115 Sports Massage: Enhancing Training, Participation and Recovery for Today's Athlete, 2nd Edition: Summary
CASE STUDY: EXTERNAL FOCUS
Trevor is a 22-year-old male. He plays on his college soccer team. This athlete has reported hamstring soreness after games for approximately 2 months. He has received regular treatment including foam rolling, PNF stretching and exercises of the affected area. He consulted the sports and rehab team for suggestions as his hamstring discomfort returned regularly. Assessment showed full range of motion of hamstrings and adductors bilaterally, although hamstrings were sensitive to direct pressure. His sagittal plane alignment of hip-knee-ankle was excellent. A lateral view did reveal slight to moderate anterior pelvic tilt.
Treatment Strategies Include: 1. Addressing the pelvic tilt: tightness in the hip flexors and low spinal erectors & weakness in gluteus maximus and abdominals 2. Muscle activation of the abdominal and gluteal muscles 3. Stretching- PNF stretching of hamstrings, Semi-straddle stretch, Hip flexor stretches 4. Manual hip flexor release Trevor’s Results: 1. Noticeable improvement in performance and reduced discomfort within the first 3 sessions 2. Addressed the imbalance between the hip flexors and gluteus maximus - powerful hip extension 3. Restored optimum recruitment of gluteus maximus 4. Decreased compensatory overactivation of the hamstrings ****Key Distinction of the successful results was to expand consideration to the hip flexors. Trevor’s hip flexors presented with increased tightness thus inhibiting the glute max resulting in the hamstrings (synergists)
super compensating and performing more hip extension becoming overworked. Question 1: What muscle is tight that is causing Trevor’s hamstring discomfort?
a. Hamstrings b. Hip Flexors c. Gluteus Maximus d. Back Extensors Commentary on Question 1: B
This is very common in running if the hip flexors are tight, they will inhibit the glute max and then the hamstrings (synergists) will super compensate and perform more hip extension and become overworked. So, athletes with sore hamstrings may have tight hip flexors that are super compensating and thus the hamstrings themselves are not inherently deficient. As a result, it becomes difficult for the hamstrings to recover because they are always being overtaxed. Question 2 : Overcompensation of the hamstrings in this example refers to the term? a. Synergistic Dominance
b. Reciprocal inhibition c. Agonist Activation d. Autogenic inhibition Commentary on Question 2: A
Synergistic Dominance. It is a compensatory mechanism and is the tendency of synergist (helper) muscles to overcompensate if the agonist muscles aren’t functioning at full capacity. As was the case in this example the hamstrings (synergists) were super compensating for the lack of activation of the glute max.
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