Monthly Archives: June 2012

Understanding Hamstring Injuries

There has been a recent increase in hamstring injuries which has sparked an interest in sports therapists. In fact, hamstring injuries ranks second in frequency among the athletic population only to knee injuries. Sports therapists and researchers have found that those who have previous hamstring injuries are twice as likely to re injure their hamstring tendon. Other predictive factors include increased age, overweight individuals, tight hip flexors, and hip muscle imbalances especially weak hamstrings.

This leads us to the best way to care for hamstring injuries. First, it must start with an accurate diagnosis from your orthopedist, or other physician. There are several categories of hamstring injuries, including acute strains, tendinopathies and avulsions. These diagnoses are usually made through a comprehensive evaluation, clinical tests, and imaging studies including X-rays, ultrasound, or an MRI.

Acute strains usually respond best to core strengthening and avoiding direct hamstring stretching and strengthening early on. Avoiding early stretching and strengthening allows scar tissue formation within the hamstring tendon. This produces stiffness within the tendon which gives the tendon rigidity to prevent micro trauma to this region during the healing process. A physical therapist will be able to identify when in the healing process flexibility and strengthening should be initiated. During rehab, agility training with sport specific exercises may be beneficial before return to full sporting activity.

Tendinopathies refer to a chronic injury with swelling, thickening of the tissue, and scarring but no active inflammation. Physical therapists will usually focus on posture, alignment, core strengthening, and soft tissue mobilization. Motor control along with muscle activation patterns may also be monitored as with chronic conditions muscle substitution patterns are often identified. These injuries can benefit from eccentric loading which strengthen from a shortened position and moving into positions of elongating the tissue.

Rupture and avulsion injuries are the most serious and occur where the hamstring tendon pulls away from the bone and sometimes pulls off a piece of the bone. These are identified through the use of medical imaging. When the tendon retracts from its bony attachment, surgical intervention may be required to reattach the tendon. Usually a lot of bleeding into surrounding tissues is noted with avulsion injuries and bruising is present. This sometimes can press on neurological structures and cause tingling in the back of the leg.

Hamstring injuries can be agitating but given the appropriate treatment most people can return to their leisurely or sporting activities with some medical attention and a little hard work.

By: Chris Athos, MPT COMT


Caffeine as a Supplement

From the office executive, weekend-warriors to well-trained athletes, they are all looking to boost their performance. One approach to kick start improvements is introducing supplementation into a routine[1].

Caffeine is an often turned to supplement and it’s not just for the lethargic office assistant. This stimulant is known for its ability to “pick-me up” or if used correctly before a workout, it can give you a boost.

The most effective way to consume caffeine is by drinking regular coffee[2]. A cup of unsweetened black coffee before a workout (30-60 minutes) can give you an advantage; however, more individuals are using energy drinks. Take caution with this approach, because they are loaded w/ sugar and additives, which will hinder your performance. If you are feeling energetic before your workout/activity and have a well-rounded meal plan, there should be no need for supplementation.

Results from caffeine are very dependent on individual, the timing and the dose/serving. So, many factors go in to using caffeine with little to no effect, or in some cases a negative effect[3].

Please check out this link for additional info.

By: Rocco Ferraiolo PTA, NASM, SPARQ certified

[1] Most of the time tiny changes in an individual’s  workout or meal plan will give you the desired boost.

[2] Dark roast, having a more robust taste has less caffeine vs. a mild blend. The longer roast time strips more caffeine.

[3] On hot days, when the body needs fluids instead of stimulants. Caffeine can become addictive as well.

The Latest Information on Sunscreen

Summertime is back in South Florida and that means we need to be careful about exposure to the sun.  For skin that is not covered by clothing, sunscreen is a good option to protect against the suns ultraviolet rays.  When selecting a sunscreen product, experts recommend a broad spectrum product that protects against both UVA and UVB radiation.  It should also have a Sun Protection Factor or SPF of at least 15.  This means if it usually takes about 20 minutes of sun exposure to redden your skin, then SPF 15 should take 15 times longer, or 5 hours.  However, sunscreen needs to be reapplied at least every 2 hours due to sweating and environmental factors.

Application of sunscreen should be started 30 minutes before sun exposure, and about 1 oz. (about a shot glass full) is sufficient for full body coverage.  Studies show that most people only apply a quarter to a half of the recommended amount of sunscreen on their skin.  This amounts to almost half of an 8 oz bottle per person for a full day at the beach.  Reapplication should be started immediately after swimming or profuse sweating.  Even on cloudy days, sunscreen should be used because of UV rays ability to travel through the clouds.

The US Food and Drug Administration has issued new rules for sunscreen labeling, but they will not take effect until December 2012.  These rules will no longer allow labels to advertise their product as “sunblock”, “waterproof” or “sweatproof”.  They will be able to claim they are “water-resistant” but they must claim the duration they will protect while swimming or sweating.   Any product with an SPF below 15 will no longer be able to claim protection from skin cancer or early skin aging.


By: Steve Bernstein PT, OMT