Page 28 - ISAKOS 2021 Newsletter Volume 1

CURRENT CONCEPTS
Hamstring Injury Prevention
With the hips slightly flexed, the athlete must make a controlled descent of the trunk toward the ground, taking as long as possible through the contraction of the hamstrings, thus generating an eccentric contraction. The athlete is allowed to use the hands to cushion the fall and to push the ground to return to the starting position, thus minimizing the concentric contraction of the hamstrings (Fig. 1).
01 Nordic hamstring exercise. (Matthew Scott, Stephen Taylor, Paul Chesterton, Stefan Vogt & Daniel Lloyd Eaves [2018]. Motor imagery during action observation increases eccentric hamstring force: an acute non-physical intervention, Disability and Rehabilitation, 40:12, 1443-1451, DOI: 10.1080/09638288.2017.1300333)
FIFA 11+ Injury Prevention Program
The FIFA 11+ injury prevention program was developed by a group of international experts on the basis of their practical experience with injury prevention programs for players over the age of 14 years. This program is a complete warm-up package that should replace the usual warm-up before all workouts at least twice a week (Fig. 2).
FIFA 11+ has 3 parts, with a total of 15 exercises, which must be performed in the sequence defined at the beginning of each training session. The approximate time for execution is 20 minutes.
Part 1: Low-speed running exercises, combined with active stretching and controlled contacts between partners.
1 Straight running
2 Hips outwards
3 Hips inwards
4 Around the colleague
5 Jump with shoulder contact 6 Rapid running back and forth
Part 2: Six sets of exercises focused on core and leg strength, balance, and plyometrics/agility, all with three levels of increasing difficulty.
7 Board
8 Side board
9 Thigh muscles
10 Support on one leg
11 Squat
12 Jump
Part 3: Moderate / high-speed running exercises, combined with fixation/starting movements.
13 On the lawn
14 With jump
15 Fixing and leaving
The main elements of FIFA 11+ are core strength, neuromuscular control and balance, eccentric training of the thigh muscles, plyometrics, and agility.
Rehabilitation
The objective of a rehabilitation protocol should be to decrease the time to return to the sport, returning the athlete to the same level before the injury, without increasing the chance of a reinjury. Therefore, the rehabilitation protocol must have criteria to assess when the patient is able to progress to the next phase. These serial measures of subjective criteria (e.g., pain) and objective criteria (e.g., strength and range of motion) allow the protocol to be adjusted to the athlete and his or her responses to treatment.
Aspetar Protocol
The Aspetar protocol for soccer players4 is an excellent guide for rehabilitation of hamstring injuries. This protocol consists of 6 stages: 3 for physiotherapy and 3 for rehabilitation in the field.
02 FIFA 11+ Injury Prevention Program (https://kneesurgerysydney.com. au/wp-content/uploads/2017/05/FIFA-11-summary-poster.pdf)
26 ISAKOS NEWSLETTER 2021: VOLUME I