Hi I injured my hamstring in a game of soccer 2 weeks ago. I went to the physio and she basically put some electrical equipment on me for a while, did a bit of massage, pressed my back and then did what she called slump stretching where she basically tried to bend me in half., like in those email pictures that occasionally crop up. It wasn't very comfortable on my back or hamstring.
Why did she do this slump stretching? I have an interest in anatomy and the body so I would be interested in your take on slump stretching, particularly for hamstring strains. What is it claimed to do and achieve, does it actually do this? Is there any evidence as to its proposed mechanisms? Do you see it as a viable treatment method for hamstring injuries, why/why not. If yes, is it suitable for all cases or does it have limitations.
Also what else can I do for treatment? Has there been any studies on this slump stretching to see if it works outside of theory? Have you ever used this slump stretching or do you have a better method to treat hamstring injuries?
Thank you. I missed the grand final through the injury so I have a while before the summer season starts again.
Good question and, like 80% of what we do in sports medicine, it is clinical experience rather than scientific evidence that leads physios to do slump stretching.
If you had a massive hamstring tear or a slipped disc then slump stretches might actually make you worse. The theory behind why they might make you better is that a lot of people are 'tight' in the low back, perhaps specifically the nerve root of L5, and mobilising the nerves might help.
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If 80% of what gets done isn't based on science what is the more important goal of sports medicine:
* injury surveillance across all levels of sports (similar to NZ).
* objectifying the gold standards to treat injuries through research.
My problem with the surveillance is that people will never agree on an injury definition eg: what presents at a hospital or what is subjectively described as an injury by participants. The advantage is prevention can occur and then you can pool resources to research the most common injuries. The problem with finding out how best to treat is that this is a very hard and costly study for the melange of different injuries that occur. Your thoughts?
It is possible to get definitions of injury that people agree upon. For AFL injury survey everyone has agreed (some reluctantly) that an injury is something causing a player to miss a game. A panel of international experts has just agreed upon definitions for cricket injuries. Under the New Zealand system, it is anything that turns up to get treatment under the insurance scheme (ACC).
Ideally we could do a randomised control trial on every form of treatment, but this will not happen. For example, surgery, which is the most important treatment, struggles to have any trials done.
Second preference to trials on everything is at least you can do surveillance. If outcomes and injury rates are getting worse, then maybe we need to modify what we are doing because things are going bad. If outcomes and injury rates are improving then usually it means that the common practice of treating or preventing the injuries is getting better.
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Thanks for the reply. As far as I know my back feels fine. Do you use slump stretch. If I booked in to see you how would you treat me and what protocols would you use to fix me.
what does a sports doctor do different to a physio and who are you best off seeing?
I think the main difference is to be a physio you don't have to palpate prostates, but it depends if you're a glass half empty or half full kind of guy Terry.
Treating a hamstring strain can differ depending upon the severity of the injury. For a first degree strain, ice and resting it with some elevation is the best way to treat it. For a second degree strain, ice, rest, and elevation are also necessary. However, a second degree strain will take around two to three weeks to heal. A third degree strain should be treated the same as first and second degree strains but may take longer to heal, around three to six weeks. Crutches may be necessary for a third degree strain. Waiting until completely healed before athletics or exercise is the best way to insure that an injury will not recur.