Tuesday, January 29, 2013

The Best Exercises Soccer Players Are Not Doing

As players fatigue, it is not difficult to imagine that they are more susceptible to injury. It is not just a matter of concentration. There are measurable physiological changes that should inform every coach's conditioning program. Conditioning should be more than just running around the field at the start of practice, or worse, punishment for losing the last game. By addressing these changes, coaches can both prevent injury and enhance performance, particularly in the latter stages of a game. In this article, I review several studies which purport to do just that.

INJURY PREVENTION

Askling and others considered the relationship between 10 weeks of eccentric training and subsequent injury in elite players. Thirty players were divided into two groups with one adding the training 1-2 times a week to their regular training. The group that performed just their regular team training served as the control group. Injuries were monitored over 10 months after the training intervention. The eccentric training group had significantly fewer hamstring injuries (3/15) compared to the control group (10/15).

The Nordic hamstring exercise was one of three interventions that Arnason et al., used to investigate the incidence and severity of hamstring strain. Participants, who were professional soccer players, performed as methods of comparison (1) warm up stretching performed independently with contract-relax stretching and (2) partner-assisted contract-relax hamstring flexibility exercises. The overall incidence of hamstring strains was 65% lower in the eccentric group (injury severity and re-injury rates were not statistically significantly different.)

In a separate study, Brooks et al., examined the effects of eccentric hamstring lowers and stretching on the incidence and severity of hamstring strains in 546 professional rugby players. The intervention group was reported to display significantly lower incidence and severity of hamstring injury than the strengthening group and the conventional stretching/strengthening group.

Nordic Hamstring Exercise


PERFORMANCE IMPROVEMENT MEANS

CONDITIONING AT THE RIGHT TIME...

Small et al, investigated, over 8 weeks, the effect of eccentric hamstring strengthening during soccer training, their capacity to tire (fatigability) and whether eccentric training has any effect on this. They commissioned sixteen semi-professional players who completed a 90-minute simulated soccer game. Isokinetic testing on the hamstrings and quadriceps was performed during half time and at the end. The subjects were divided into two groups, both performing the “Nordic hamstring” eccentric exercise twice weekly for the entirety of the study. One group performed the exercise during the warm-up, and the other during the cool-down. This latter group that had the better results as far as the study was concerned. They "showed significant increases in eccentric hamstring peak torque and the functional eccentric hamstring to concentric quadriceps ratio post-intervention compared to the warm-up group." The investigators concluded that eccentric strength training performed post-training reduced the effects of fatigue, but the beneficial effects are time-dependent. (Interestingly, FIFA's 11+ program has the Nordic hamstrings exercise as part of the warm-up.)

Clark et al., found that after four weeks of training with the Nordic hamstring exercise, vertical jump and peak torque of the hamstrings increased.

In the study by Askling et al., that I mentioned before, the investigators checked strength and speed as well. The eccentric training group showed statistically significant improvements in strength and speed.




... IN THE RIGHT WAY

Training the hamstrings, like training any other component, should not be a haphazard thing. It must follow the principle of progressive overload. Comfort et al., in agreement developed a continuum addressing rehabilitation needs for the injured athlete up to sport specific work for those targeting improved performance. It follows the 3-phase approach to hamstring rehabilitation after injury. After the first phase, they suggest low-velocity eccentric activities such as

  • stiff leg dead lifts,
  • Nordic hamstring exercise, and
  • split squats. 
  • in split-stance deadlift (“good morning” exercise) with the load in front of the body, as opposed to a posterior load utilized during the traditional performance of this exercise. The subject then leans forward through flexion ...
  • single and double leg deadlifts,
  • eccentric lunge drops (Begin in a split stance position and drops rapidly into a lunge position.)



The next phase involves higher velocity eccentric exercises designed to increase hamstring torque and lower extremity power:

  • squat jumps,
  • split jumps, 
  • bounding,
  • depth jumps
  • box jumps.
Split Jumps (Men`s Health)


Finally, sport specific progressions should complete the program.

Note: The italicized exercises were not listed in the program suggested by Comfort et al. Instead, they were from a separate discussion of conditioning the hamstring both for rehabilitation, injury prevention and performance enhancement by Brughelli and Cronin. I thought that they would fit particularly well as I try to provide a variety of exercises.

Comfort et al., also suggest a directional overload within their continuum. Progress from unidirectional linear movements to bidirectional and then multi-directional movements. Some of these exercises may include

  • single leg bounding, 
  • backward skips, 
  • lateral hops, 
  • lateral bounding,
  • zigzag hops and bounding. 

Once multi-directional closed and open chain exercises are tolerated, the next step is to address stride length and stride frequency. The former can be affected by running uphill while the latter can be improved by running downhill. Downhill running will also help the athlete get used to shifting between concentric and eccentric movements.

                                         

REFERENCES


Daniel Lorenz, D., Reiman, M. (2011). The Role and Implementation of Eccentric Training in Athletic Rehabilitation: Tendinopathy, Hamstring Strains, and ACL Rconstruction. The International Journal of Sports Physical Therapy. Volume 6, Number 1, Page 27


Greig, M and Siegler, JC. (2009). Soccer-Specific Fatigue and Eccentric Hamstrings Muscle Strength. Journal of Athletic Training. Volume 44, Number 2, Pages 180–184



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