Two Coaches & a Coffee

Speeding Past Injury: Rethinking Hamstring Rehab

• Darren Burgess & Jason Weber • Season 3 • Episode 5

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We delve into the complexities of hamstring injuries and explore an alternative narrative behind recurrence in athletes. Through an analysis of an AFL re-injury hypothetical, we examine current training philosophies and propose a re-evaluation of how athletes prepare for return to play.

• Examining AFL hamstring injury and recovery 
• Investigating traditional sports rehabilitation methods 
• Exploring the role of data and technology in injury prevention 

Join us in challenging the status quo in athlete rehabilitation!


Sponsored by SPEEDSIG.com

Jason Weber:

I'm Jason Webber and welcome to Two Coaches and a Coffee. Unfortunately, Darren and I have really been challenged on schedule this week, so what I've got for you now is just a little rant. I went on yesterday, got a lot to do wit spee s, but it's really about our industry and how we address information and running mechanics, specifically with respect to injury. So I really hope you take something away from this with respect to challenging your thinking and I look forward to speaking to you again real soon with darren, as soon as we can find time to get together. Thanks, and in this blog I'm just looking to overview an injury that's come up in the press in the last 24 hours. It's now February 27. In Australia, just this last 24 hours, we've seen a young AFL football superstar of the game, hayden Young. We've seen a young AFL football superstar of the game, john Hayden Young, come out with a repeat hamstring injury.

Jason Weber:

Now the purpose of this blog is not to have a shot at anybody but, much like I do with Darren on our podcast, two Coaches and no Coffee, I want to look at the components that are publicly available here. Just examine them for the point of coaches starting to or trying to learn from experience and learn from what's going on. Now I don't know what's happened and I'm not having a shot at anybody by any stretch, but I am suggesting that maybe, if we consider this ongoing problem that's endemic in all field sports, can we approach it differently, and it's something that I've tried. I've been working on trying to figure this out for the last 10 years Now. I've been in the game of professional field sports rugby and AFL predominantly for over 27 years, so this isn't a new problem, but what I think we need is a new way of looking at it. So this little blog is just about examining what's gone on and possibly understanding it a little bit better from a hypothetical perspective. I don't know the facts at all, I don't claim to know them, not having a shot at anybody but I just want to examine it for the point of sharing information with my industry, because I do believe and I say this publicly quite a lot.

Jason Weber:

I think our industry strength and conditioning, rehabilitation, physio need to be better. I think docs need to be better too. Like medical, we need to be better. Now, some of that is because of the information available to us. It's not because people aren't working hard and it's not because people aren't smart enough. I think people are trying to extraordinary lengths to get things right, but when we don't have necessarily the information we need, how can we create an intervention that will serve a great purpose if we don't know exactly where we need to go?

Jason Weber:

So if I look at this incident, so this incident was originally reported on February 4th, so it's February 27th today, so 23 days ago. He's come out and trained sometime in the last 48 hours and it's gone again. So you look at that, it's a 23, 21 day injury maybe. So that's sort of like a grade 1B. You don't know where it is, but for the sake of discussion we'll make it bicep fem, mid belly, distal muscular junction, anything around that. So we're not saying that it's complicated, we're just guessing. Remember, I don't know the information, but that's 23 days. So of that 23 days he's probably only trained meaningfully, maybe two to three times. From an AFL standpoint, maybe two to three times, and I mean going at ground balls, sprint, repeat speed. You probably only got two in there maybe one bit of match sim, something to that effect, before it's gone again. So in 23 days, let's say he's trained twice, it's gone again. Now they're saying publicly in the paper he won't be available for the March 15th game. We're surmising that he might be available March 22. That's another 23 days. So again, we'd expect that he'd probably only train maybe twice in that. So that's four days in 46 in the lead-up to a competition that is one of the hardest-running sports in the world. So the compromise to the athlete is enormous, is enormous and, as Birgit and I have talked about, the biggest risk factor to predicting injury is previous injury. So if you've got two back-to-back, you're now red lights flashing, alarm bells are on.

Jason Weber:

So what might have been done in that period? I've no doubt it would have been MRI'd. They would have got a great diagnosis. They would have looked at it clinically, right. What's the function? What have we got? What are our clinical signs in the physio or the medical practice? Have we got range of motion? Have we got strength, et cetera, et cetera. All would have been systematically done right, no question they would have gone to the gym. They would have gone right. We need to regain strength before we gain speed and I'm sure they would have ticked off the going of. A common trait of the mutt would be we look at eccentric hamstring, right? Okay, no doubt they've got some parity left to right. They would have some confidence in that.

Jason Weber:

We go out to the field. This is where I come in. We go out onto the field and what do we do? We use gps. We measure speed, we measure how many reps. You know what speeds, what distances, what reps, all of that stuff. Same stuff we've been doing for the 20 odd years. How long it's inside gps? For 20 years, same stuff. We've been doing nothing different.

Jason Weber:

Now, was there any analysis done in the field of how the running was done? Not sure. I would say no, right, and I'm not. The team he's with may have done something, but I'm suggesting that he probably did, and most teams around the world that I'm seeing, and they're not. Now, my bent in all of this is okay, we reduce clinical symptoms, we can demonstrate strength, we go on the field. All we do is run them and we have this survivor mentality. So if we run them today at 60% and they survive tomorrow, they must be good. Now, you've got to question that logic. I question it because I've lived it for a long time. You've got to question that logic. I question it because I've lived it for a long time. My bent is when we run a percent, ideally we've got pre-data about their running mechanics and we know where they sit. They come back and they run 60, we can say, right, that's where they are. And they run 70%. That's, we know where they are, exactly where they are.

Jason Weber:

There's a couple of great papers and I've put together a couple of papers on this and in fact for anyone looking at this blog reading it, I'm going to put a connection in down below somewhere. I'm not social media savvy but we're going to get that. We'll get a link down there to some of the reviews I've done on this. But there are a couple of great papers that look at the deficit in horizontal force on the ground during running after hamstring injury. There was a great paper out of the EPL that showed that that didn't exist. Now I've talked to the authors of that paper and I'm adamant that what they did was they rehabilitated the injury really perfectly and they got great results. But I think in the two studies that showed there were poor results or poor rehabilitation of the hamstring, they're in a lower level sport and what I'm suggesting is are we making mistakes even at levels like the AFL where we're not getting absolute recovery of that hamstring Because we're not measuring it.

Jason Weber:

All we're saying is you can go from A to B, create speed, but how they're doing it's changed. Now I know for a fact from Spesic one of the biggest changes we see with hamstring injury and with an ACL reconstruction with a semi-tendonosis graft is we see a change in hip lock. Now I've had two discussions in the last two weeks with three Olympic-level, multi-gold medal-winning Olympic coaches and we've been talking about hip lock, its impact, what happens to it when you get a hamstring injury and what happens to it in acceleration. So we've got this position where we know hip lock is super important In team sport. We're not measuring it. We're not measuring it. We're not doing it. We're doing the same stuff we've been doing for 20 years. So that's where I design spacing and no question this blog's about that.

Jason Weber:

I'm trying to share what we're doing. We're trying to use that GPS, imu unit, catapult or stat sports on the lumbar spine so we know where the body's center of mass is, or estimated center of mass. From that we can look at both legs, we can look at the vectors forward and backward, we can look at what the pelvis is doing. We can communicate this information. The other thing I'm going to add for anybody watching this video blog or reads the blog that I write with it, we'll put in a case study as well.

Jason Weber:

A great case study we did out of UK football last year, end of last year. Five repeat hamstring who did? We've got all their strength data in this, all strength metrics ticked off, including ridiculous levels on eccentric strength. If that blows your hair back, it doesn't blow mine back, clearly. But they also had markless motion capture data. So markless motion capture. Some good data came about. Performance, but there was no left to right. There was no designated difference. To identify the issue, speedsig were able to detect ground contact problem and a horizontal force problem which we were able to work with the team to come up with strategies to repair that, to fix it, to take what we'd already developed in the gym and we've obviously got going, get them back on the field but know more about what we're doing.

Jason Weber:

What drives me insane, and drove me insane for many years in team sport, is we don't really know. We have what I call a water cooler conversation, so we all stand around and we watch the athlete run and we go. Well, my opinion's this and your opinion. What are we about here? This is just prescription by jury. That's not good enough. Our industry is better than that. We're all calling ourselves scientists, we're using all the tech and we talk about the number of people talking about AI. How about we just figure out what the athlete's doing and we use it in a highly reliable, valid and scalable manner so we can capture data? That means something. Now, if you want to have a look at what we're doing with SpeedSeq, get on the links, jump on our webpage, speedcigcom. Yes, we're doing that. We're doing that with teams NFL, epl, afl, rugby League in Australia, nrl, national Rugby Union, six Nations teams. What we're trying to do is bridge that gap. We're trying to take GPS and it's the good stuff that it does to good stuff people doing in the gym.

Jason Weber:

But get onto the field on the field filling that blank spot so we know what's going on, so we can prevent the forlorn figure of a great player like Hayden Young walking around the boundary in running shoes because he can't run. Remember four training days in 46, minimum. That's if he goes back in 23 days after this most recent term. There's maybe a bit of now. They might be going well. Let's give him another week. So then that becomes, you know, six, seven days training in inarguably. You know 33 days, sorry, 53 days. That's an enormous miss and that's where our athletes get burned. The hamstring injury might be that bad and he comes back and that's fine, but then he hasn't trained, he hasn't done everything at the speed he would expect and he's a young player, so he might bounce back pretty well, but then in a couple of years there's an older player. You have the same thing. The older player doesn't bounce so well. Then we start seeing the repeat injuries and what we see in older players is, once they start missing this bulk of training, then that training load comes down and Birgit and I have talked about that a lot.

Jason Weber:

Like getting this right means asking harder questions and, more than that, asking how do we get the answers, how do we find the next bit of information? Not sitting in our laurels and thinking, hey, we've got a noise board, hey, we've got force plate, hey, we've got GPS, we've got everything. We don't. And I'm not suggesting for a second that speed is the absolute answer to everything. It's not. But you know what it is In the continuum from we come on the field sorry, leave the gym to the field. It fills an important gap here and what it might be is. It's basically the step before we do something else and we move forward. But what we can't do is sit on our laurels of 20 years of GPS data and go well, that's it right. What's next? We need to be better Again, like I said valid, reliable. We need to be better Again, like I said valid, reliable, scalable. We need multiple touch points of information in order to understand validity of running.

Jason Weber:

I had the pleasure of working with the great Professor Joe Hamel at the University of Massachusetts and he was very clear to me when we were speaking on this subject about how the variability in running. You need data to understand that variability. Capturing a couple of steps in January and capturing a couple of steps in June, not enough. Not enough to know. I had a great chat last night with a young coach up in the UK, a former resident of Alabama, but he was doing the same thing. He was saying to me hey, man, I'm videoing all of these guys. The best I can do. Of the squad of 40 young athletes he works with, I can video 10 and I can analyze them to the best of my ability. We've got to be better. We've got to be scalable. If we're going to use tech, it's not just AI. We need to use tech to multiply our abilities and our liability.

Jason Weber:

I hope everyone got something out of this, really hope. I want people to walk away from this thinking that what's the next thing we can do. If you read Johan Lade's work Johan Lade and I met on this. We've discussed it multiple times. He's thinking down this path already. He's looking for solutions. He's looking for ways to do this, and I know I'm not the only one in this space. There are plenty of other great practitioners thinking of. But I've chosen a technology path to follow because I know valid, reliable, scalable that's what we need, because I've been in the gig for 20 years, so I know what coaches need. So all the very best. I hope you walk away from this with something to think about and challenge yourself and we keep getting better.