four points of attachment with the TrueStretchTM Sagittal plane leg reach with foot in trough Leg rotation of foot in trough Bilateral arm anterior reach and hold Bilateral arm overhead posterior reach and hold Bilateral overhead medial reach and hold Bilateral arm overhead lateral reach and hold Bilateral arm right rotational reach at waist height and hold Bilateral arm left rotational reach at waist height and hold Frontal plane bottom up tweak with down leg moving to same side platform with all three planes top down arm tweaks Transverse plane bottom up tweak with down leg internally rotated with all three planes top down arm tweaks Assuming that we already have cleared the hip flexors, calf, hip rotators, thoracic spine and the entire trunk An integrated isolated stretch to the hamstrings Anterior reach and hold with leg rotations on 6 box with anterior, overhead posterior, overhead lateral, overhead medial, right rotational, left rotational arm reaches Anterior reach and hold with leg rotations on the ground with all three plane arm reaches Anterior reach and hold with leg rotations on table with down leg toed in with all three plane arm reaches Anterior, lateral, posterior lateral rotational lunges with bilateral arm reaches to knees Anterior lunges with bilateral arm anterior lateral and anterior medial reaches at waist height Anterior, lateral, posterior lateral rotational lunges with bilateral arm anterior reaches Anterior, lateral, posterior lateral rotational lunges with bilateral arm reaches with return to overhead posterior reach Single leg balance with bilateral arm anterior, anterior lateral, anterior medial reaches at head height Single leg balance with various tweaks including knee flexion, various arm drivers, the amount of momentum, range tweaks, speed tweaks and manual reaction All lunges tweaked with free weight loads with various arm drivers

10 Swing phase eccentric loading with bungee cord Posterior lunge with bungee cord explode into anterior lunge with dig heel into ground tweak Same as above with bilateral arm anterior reach Same as above with bilateral arm overhead posterior reach Posterior lunge with bungee cord explode into anterior lateral and anterior medial lunge Bungee cord loaded anterior reaches Mr. Ed counting Posterior lunge with bungee cord explode to anterior lunge and anterior leg reaches with bilateral arm bungee pulls in all three planes The key to rehabilitation is to attack the potential causes and then isolate out the hamstrings while integrated within pure function. All of our exercises need to be homeworkable. Debrief with Bob Wiersma, Executive Director, Functional Rehabilitation Network The mechanism of injury of the hamstrings Acute hamstring injuries and micro injuries of the hamstrings The mechanism of how the hamstring breaks down Understanding the deceleration of the forces in the transverse plane forces with a turn of the body Prevention through proper training and conditioning of hamstrings... concentrate on the transverse plane, eccentric loading, and a functional progressive dynamic approach Understanding the ecconcentric function of the hamstrings Why do isolated hamstrings curls? Rehabilitation and training and conditioning need to concurrently deal with mobility, stability, and proprioceptive reaction We need to start with function, we need to end with function and somewhere in the middle it has to be pure function The need for a flexed knee during hamstring mostability exercises The use of tweak loads with free weights and bungee cords The concept of functional minor polio The relative time duration of hamstring rehabilitation Pure functional rehab based on success You can t blame the hamstrings A hamstring will reform functionally if you do functional training Expecting functional success everyday

11 Dougy, Dougy, Dougy we are going to find out if we have any hammie, hammie, hammies. Already have done a proper 3D active warm up program Bilateral kettleballs work-out Single leg balance overhead sagittal, frontal, transverse plane drives Single leg balance alternate overhead to anterior drives Single leg balance alternate overhead to lateral and medial drives Single leg balance alternate rotational drives with opposite arm over head reach Single leg balance alternate rotational drives with opposite arm anterior reach 3D Lunge Matrix 3D Lunge Matrix with bilateral arm reach knee to shoulders 3D Lunge Matrix with bilateral arm anterior reaches to shoulders 3D Lunge Matrix with bilateral arm medial and lateral knee reaches to shoulders 3D Lunge Matrix with bilateral arm rotational reaches at hip height 3D Lunge Matrix with bilateral arm anterior reaches to an anterior kick with overhead reaches 3D Jump Matrix with bilateral arm foot to overhead reaches Amazing job by Doug Gray... his dad is oh so proud of him

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13 In order to go from a marginal player to a better player, a wise player looks at the great players and biomechanically analyzes what they do differently in order to become great and efficient. In basketball one of those differentiations is the ability to square up and balance in order to load for any type of a jump shot. In golf, one of those differentiations is to effectively load the hamstrings in all three planes for a powerful and consistent golf swing. Typical compensations for unprepared and neurologically tight hamstrings include hyperextended position of the knees and a thoracic flexion or kyphosis position.

14 Hammie Range Drills Right stride stance, toed out, butt out, vertical swing Right stride stance, toed in, butt out, vertical swing Left stride stance, toed out, butt out, vertical swing Right stride stance, toed in, butt out, vertical swing Right leg anterior reach and hold with leg rotation, butt out, vertical swing Left leg anterior reach and hold with leg rotation, butt out, vertical swing Golf stance, bilateral arm overhead posterior reaches, butt out, vertical swing Golf stance, bilateral arm overhead lateral reaches, butt out, vertical swing Golf stance, bilateral arm overhead rotational reaches, butt out, vertical swing The key question to ask with any transformation drill is Can I do the thing better? Practice properly based on good biomechanical principles

15 RESEARCH ROUNDTABLE WITH DR. DAVID TIBERIO Sherry MA, Best TM, A comparison of two rehabilitation programs in the treatment of acute hamstring strains. J Orthop Sports Phys Ther 2004 Mar 34: What a great job Bob Wiersma does with his debriefs Functional studies are gutsy studies knowing that we are giving the better medicine to the functional group This study used the trunk in more than one plane as a driver to the hamstrings The function of the hamstrings is to control the trunk in all three planes of motion Sagittal plane static group versus transverse plane dynamic group Return to activity: 37 days versus 22 days Re-injury rate within first two weeks: over 50% versus 0%

16 Functional exercises prepare one for functional activities Definition of gaposis Re-injury rate within the first year: 70% versus 5% Understanding the true cause of hamstring injuries Our Chain ReactionTM integrated functional rehab and training may be treating the cause without us specifically identifying the cause, compensation, symptom relationships If Pooh Bear looked at the function of the hamstrings Getting at the hamstrings from a bottom up approach, from a top down approach, and a combined approach in all three planes. A word of gratitude to those who did this excellent study. A special thanks to Dr. David Tiberio