loris bertolacci

Sport, Health and Fitness


Hamstring Injury Rates are not going down. Recurrence rates are, but Hamstring Injury remains a frustration. I wanted to explore the INSEASON period as a time when most injuries occur and a block which is totally different to pre-season due to the fight or flight response and recovery needs after games. The research meets practice pretty well in preseason. But inseason, the search for predictive models needs to be approached with caution because of the chaos that AFL brings.

Recent research on fascicle length inseason is fascinating and could lead one to a conclusion that we should smash the Nordics all year round.

“Fascicle lengths of BFlh vary across the in-season period in elite AFL players and the extent of these alterations appears to be influenced somewhat by HSI history. However, independent of injury history, there was a gradual decay in fascicle length as the season progresses.” 1

What I haven’t been able to find is whether the timing of new hamstring injuries occurs timed with “gradual decay in fascicle length”? My gut feel is not quite. I struggle with the definitions of High Speed Running and Accelerations with GPS because it makes intuitive sense to me that hamstring injuries occur at 100% intensity. From a load perspective and fatigue this research is invaluable, but we do know that hamstring injuries occur at close to or at 100% intensity. I have used GPS data extensively, but it almost does not cut it when looking at huge eccentric forces that occur at terminal swing range of lower leg.

So with GPS data tread very carefully! This table from Sherry shows at 95% maximum speed seems 80% eccentric force needed! From 95% to 100% increases 20%. Almost a fight or flight response.


So I am going to assume that there is no spike in hamstring statistics at the end of the year. I might be wrong. Don’t have the data.

Jesse Owens in the mid 30’s jumped > 8m in long jump so produced force and ran what is thought the be equivalent to 10 flat now all things considered. And let’s assume no conditioning but just adapted to maximal speed. AFL players would dream of being as good an athlete as Owens bar one or two maybe. So we always need to understand the neuromuscular basis of adaptation and not just structural. He ran often at 100% and adapted and there was no formal conditioning. In reverse my bet is this can never happen. Yet most of the discussion is what happens in conditioning. The gym.


In professional Soccer in Europe hamstring injuries are on the rise as Ekstrands study shows.

Conclusions Training-related hamstring injury rates have increased substantially since 2001 but match-related injury rates have remained stable. The challenge is for clubs to reduce training-related hamstring injury rates without impairing match performance” 2

In the AFL the issue is more in games. So in Soccer in Europe very tough to get that eccentric loading in a week when multiple matches are played and they have a short pre-season. Whilst studies are showing that teams are not using Nordics have more injury, I really think this research would have to be examined closely to how often teams play and just recovery. But it has to be taken into account despite historical rise in injury rate and one would think greater adherence to injury prevention methods would work. Maybe!

Periodization in the AFL fits a pretty stable model. The research with Eccentric Hamstring Strength is a given in my opinion.

“Low levels of eccentric hamstring strength increased the risk of future HSI. Interaction effects suggest that the additional risk of future HSI associated with advancing age or previous injury was mitigated by higher levels of eccentric hamstring strength.” 3

So there is no doubt that this needs to be addressed pre-season. And then enough sprinting must be included preseason to enhance immunity from injury.

A neat study on Gaelic Football adds to need for maximal velocity running in the prep phase.

“High chronic training loads and exposure to bouts of maximal velocity running reduce injury risk in elite Gaelic football” 4

And then the “little rocks” need to be addressed. 1. Biomechanics and 2. Lumbo Pelvic issues with 2 neat studies demonstrating these vital “little rocks”.



Most clubs will advise players who had a full load the season before to have a break and then ramp up training prior to pre-season starting in November or December depending on whether they played finals or are allowed more weeks off due to their years in the system. Most clubs also will assume that healthy players have done a build-up of training prior to the formal pre-season so usually they are expected to be ready for high speed (maybe not sprinting) from day one.

AFL Periodization Table I made up referring specifically to Hamstring Injury protocols.


When I started AFL in the late 80s a few people made me some glute ham machines! I had used them in Europe in 70’s and also read Dr Yessis review.


So I don’t want to get into a discussion on what type of exercises we would use and when should we progress from concentric to eccentric to maximal eccentric but this search for the Holy Grail probably started in the Greek Olympics!

In the 2000 to 2007 period in AFL it was pretty basic with me. Nordic lowers, RDL’s, Glute thrusts, pilates scooter exercise, 2 up/1down leg curls, back extensions 2 and 1 leg , high bench step-ups, swiss ball curls, isometric bridges and many other variations. Focus was high level eccentric exercises in prexmas block. Sprinting was increased from short accelerations at high speed to maximal velocity by Xmas so we had a big “minestrone” of eccentric stress. DOMS was loved (except by skills coaches) and we tried to take players to the edge but not over to get that immunity going! All this worked and from 2001 to 2006 we had half the hamstring injury rate to AFL averages. That is RAW HARD DATA!  One year tells you nothing but raw hard data of 3 years of more says you are doing something right. But we also made sure lumbo pelvic issues were addressed and biomechanical issues addressed.

I would prefer a player has a high chronic load of maximal speed and low to medium high speed running than low load of maximal speed running because that player will in my opinion be more prone to injury. And a factor called the SPEED RESERVE needs to be mentioned. If players have run at high intensity in pre-season they may never need that in season so the concept of a SPEED RESERVE may overtake the need to whack into eccentrics in season. Go faster, accelerate faster than you will in season and survive preseason and you may have a Speed Reserve which may translate to architecture?

But in general if you adhere to Gabbetts research on loads and get into the players from all angles eccentrically not a bad recipe pre-season.

Come January in the AFL brings a unique problem. This is where research and periodization and psychology don’t quite interact. After the Xmas break all the players and coaches get new boots for Xmas! They know the season is close. Grounds are fast. So every factor needs to be taken into account individually, given skills loads and intensities increase, gym (performance weights) intensity often still increase, and simply the athlete is better prepared so goes a bit faster!

The next phase in February is tricky. And this then falls into the laps of the coaches, high performance department and medical staff to make the right decisions or just have a philosophy. Given Intra club games commence and micro-trauma increases and fight of flight kicks in. How much you push the window in this phase is so individual. Chronic loads may still be elevated but are you still dosing eccentrically at same loads and volume? There is a massive distinction between maximal sprinting and high speed running.


Statistics for Hamstring Injury are not dropping but recurrence is which simply suggests better rehabilitation and return to play protocols. And most injuries are in a game. Recent data is looking at weekly spikes in high speed running as a predictor to injury. The main decision from staff is when did INSEASON start?  Then the next question is IF a player has had a full preseason, have they worked maximally in speed in games. Then do you continue to dose eccentric exercises or do you rely more on the protective mechanism of running at maximal intensity weekly? Again with GPS this is tough. Because players may be > 24km/hr and accelerations of >3 but may never reach maximal speed. GPS data is great for LOAD feedback but not maximal eccentric load feedback.

Let’s examine players who are playing regularly and who are deemed to be reaching maximal speeds in a game on a weekly basis. Should a lower intensity posterior chain program be incorporated? Will there by a massive drop in season on the nordbord or on an isokinetic eccentric test or a flywheel test? Evidence suggests architectural changes occur in season. Can you reliably test players maximally in season though? In my opinion a lot of players will hold back if they feel anything in season. Plus the logistics are massive because in season they take 48 to 72 hours to recover before a max eccentric test can be done. I assume these studies are happening but from an historical perspective some of the fitness tests in season I did were a waste of time.

So there is some “panacea” PRESEASON with the big rocks being a progressive speed program and eccentric hamstring strength program in place that pushes the window and elicits adaptation and maybe a SPEED RESERVE,  PRE-SEASON is the BIG BABY or ROCK with eccentric adaptation and then tick other boxes.

But INSEASON the word multifactorial takes on another meaning. One of my friends in the AFL said the secret is that all staff and players are on the same page. Everyone knows what is happening to a player, their load, treatment and management. Thus information is passed on ASAP after games and with everyone on the same page from Sports Scientists to Welfare Officer to Coach a decision can be made how to dose a player on the ground and in the gym. This leads to a “somewhat” broad brush of administering eccentric dose preseason to very individualized approach in season.

INSEASON the shift should be subtle in my opinion but a half-baked Nordic after a Skills session on a Wednesday night is in my opinion maybe a waste of time. And if a player has kicked a lot that session plus not recovered from the game then a valuable exercise could become another stress which the player can’t recover from before the next game. And this is tough to predict and is part science, part management, part art.

So apart from dosing eccentric when needed of course (players who missed games/game time) loaded players may benefit from a slight shift in exercise protocol in season for hamstring strength. Exercises such as back extensions 1 and 2 legs, eccentric leg curls, swiss ball curls preferably unilateral, hip extension exercises and so on. Some form of performance weights need to be maintained but this is different. For example a trap bar deadlift with low reps. Dynamic warm-ups become critical.

It actually becomes tougher in season and means a lot of work has to be done by STAFF looking at any factor that could assist in preventing hamstring injury from load management to eccentric

dosage to ‘small rocks”. By “small rocks” I mean things like glute activation or range of motion or wellness or anything!

I think there will never be a load ratio or strength test that can accurately predict an injury. Bahr has shown screening cannot predict injury. 5. So in terms of hamstrings just throw a hamstring program at them preseason and track players who have been injured all year round. Despite some people saying they have found some predictive screening protocol I will stick my neck out and say they will always have their hands burnt with a hamstring injury in season when they least expect it.

So in season is more multifactorial management of players. I came up with a little table that reflected how one might approach hamstring injury prevention in AFL and stuck my neck out and put some % in without data, just used ART!

SCIENCE: Ticking BIG ROCKS of Hamstring Strength and Speed Dosage and ticking little rocks with areas such as Biomechanics and Lumbo Pelvic issues

ART: Well you always have to make a decision and would be nice if GPS data or a NORDBORD test removed the grey areas!

MANAGEMENT: Preseason the priority is that players are eccentrically dosed and exposed to maximal sprinting and so player cannot be mollycoddled BUT caveat is enough management to avoid actual injury!

table 2


  1. IN-SEASON ARCHITECTURAL ADAPTATIONS OF THE BICEPS FEMORIS LONG HEAD IN ELITE AUSTRALIAN FOOTBALLERS. Ryan Timmins, Matthew Bourne, Morgan Williams and David Opar. Br J Sports Med 2017 51: 395
  2. Hamstring injuries have increased by 4% annually in men’s professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study            Br J Sports Med. 2016 Jun; 50(12):731-7.
  3. Opar, David A., Williams, Morgan, Timmins, Ryan, Hickey, Jack, Duhig,Steven, & Shield, Anthony (2014) Eccentric hamstring strength and hamstring injury risk in Australian footballers. Medicine & Science in Sports & Exercise, 46.
  4. J Sci Med Sport. 2017 Mar;20(3):250-254. High chronic training loads and exposure to bouts of maximal velocity running reduce injury risk in elite Gaelic football. Malone S1, Roe M2, Doran DA3, Gabbett TJ4, Collins K2.
  5. Why screening tests to predict injury do not work and probably never will. a critical review. Bahr R.Br J Sports Med 2016; 5, 776-780

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October 29, 2017 Posted by | Rehabilitation, Strength and Conditioning, Track and Field | 2 Comments

Is there a case for Decelerated ACL Rehabilitations?

Below is a link to an article on the recurrence of ACL injuries in the AFL.

Article on AFL Website “Recurring ACL injuries” May 6, 2014 Adam McNicol

“Eight of the injuries suffered in 2013 were cases in which players needed a second reconstruction after their initial graft failed. In three of those cases, a LARS graft had been used. Sparking concern is the fact that no more than four players experienced the failure of a knee ligament graft in one year during the previous decade”

Hamstring strains continue to be NO 1 injury in the AFL without fail, so one has to tread carefully about making too many conclusions after one years data.

But what interests me a lot is the concept of accelerated ACL rehabilitation. Because it is a fairly easy rehab program versus many others, in my view it is fraught with danger. So many athletes feel quite ok by 6 months and many young athletes simply cannot understand why they can’t twist, turn and play when they feel ok. The science behind grafts doesn’t gel with them. If it doesnt hurt and feels ok running “I should be ok!”

There are many studies appearing that look at the time to return of ACL rehab. and also recurrence rates and numbers vary. One interesting study given my interest now is often with the young athlete was a 2012 study American Journal of Sports Medicine: “Return to High School– and College-Level Football After Anterior Cruciate Ligament Reconstruction. Below is a summary of study:

” One hundred forty-seven players (including 68 high school and 26 collegiate athletes. Return to play rates for all high school and collegiate athletes were similar (63% and 69%, respectively). Based on player perception, 43% of the players were able to return to play at the same self-described performance level. Approximately 27% felt they did not perform at a level attained before their ACL tear, and 30% were unable to return to play at all. Fear of reinjury or further damage was cited by approximately 50% of the players who did not return to play. ”

But I thought an interesting excerpt from an abstract was made in the following study about return to play after ACL rehab.
International Orthopaedics February 2013,  Return to sport following anterior cruciate ligament reconstructionJulian Feller, Kate E. Webster

“Little is known about how to determine when it is safe to return to sport following ACL reconstruction or how to predict whether an athlete will be able to successfully return to sport. Finally, it needs to be recognised that return to sport following ACL reconstruction is associated with a risk of further injury and the development of osteoarthritis”

Yet time and time again on the internet or at conferences we get neat little packages of when to progress through a ACL rehab. and it reads so nicely given it is a ‘boxed in” with progressions such as ability to balance or ability to leg press or hop on the spot. Usually a neat powerpoint with each slide being a neat progression.

Given what is is appearing in studies of graft maturation and also the fact that players often take a minimum of 18 months to get some real form going one wonders if a more conservative approach is required. My subjective experience has been that athletes who  have progressed slowly and taken 12 months to rehab seem better off. I said seem! No data.

One study I read about graft revascularization said that it took 2 years to come back to normal.

Skeletal Radiology (2013) “By 2 years postoperatively, revascularization completion coincides with the homogeneously low signal intensity of the graft, closely resembling native ACL”

I know that some people can play at 6 to 9 months and are ok. And certainly avoiding high risk positions sometimes can be lucky or simply things just stick.

Another older study threw up the interesting notion of how well players perform at 18 months and this study suggests not as well which is my subjective experience.

Outcomes of Anterior Cruciate Ligament Injuries to Running Backs and Wide Receivers in the National Football League The American Journal of Sports Medicine, 2006
The present study found that approximately four fifths of NFL running backs and wide receivers who sustain ACL injuries return to an NFL game. The majority of returning players first compete in an NFL game 9 to 12 months after injury. On return to competition, running backs and wide receivers after ACL injury are approximately two thirds as productive as they were before injury. These players were selected as the focus of the study because running backs and wide receivers are the offensive skill positions with the highest frequency of injury,3 and components of their performance can be objectively measured.

And an even older study spoke about how one leg hops did not return to normal after 18 months. This is something I have often seen given lack of confidence when hoping. At one conference I went to recently a study had players hopping 3 hops the same as the good leg after 6 months. But the distances quoted were very poor so in my opinion meant little given there was doubt that the athlete has been tested maximally on the contraleteral leg. And so many footballers just hop so poorly anyway. I did a million hops myself and with athletes and have a good feeling for benchmarks for 3 hops. In my opinion these tests have to be maximal otherwise like a lot of testing is pretty useless data.


J Athl Train. 2002 Strength, Functional Outcome, and Postural Stability After Anterior Cruciate Ligament Reconstruction

“After ACLR (mean = 18 ± 10 months), subjects did not have significant loss in bilateral or single-limb postural stability when assessed with a Biodex Stability System.Functional hop performance were not within normal limits when compared with the contralateral limb and a control group.  (as assessed with a single-leg hop-for-distance test) may not return to normal (±5%) for up to 2 years”

Exercise Physiologists and rehabilitation specialists often get very excited about getting a player back to play. But with the statistics seemingly showing that there are many issues associated after an ACL rehabilitation, I wanted to throw up a curve ball.

What would these statistics be if worldwide everyone for 10 years  slowed down and progressed slowly and played high level sport ( twisting/pivoting/accelerating etc) after a 14 or even 18  months ACL rehab?

I remember once at a conference an eminent doctor in the AFL saying that 3 weeks was enough for an AFL hamstring rehab because whilst there would be the odd clanger 4/5 weeks was just too long and hurt clubs on the field missing good players. Well years later clubs were forced to take longer with hammie rehabs and recurrence rates were lowered.

Tough one the ACL reco. But what worries me so often is the cavalier attitude of young athletes who have been reconstructed, the lack of understanding of what is happening and the excitement that many rehab professionals have in getting an athlete back on the pitch early. Plus the Internet!






May 6, 2014 Posted by | Rehabilitation | Leave a comment



Available on my website now

Loris Bertolacci Site


This E Book is a complete resource for anyone that needs to devise practical programs for hamstring rehabilitation. It delves into the current research on this area to back up the programs.

This 120 page manual includes over 150 Exercises and 8 different programs including specifically designed Running, Agility, Stretching and Weight Programs to help any athlete get on the road to a safer and more sound recovery.

Section 1: Hamstring Theory

  1. Introduction

  2. Anatomy

  3. Overstriding and Hamstring Injury

  4. New Studies Implicates the Core in Hamstring Injury

  5. Other Muscles that Impact on the Hamstring

  6. Hamstring Exercises

  7. Why Injuries

  8. Trunk Stability and Hamstrings

  9. Different sports and Hamstring Rehabilitation

  10. So what do you do if you hurt your Hamstring?

  11. Healing Times and Rehabilitation

    Section 2: Practical Section

    Program Advice

  12. Sample Sessions

  13. Mobilization Sessions

  14. Running Sessions

  15. Mobility Drills

  16. Running Drills

  17. Running Sessions 2

  18. Strides

  19. Agility Sessions

  20. Weights Sessions

  21. Stretching after Training

  22. Plan your own rehabilitation

October 14, 2007 Posted by | AFL, General, Rehabilitation, Soccer, Strength and Conditioning, Tennis, Track and Field, Volleyball Strength and Conditioning | Leave a comment

Hamstring Injury Statistics in the AFL and E Book

What qualifies me to write an E Book on Hamstring Rehabilitation?

I was a track coach in the 80’s before starting in the AFL in 1987 and trained some good sprinters and jumpers and so experienced first hand the needs of high speed running.

I was very lucky to work in the AFL for 20 years and to experience the day to day needs of rehabilitation, and in this case hamstrings.

Given this “hands on” practice I learn’t by trial and error. But also I was privy to many experts in this area. I researched every journal, went to conferences and spoke to anyone who seemed to know what they were doing, here and overseas.

From 1997 to 2005 in particular I was able to develop some specific strategies to try and prevent hamstring injuries and also rehabilitate them efficiently and not make mistakes in when to return to competition. Recurrences cause so many long term problems.

I have already gone through this in another article. ( Hamstring Injuries in the AFL. Perception becomes Reality). It involves a multifactorial approach. From core stability to running fast to recovery and load management.

The statistics I achieved validated my plans. I had an average of under 10 games lost per year to hamstrings. AFL has averaged approximately 20 games lost per club per year. My worst year in this block, was one year at average AFL statistics.

Apart from the AFL, I have worked with many elite sportspeople and athletes over this time and continue to do so. I have worked in soccer, tennis and track and field recently and saw the different demands on hamstrings compared to the AFL. This year I also did some work in Volleyball and the equation changes again.

The best way to learn how to do something is hands on. I have done that. But I also have taken an evidence based approach to ths area.

The E Book will have a comprehensive theory section and then some practical programs that can be used for 2/3/4/5 and 6 week programs.

I am sure it will be useful and interesting.

October 4, 2007 Posted by | Rehabilitation, Uncategorized | Leave a comment


The biggest mistake with hamstring running programs is to have more than a 10% increase in speed from running session to session. Whatever the method you use, it is critical that you progress evenly from session to session. The other biggest problem is that because often, at Day 10 for example, the leg feels ok, the athlete gambles. He or she runs at 80% instead of 70% to see how the leg feels and recurs. Thus you have set yourself back longer. So much is written about gym and rehab programs but little advice is provided about running programs. In fact this is the critical area. Thus in a “garden variety” 21 day hamstring rehab one would jog at day 5 to 6 then do that for a few days. Then the next sessions at day 8 or 9 might be strides at 50% speed and no faster.Then this is progressed evenly with 10% increases every second day. Given the short time frame, often it is difficult to go 100% at day 18 as a test, so the program has to be structured to allow the player or athlete to perform fresh and ready on day 21. Again running programs are the number one concern in a hamstring rehabilitation program, and you may use repeat 100m strides or flying 20m or flying 30m. It doesn’t matter. What matters is that you progress to a plan carefully and done gamble. Remember when you go to the casino you can win, but in the end the casino always wins.

October 2, 2007 Posted by | Rehabilitation | Leave a comment


Soon I will publish an E Book on strength and conditioning programs after a hamstring injury. Specifically soft tissue and not back related etc. One area that seems to cause problems is athletes working too intensely too soon after a muscle injury is diagnosed and taking gambles. Jarvinen’s review emphasizes the need for 3 days immobilization to allow healing as a critical phase. Respecting the stages and phases of healing in soft tissue injury is vital. Some researchers categorize these stages differently. From acute ( inflammatory) up to 7 days to proliferation ( 7 to 21 days) and maturation and remodelling ( >21 days).

Not respecting healing dogma is fraught with danger given that means trying to beat nature. Programs in my e book are based on this dogma. And Jarvinen is very clear about the processes involved.

I was lucky to work in the AFL for 20 years and since 1999 till April 2006 I was operating at approximately half the average games lost for hamstrings in the AFL. I coached sprinters in the 80’s and simply spent a lot of time researching and working this area.

Muscle Injuries: Biology and Treatment: Järvinen
The American Journal of Sports Medicine, Vol. 33, No. 5

This study emphasizes the need to immobilize in the acute phase which as minimum from healing studies should be 3 days.


Even slight use of the injured muscle in this Acute Phase needs to be avoided according to Jarvinen. He also talks about reruptures at the same site if mobilization is too soon. By resting in this phase less scar is put down.


PARADOX: Use it or lose it!

The rest in the immobilization phase allows the scar to get some strength. In fact after 10 days the scar is quite strong

After the immobilization phase is over then active mobilization enhances the penetration of muscle fibres into the scar tissue, limits the size of the scar and aligns the regenerating muscle tissue.

“If immobilization is continued past the acute phase (first few days) of muscle regeneration, the deleterious effects become particularly evident during the remodeling phase of muscle healing”

September 4, 2007 Posted by | AFL, General, Rehabilitation, Soccer, Strength and Conditioning, Tennis, Track and Field, Volleyball Strength and Conditioning | 1 Comment

Hamstring Injuries in the AFL. Perception becomes Reality

If you check my CV, you can see I was co-ordinating strength and conditioning programs at Essendon from 1994 and Geelong from 1998.

Hamstrings are the biggest cause of injury in the AFL. The game goes for 120 mins and has 4 breaks. They will start warming up at 1.20 for a 2.10 game and then rest before running out. Then 1/4 time/1/2 time and 3/4 time. Game finishes at almost 5pm! They kick on the run and also bend over at speed. Just a recipe for injury. Also they have to carry some bulk for contact needs, but still run and run. Thus more hamstrings than soccer and rugby for instance.

In 1997 a group of Essendon coaches, fitness, medical and management people went to the AIS to examine training methods.

With respect to injury management it was an important trip for me. I changed my training methods a lot then.

Proprioception circuit before weights. Screening of biomechanics of players. Core stability screening. Core stability and core strength circuits. Specific unilateral training for the lower extremity. Specific attention to gluteal and hamstring strength work. Lots of running drills and faster running. More individualized training. Full time massage therapists. Full time physiotherapists, Full time training. Databases of loads and education of coaches to manage training loads and kicking loads inseason a bit better. Pre- training meetings to plan training with medical staff.

What I saw in the 1998 was a big drop in soft tissue injury after those initiatives, especially hamstrings.

I had done comprehensive isokinetic testing a few times in the 90;s but this multifactorial approach seemed to work better.

I went to Geelong in 1998 with a brief to reduce injury. I implemented the same initiatives. I used Mark Sayers the biomechanist to screen every player. Employed more masseurs. They did lots of core stability and core strength work. They trained faster. And so on. It really seemed to work. We had a huge drop in soft tissue and hamstring injury rates. There seemed to be some consistent line to all this.

I remember one year getting to round 18 and not having lost a player to hamstring injury, Then fatigue hit with a player and we lost a few games to hamstrings but not many. So all these initiatives as a whole seemed to work. Which one helped most? Now that is a tough question. Massage or core stability or running faster? Difficult! I always lean to fast running in the preparation block as a key.

I was operating at about half the incidence of games lost for hamstring injury relative to the AFL.

But perceptions can become reality in elite sport.

Unsubstantiated media reports of huge soft tissue injury rates and hamstring injury in particular often abound.

Now every club gets hamstrings. One must look at trends and overall rates over years with the same staff in a club.

One well informed scribe said I had been sacked from Essendon for too many hamstrings! Just weird . I left. Simple. This type of ‘waffle” often becomes the norm in the media. On TV and radio. Raw hard data was never accessed. Then “JO BLOGGS” starts saying the same thing. Oh well!

The crazy part of all this was that a representative from a Monash University Hamstring Injury Research group had spoken to me about how they had noticed I had a consistent low rate in Hamstring Injuries and how interesting that was. Oh well. All history now!

More importantly the take home message is to use a multifactorial approach to hamstring injury prevention and rehabilitation. Make sure you have ticked most boxes. I will soon be putting some information out on a strength and conditioning program for hamstring injury.


1. Core Stability. Is the inner core functioning properly?

2. Core Strength: Has the athlete got sufficient strength to cope with the forces required in fast sports.

4. Pelvic Stability: Is the athlete unbalanced or does the athlete have a weakness in gluteus medius for example.

5. Overstriding: Is the athletes running technique a disaster? Combined with lack of pelvic stability do they over-stride and tire the hammies out.

6. Hamstring and Gluteal Strength: Does the athlete lack the abilty to switch the glutes on or have little strength both concentrically or eccentrically or the whole lot?

7. Lower back problems; Do they exist? Gluteal referred problems?

8. Previous history of injury.

9. Has the athlete prepared themselves for fast running and adapted to high eccentric loads in pre-season.

10. Is the athlete fit enough? Can they last?

11. Is the athlete too tired from training?

12. Has the athlete trained hard the day before and is doing fast running today and thus will be more prone to injury?

13. Are you too old?


That is why there is no cookbook recipe to preventing hamstrings.

Just need to keep ticking those boxes

August 10, 2007 Posted by | AFL, Rehabilitation, Strength and Conditioning | Leave a comment

Sandilands, Osteitis Pubis and Rotations in the AFL

It was reported in the media that Aaron Sandilands from Fremantle has Osteitis Pubis. In 2005 especially I noticed early in the season that clubs like Sydney, West Coast and Adelaide were playing 2 Ruckmen. There had been the intervention with the centre circle to stop PCL injuries. But clubs had realized that playing 100 minutes plus for ruckmen was just too much. Almost a midfielders role and yet these guys are huge men. Some have amazing endurance capacities but still big blokes who are not going to excel in distance running. They are more like big rowers.

One exception was Jim Stynes who played so much football. He was quite light and an exceptional runner and also played in another era.

The problem that clubs had and have is that their ruckmen has to get some possessions and be a normal player unlike the lumbering giants of the past. This was the only way of justifying 2 ruck players.

Coaches in general were scared to go 2 ruckmen in the early 2000’s ( although EFC had Alessio and Barnes) given they wanted run. So rotations and ruckman that can get their hands on the ball have become the key. And so many ruckmen were worked into the ground in this period when the game became super quick, making them look even worse given they often played 100% of game time .

I was very keen for this to happen in 2005 . IE Rotating ruck men and rotations in general. Sydney had Ball and Jolly,West Coast ( Cox and Seaby) and Adelaide ( Biglands and Hudson). All these players rotated almost predictively when interchanges were studied and also had an impact on the game both as ruckman and as general players picking up kicks and stats around the ground. Also given the increase in the speed of the game the theory was to decrease their risk of overuse injury and injury in general. But performance was the main aim.

So back to Sandilands. I don’t have his game time statistics but it seemed to me that in 2006 he played a lot of football on the ball and did some very hard running. He played 18 games and bore the brunt of the load in the ruck as far as I could see.

Just a tough gig to do it without adequate help. Ottens and Blake are working effectively in tandem now since Mark has matured. In the Sydney final of 2005 King was playing his 3rd game in 18 days ( Sun RD 22 Rich/Sat Final Melb/Fri Semi Sydney) and came up against Ball and Jolly by himself and was off with a hamstring by the 3rd quarter. Ball was the class act and Jolly is a good hard runner.

So Osteitis is often a reflection of load and the inability of the core to stand up to fatigue. I think we will see Sandilands rotated a lot more next year.

But eh I might be wrong. Trends and players often go against theories. What will be the new trend in this area? 2 * Jimmy Stynes?

July 30, 2007 Posted by | AFL, Rehabilitation, Uncategorized | Leave a comment

AFL and Hamstring Rehabilitation

Hamstring Rehabilitation in the AFL

Given my association in the AFL and also track and field I have learnt a lot about hamstring injury prevention and rehabilitation. I was also lucky enough to coach sprinters who put huge stress on their hamstrings. Now I am involved with soccer where the rate of hamstring injury is lower.

At Geelong Football Club in particular I had a very low rate of injury from 1998 to 2006 and kept games lost at less than half the rate of the average in the AFL which is approximately 20/22 games lost per year.

In the early 90’s I often consulted the AIS and Craig Purdam and Peter Stanton on this topic. Especially because at Essendon we had Dean Wallis who had chronic injuries. The only solution in the end with Dean was lots of fast running and eccentric weight training. This was 1990 and looking back we should have also done more specific core stability work. An athlete like Dean who is explosive needed fast technically efficient running, eccentric weight training and core stability work.

Luck or management with low soft tissue rates? Definitely management with a process in place. I was employed in 1998 ( Gary Ayres) to assist the club in injury management more than anything. And what was the mainstay of that process? Simply the most important variable is running fast in pre-season as soon as possible whether in skills or running to achieve specific adaptations without breaking people down. Alan McConnell ( now AIS) had already organised indoor and outdoor small games in the PXMAS block and these games played at 100% intensity coupled with specific running and conditioning meant that there were very few soft tissue injuries in 98/99.

But after addressing sports specific running needs I made sure many variables were covered. Core stability and core strength. Running mechanics and overstriding. Drill education. Massage. Specific muscular imbalances. Specific hamstring muscle weaknesses. From concentric to eccentric to functional training. Totally individualized approach to preparation in strength work. Lack of gluteal firing. Poor range of motion. Hip imbalances. Plyometrics. Monitoring fatigue and periodization of training. Having sufficient aerobic and anaerobic fitness to not allow fatigue. The list goes on.

Hugh Seward at the 2006 AFL conference on hamstrings said that the AFL was undertaking research to pinpoint solutions to hamstring injuries. A great initiative but he made it sound as if there was little known about the area. Unfortunately there will never be a cookbook for all this. But the research is out there and this is a multifactorial issue that needs to be addressed for each individual.

The cure is hard intelligent work. Again in the animal kingdom and humans simply running fast and adapting to that stress is the best solution. And even in rehabilitation progressively running faster and respecting the laws of nature and healing is a very effective tool.

But in many rehabilitations individuals must be assessed from tip to toe to achieve the the required result. The biggest problem I see time and time again is trying to beat nature. Simply takes tissue “X” days to heal and strengthen ( IE approx 3 weeks plus for basic healing and up to 8 for full strength). Simply takes “X” time to adapt to high intensity exercise ( over a week for a session and 6/8 weeks for a programme). So one has to always respect these laws and suffer the consequences if one doesn’t.

One thing that is confusing for many is the simplistic nature of how researchers and strength and conditioning experts sometimes polarize injury prevention and rehabilitation methods with almost religious fervour. Often there is a marketing spin to all this.

Some athletes have to spend time on totally non – functional unilateral concentric exercises to reverse imbalances and then transfer this to eccentric and then running specific needs. A long process. Some need to do some inner core work and slow drill work for weeks and then move to fast running. Others as I have explained simply have to run fast. And some lucky , lazy people seem to rest for 8 weeks, run fast once, get sore as hell then adapt in 2 weeks and play. The knowledge is out there now. It is all over the place. Soft tissue injuries will occur.

Do some hard smart investigative work and find out what your athlete needs and then be specific and evidence based and create an individualized solution.

July 21, 2007 Posted by | AFL, Rehabilitation | Leave a comment