Ham – Hammie – Hamstringer – Hamstring – Hamstrung

Andrew Charniga

www.sportivnypress.com

A hamstring {pull/tear} is but a single, non-contact lower extremity injury, among the many now common in the National Football League (NFL) and ubiquitous as well; in American amateur sport. It is something of a canary in the coal mine representing just one of many examples of a prolonged fragilization of American athletes.

The ubiquitousness of Hamstring {HPT} have coincided along with various foot, ankle and knee ligament maladies; some of which have, in previous years physicians have typically associated with car accidents; even falling off horses; (a Lisfranc foot injury is named for Napoleon Bonaparte’s physician).

It is common knowledge, susceptibility to a future hamstring pull/tear rises if the athlete has succumbed to a prior injury. Likewise, if an athlete has suffered an ankle injury. Since the most common injury in sports such as football is an ankle injury – an athlete’s prospects of a career scarred by multiple lower extremity injuries is rather dim.

New specialty surgeries have emerged in response to the ever growing ‘market’ of athletic injuries `such as ‘tight rope’, ‘Tommy John’, speed bridge repair of Achilles tear; various minimal invasive knee ACL procedures. A special collapsible medical tent (now commonplace on all sidelines from collegiate football to pro ranks) have emerged to mitigate the injury epidemic in American sport. The ‘injury tent’ is designed for privacy to conduct on –  field medical evaluations. Injuries are so prevalent, the frequency of non – contact lower extremity injury having become so widespread; use of the name ‘injury tent’ has been given way to ‘the tent’, ‘the blue tent’ and other euphemisms; so as to divert attention away from the multitude on – field calamities.  Confirmation of a consilience of induction, i.e., a cause effect susceptibility to injury in America sport presented in previous essays (see Charniga, www.sportivnypresss): there exist many common denominators linking injury incidence across a wide the spectrum of American sport: Baseball, football, soccer, basketball, softball, lacrosse, and so forth.

Hamstring injury in the NFL un – mitigated: because of/or despite research?

Two previous essays have dealt with the omnipresent hamstring injury; a wide spread conundrum of the overall non – contact lower extremity injury ridden landscape of American sport (see Charniga, www.sportivnypress.com).  According to a recent study (Manier, 2022); incidence remains unaffected by 50 years of specialized research which includes injury prophylaxis of strength ratios between hamstring and quadriceps muscles:

“The incidence of hamstring injury is 0.81 per 1000 hours, representing 10% of all injuries in field-based team sports. Injury  incidence increased with older athlete age, in match scenarios (compared with training) and on grass surface (compared with artificial turf). Incidence was not moderated by body mass or stature, and importantly, has not changed over the last 30 years. Our findings suggest that more work is needed to reduce the incidence of hamstring injury in field-based team sports.” Maniar, N. et al Maniar N, et al. Br J Sports Med 2022.

Figure 1. NFL player performing ‘Nordic curls’ and subsequently grabbing leg after sustaining hamstring injury; widely believed to help prevent hamstring injuries; thus despite the mechanics between these types of exercises, running, jumping and so forth (real world conditions) where hamstring injury is most likely to occur; are quite different. In all probability, exposure to real – world conditions {on fields or courts) is lacking.             

The effectiveness, the practicality, the validity of research of hamstring injury in sport emanates principally from academia; where so many produce research works; constructed of a myriad of numbers so as to spawn a buzz phrase “we have data”. All of which can collectively, for all practical purpose; can be dismissed out of hand as current incidence; just from the data from the NFL shows (see table).  

The weekly incidence of hamstring injury reported by the National Football League (NFL) from one week  in 2023 presented in the table; is eye – popping anecdotal evidence of the magnitude of the problem of keeping players healthy and ready for the field or court.

Presented in the table is a compilation of NFL players who’ve suffered hamstring injuries as reported by CBS sports.  

Hamstring injuries reported by the NFL for the week of 10-10-2023; CBS weekly injury reports and NFL players salary data (spotrac.com).

NFL players

NameTEAMPOSAgeInjury$$ (GUAR)
Thompson, J.AZFS25Hamstring20,000,170.00
Budda BakerAZSS27Hamstring33,100,000.00
T. WallaceBaltWR24Hamstring685,364.00
Bay. SpectorBuffLB25Hamstring103,725
Jus. ShorterBuffWR23Hamstring323,948.00
X., WoodsCARSS28Hamstring6,035,000.00
Jay. HornCARCB24Hamstring21,112,146.00
J. JohnsonCHIDB24Hamstring3,168,595.00
Tr. HomerCHIRB25Hamstring1,750,000.00
E. St. BrownCHIWR25Hamstring85,000.00
J. BlackwellCHIDB24Hamstring870,000.00
   G. DulcichDENTE23Hamstring1,004,828.00
J. MitchelDETTE24                      Hamstring975,638.00
J. GibbsDETRB21Hamstring17,845,130.00
JonesGBRB29Hamstring13,000,000.00
Z. AndersonGBS26Hamstring10,000.00
J. ScruggsHOUC23Hamstring3,212,944.00
D. StingerlyHOUCB22Hamstring34,657.513.00
J. WoodsINDTE25Hamstring1,343,118.00
BraswellJACCB24Hamstring167,592.00
G. JuniorJACCB24Hamstring
G. KarlaftisKCE22Hamstring11,935.473.00
J. BennetLVCB23Hamstring823,596.000
JamesLACSS27Hamstring42,000,000.00
J. BosaLACOLB27Hamstring102,000,000.00
LeonardLACCB24Hamstring99,664.00
J. JeffersonMNWR24Hamstring13,122,805.00
L. CineMNS24Hamstring11,494,150.00
J. NailorMNWR24Hamstring180, 660.00
L. JohnsonNOCB26Hamstring
J.T. GrayNOSS27Hamstring3,500,000.00
J. WilliamsNORB28Hamstring8,150,000.00
ThomasNYGT24Hamstring67,000.000
EcholsNYJCB26Hamstring174,185
K. YeboahNYJTE25Hamstring
S. BrownPHES23Hamstring177,776.00
P. Harvin PITP25Hamstring80,736.00
P. FreiermuthPITTE25Hamstring2,678,140.00
D. JohnsonPITWR27Hamstring27,000,000.00
R. BealSFOLB24Hamstring244,976.00
BurnsSEACB28Hamstring
S. DennisTBLB23Hamstring317,324.00
D. PittsTBWR30Hamstring55,000,000.00
M. EvansTBWR30Hamstring55,008,000.00
L. GiffordTNLB28Hamstring1,000.000.00
J. ChesnutTNRB23Hamstring
C. HolmesWACB26Hamstring93,880.00
      
   25.2 Avg. Yrs $266,394,130 .00

One and Done?

A hamstring injury is typically not ‘a one and done’’ problem) that is to say this injury in a 23 year old could easily return as the athlete ages; especially if the same conditions of sport and auxiliary exercises are performed.  Consequently, the long term productivity of an athlete who suffers a (HPT) can be comprised beginning at an early age. The implication is significant when the guaranteed salary is factored in.   

The guaranteed salaries of the of the 48 player collective injured players found in the table: (based on their contracts) is a staggering of $266,394,130.00. The range is from $0 to $102,000.000.00; or, an average of $5,549,877.71 across 48 guys.

There are numerous general factors (known , unknowns) common to the thinking and subsequent research efforts of the academic – medical complex; which predispose American athletes to  serious, excessive non – contact and benign contact injuries across the spectrum of sports:

/ a conceptual over – simplification of muscular strength, especially as determined with machines; attributed to muscle fiber types and so – forth;

/ the false notion that a non – contact lower extremity injury can be traced to muscle weakness/and or imbalances between antagonistic pairs; for example a strength ratio of 60% hamstring to quadriceps;

 / illusions of the effectiveness of a coach’s extraneous control of motor patterns;

/ failure to glean insight for research by comparing the rate of serious injury under the relatively benign conditions of American sports; with sports where the injury rate is very low to non – existent (Achilles tear in weightlifting)

/ rational conceptualization as to how an injured athlete manages to overcome the built – in stress/strain failure limitations; which serve as natural protective barriers to tendon/ligament/fascia failure.

/ a comparison injury rate in American sport with other sports lacking the academic-­medical influences. For instance, why is an Achilles so commonplace in American football, basketball And, almost unheard of in weightlifting?

/ inability to envision the two – joint (also called biarticular muscles such as the most common site of injury to hamstrings rectus femoris lateral head) functioning as “energy straps”, i.e.,  spring mechanisms; not a mere muscle which is trained to shorten or conversely lengthen:

“The Nordic hamstring exercise (NHE) is the exercise most included in programs designed to prevent hamstring injuries [11]. A recent meta-analysis and systematic review found that NHE can lower the risk of injuries by 50% among athletes [12], making it one of the most effective strategies for preventing hamstring injuries in sports [13]. It is therefore somewhat paradoxical that the implementation of the NHE remains inadequate in male professional football; however, teams that incorporated NHE into their team training experienced a reduction in hamstring injuries.” Augustsson, J., Alt, T., Andersson, H., “Speed Matters in Nordic Hamstring Exercise: Higher Peak Knee Flexor Force during Fast Stretch-Shortening Variant Compared to Standard Slow Eccentric Execution in Elite Athletes” Sports 2023, 11(7), 130; https://doi.org/10.3390/sports11070130

Figure 3. Female world champion weightlifter performing clean and jerk with record weight which subjects lower extremities (especially Achilles tendon) stress – strain forces significantly exceeding those typical of field and court sports. Charniga photo

Better to say – nothing: if you know nothing’

Typhoid Mary – Meets Typhoid Jack’

In light of the abject failure of western science (Academia) and medicine to address the hamstring conundrum; perhaps it is of more appropriate to ‘encapsulate the grab the back of my leg injury’ a single statement to encapsulate what should be not only apparent; but patently obvious.

Two individual circumstances from basketball; one professional male; the other collegiate female can serve this purpose.  In both cases the damaged players had been called ‘generation talents’.

“Really, Really, Really well:”

Two prime examples of a mindset which defines and encapsulates the injury conundrum of American sport:

 1/ The U of Connecticut women’s basketball program.

Youthful players under the care and influence of the coaching medical and athletic staff suffered, heavy and excessive injuries in recent years not atypical of other programs; but not to worry:

We’ve always handled [injuries] really, really, really well,” Auriemma said last week when asked about the potential of Fudd’s long-term absence.

 “We’ve always been pretty resilient. For us to win 31 games last year, given what we went through, they respond, they don’t pout. They really don’t.”

UConn guard Azzi Fudd will miss the remainder of the 2023-24 season after suffering ACL and medial meniscal tears in her right knee, the team announced Wednesday.

Fudd suffered the noncontact injury last week in practice when, according to coach Geno Auriemma, she went up for a shot and afterward remarked that it felt funny. She missed No. 6 UConn’s past two games against Maryland and Minnesota, both wins, watching from the bench alongside teammates.

“We’re all just so upset for Azzi,” Auriemma said in a statement. “She worked hard to be healthy for this season, and it’s unfortunate when you put in a lot of hard work and have a setback like this. Azzi loves the game and works tirelessly. I’m confident she’ll rehab with the same work ethic and come back better than ever.

This is also the second torn ACL that UConn has dealt with over the past two seasons, following Paige Bueckers‘ injury that caused her to miss the 2022-23 season. Redshirt freshman center Jana El Alfy is also out for the season with an Achilles injury she suffered in July.

Expectations were high internally and externally that Fudd, who has averaged 13.1 points in her 42 games in Storrs, would have her most impactful season yet while playing alongside Bueckers. But the pair of highly regarded recruits will have played only 17 games together over three seasons due to their respective injuries.”

These instances from female collegiate basketball; resonates, as a whole with collegiate sport; It is similar to that of the female program above. In both cases high impact players are sidelined. The university’ medical infrastructures bears the financial burden; so, the pain incurred is the actual injury. And, lest one forget, the athlete’s pain and her support group experience i.e., the athlete’s family; when, a broken young body comes home.

2 – Klay Thompson of the Golden State Warriors. A prolific shooter for the formerly top three point shooting team in the NBA.

Figure 4: Klay Thompson rehabbing(??????) from ACL tear. Within weeks of returning he tore Achilles: Two whole seasons were lost. Female Olympic champion cleaning heavy weight with no ligamentous repercussions: bottom Charniga photo.

Thompson suffered an ACL (anterior cruciate tear in his knee). It took a year of rehab for him to return to the court; only to injure his Achilles within weeks of his return. He missed another full year of NBA play.

Recently he went 0 for 10 shooting:

“Thompson’s season finale left a lot to be desired, as he was held scoreless on 0-for-10 shooting, including 0-for-6 from 3. It was just the fifth time in Thompson’s career he failed to score. It was his second time under Kerr, but the other was when he was ejected 1:43 into a Nov. 23 game against the Minnesota Timberwolves.

So, what does all of this add up to? The injury epidemic is not an aberration of science; but a state of mind. The fact of the matter is, if the program (collegiate sports) and professional teams have enough money and a steady influx of bodies; the injuries are put on a rear burner. The impact (see U of Connecticut above) is obscured by bizarre semantics:

We’ve always handled [injuries] really, really, really well,”

The reasons collegiate and professional team programs handle injuries “really, really, really well”, is essentially two – fold: plenty of bodies and plenty of money to fill the gaps created by injury; medical and training staffs insulate the programs with claims to mitigate the problem with phony science propagated by ‘scientific’ literature; ranging from flawed to fraudulent: see, https://www.wsj.com/science/academic-studies-research-paper-mills-journals-publishing-f5a3d4bc

Dallas Cowboys left tackle Tyron Smith is unlikely to return before December after his left hamstring tore and came off the bone during Wednesday’s practice, sources told ESPN on Thursday.”

References

/ Jan Ekstrand ,1 Håkan Bengtsson ,1 Markus Waldén ,1 Michael Davison,2 Karim M Khan ,3 Martin Hägglund “Hamstring injury rates have increased during recent seasons and now constitute 24% of all injuries in men’s professional football: the UEFA Elite Club Injury Study from 2001/02 to 2021/2

/ https://www.wsj.com/science/academic-studies-research-paper-mills-journals-publishing-f5a3d4bc

/ Charniga, A., https://www.sportivnypress.com/2021/hamstring-injury-in-sport/

/ Charniga, A., https://www.sportivnypress.com/2021/hamstring-injury-prophylaxis-fallacies/

/ Charniga, A., https://www.sportivnypress.com/2017/practical-solutions-to-the-problem-of-achilles-rupture-and-the-proliferation-of-injuries-to-the-lower-extremities-of-football-players/

/ Charniga, A., https://www.sportivnypress.com/2015/its-all-connected-part-iii-reverse-engineering-injury-mechanism/

/ Charniga, A., https://www.sportivnypress.com/2023/a-delusion-of-illusion-i-when-more-is-less/

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