Pain Free and Pain Threshold Rehab Following Acute Hamstring Strain Injury
May 9, 2023
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Dr. Zach Baker, a specialist in sports medicine and rehabilitation, discusses pain-free and pain threshold rehab following acute hamstring strain injuries. Topics include managing pain levels during rehab, comparing outcomes of pain-free vs. pain threshold protocols, and strategies for recovery and prevention of reinjury.
Incorporating a pain threshold approach in hamstring rehab can result in better strength recovery post-injury.
Progressing exercises with a pain threshold approach can be beneficial in hamstring rehabilitation without increasing reinjury rates.
Deep dives
Importance of Pain Threshold in Hamstring Rehabilitation
The podcast discusses the importance of incorporating a pain threshold approach in hamstring rehabilitation. It highlights a study comparing pain-free versus pain threshold rehabilitation following acute hamstring strain injuries. The results showed that the pain threshold group had greater recovery in isometric knee flexor strength and better maintenance of hamstring length improvements. The study concluded that pushing patients past a certain pain threshold can be safe and effective in promoting recovery, without causing adverse events.
Research Design and Findings
The podcast delves into the study's design, which was a double-blind randomized control trial involving 43 participants. The participants were divided into a pain-free group and a pain threshold group based on pain levels during rehabilitation stages. The study found that the pain threshold group showcased increased hamstring flexibility and isometric knee flexor strength, with similar reinjury rates compared to the pain-free group. Notably, the pain threshold approach did not accelerate return to play but allowed for improved recovery aspects.
Practical Applications in Clinical Practice
The podcast explores the implications of the study's findings in clinical practice. It emphasizes that avoiding pain altogether during rehabilitation may not always be necessary and that progressing exercises with a pain threshold approach could be beneficial. Furthermore, it suggests incorporating early and progressive exercises to enhance eccentric knee flexor strength and hip extensor strength while respecting moderate to long muscle lengths. Additionally, the discussion touches on the use of blood flow restriction (BFR) training as a valuable tool for hamstring rehabilitation, providing insights for effective treatment strategies.
Dr. Zach Baker and our Sports Resident, Dr. Bami Adu discuss the Hip, but more specifically pain free and pain threshold rehabilitation following acute hamstring strain injury as part of their Journal Club!
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