Tuesday, May 26, 2015

Does Vick's running style cause his hamstring ailments?

Michael Vick's injury has set off a firestorm of questions around the Philadelphia Eagles. Dr. Moore answers the question of how and why hamstring injuries occur?

Does Vick's running style cause his hamstring ailments?

If you didn’t know better, you’d think hamstring injuries were contagious with the way they spread like a virus through the NFL once the season starts. It seems that every team has someone out with a hamstring issue, and the Eagles are certainly no exception with QB Michael Vick currently sidelined.

Much less advertised in everyday life, many athletes are subject to this pain. Most people ignore it and try ways of getting around it but are still able to do the activities they love. Many try to stretch it until they no longer feel pain, or have someone push them into pain also seems to be a popular choice for a hamstring injury. I haven’t quite figured that one out yet. Here’s a tidbit—if it hurts, don’t do it. It is not helping the situation. So what is going on?  Why does it seem like hamstring injuries are becoming an epidemic?

Easy answer. Running. Seems simple enough, right?  If you do an in-depth analysis of Vick’s gait, much like many other people, he has an increased, what is termed ‘over-stride angle.’ This is done through a computerized running analysis that I am fortunate to have in my clinic. But every person that I have had on the treadmill and report hamstring pain has an increased over-stride angle.

In simplest terms, it most often means people over extend their stride and then strike with their heel and not with their midfoot when running. However, I assure you, I see an increased over-stride angle in forefoot and midfoot strikers as well.

Without going into a great amount of detail, increasing the over-stride angle also increases the microfiber trauma in the muscles surrounding the hips. The hamstring muscle group is one of the muscle groups that are damaged when there is an increased over-stride angle. So every time Vick runs he causes hundreds of thousands of individual muscle fibers to tear, microtraumas, the same as anyone else with hamstring pain. Microtraumas are completely normal and happen every day to everyone with just normal activity. It is the ones that occur over and over and over again are the ones that prevent proper healing and eventually lead to pain.

As part of the repair process of these microtraumas, the body forms scar tissue inside the muscle. Again this is a normal process. The scar tissue also forms in the connective tissue between the muscle fibers. The connective tissue has the job of allowing the muscle fibers to slide easily on top of one another.  This scar tissue restricts motion so the area can heal. Consider the scar tissue as a cast on the muscle. It allows the muscle fibers to have limited motion while they heal. As these casts become more prevalent it impedes the muscles ability to function normally and then the pain starts. The muscle has formed so many casts that it can no longer function in its normal capacity and it can no longer sustain any more microtraumas. So it stops people dead in their tracks and makes them unable to run and perform high level activities, such as football.

Unfortunately the scar tissue does not go away on its own or with stretching. It needs to be broken up using specialized manual techniques. Foam rolling the hamstrings does help, especially when the microtraumas have not become so great that they have caused pain. Adding foam rolling to the hamstrings following an intense workout will help break up and remodel some of the scar tissue—which may keep you off the sidelines. 


Read more Sports Doc for Sports Medicine and Fitness.

Owner of Total Performance Physical Therapy, North Wales and Hatfield, PA
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Whether you are a weekend warrior, an aging baby boomer, a student athlete or just someone who wants to stay active, this blog is for you. Read about our growing list of expert contributors here.

J. Ryan Bair, PT, DPT, SCS Founder and Owner of FLASH Sports Physical Therapy, Board Certified in Sports Physical Therapy
Brian Cammarota, MEd, ATC, CSCS, CES Partner at Symetrix Sports Performance
Ellen Casey, MD Physician with Drexel University Sports Medicine
Desirea D. Caucci, PT, DPT, OCS Co-owner of Conshohocken Physical Therapy, Board Certified Orthopedic Clinical Specialist
Michael G. Ciccotti, M.D. Head Team Physician for Phillies & St. Joe's; Rothman Institute
Julie Coté, PT, MPT, OCS, COMT Magee Rehabilitation Hospital
Justin D'Ancona Philly.com
Peter F. DeLuca, M.D. Head Team Physician for Eagles, Head Orthopedic Surgeon for Flyers; Rothman Institute
Joel H. Fish, Ph.D. Director of The Center For Sport Psychology; Sports Psychology Consultant for 76ers & Flyers
R. Robert Franks, D.O. Team Physician for USA Wrestling, Consultant for Phillies; Rothman Institute
Ashley B. Greenblatt, ACE-CPT Certified Personal Trainer, The Sporting Club at The Bellevue
Brian Maher, BS, CSCS Owner, Philly Personal Training
Julia Mayberry, M.D. Attending Hand & Upper Extremity Surgeon, Main Line Hand Surgery P.C.
Jim McCrossin, ATC Strength and Conditioning Coach, Flyers and Phantoms
Gavin McKay, NASM-CPT Founder/Franchisor, Unite Fitness
Heather Moore, PT, DPT, CKTP Owner of Total Performance Physical Therapy, North Wales and Hatfield, PA
Kelly O'Shea Senior Producer, Philly.com
Tracey Romero Sports Medicine Editor, Philly.com
David Rubenstein, M.D. Sports Medicine Surgeon, Rothman Institute
Robert Senior Event coverage, Sports Doc contributor
Justin Shaginaw, MPT, ATC Athletic Trainer for US Soccer Federation; Aria 3B Orthopaedic Institute
Thomas Trojian MD, CAQSM, FACSM Associate Chief of the Division of Sports Medicine at Drexel University
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