The Diary

21 January 2008: Everything You Wanted To Know About Hamstrings, But Were Afraid To Ask!

They say it never rains but it pours?. When Ish Miller collapsed as if shot in front of the Smethwick End early on during yesterday?s first half, my initial assumption was that he?d done it deliberately, so as to con the referee into giving Cardiff a stiffish dose of their very own mendacious medicine, but subsequent events involving our physio?s rapid arrival on the pitch, then helping Mogga?s little wounded soldier back to the players tunnel at a snail?s pace, quickly served to convince me that Ish?s actions had, in fact, been very much on the level.

I?ve since had a look at what the club had to say about the injury on their website: a hamstring is suspected, and initial assessments by the medical people indicate they?re working on the basis that Ish will be out for between two to six weeks. Coming on the back of a recent four-week lay-off for a knee problem, I don?t suppose Mogga?s been leaping around our dressing-room with unbridled joy at the news, but there you are.

The main reason they can?t give a more definitive diagnosis, as yet, is because it needs time for all the miscellaneous crud to settle in the region where it happened, before a proper look-see can be done. Only then is a scan worth doing: to leap in with both feet beforehand would only serve to confuse the issue considerably. Severe inflammation/swelling obscuring an injury is one of the main reasons why it?s not altogether unknown for overworked and exhausted junior doctors in Casualty to look at the X ray done on Little Johnny?s puffed-up arm, and miss a fracture, which only becomes really obvious once the initial swelling?s gone down (and, unfortunately for the medic concerned, well after the worried parents get a second opinion, then go ballistic when the second quack finds Junior?s fracture, as sweet as a nut!).

We all know where the hamstrings are located ? they?re the stringy bits running behind the thigh: go on, feel ?em for yourself, but not in public, unless you want to get locked up for being a bit of a weirdo ? and they?re attached to the bottom of the pelvis at one end, run down the back of the thigh, as indicated by the stringy bits, then finish in various locations just below the knee. Their job is to help bend the knee, so when they do ?pop?, players can find themselves twiddling their thumbs for quite some time, as per poor Ish,, if what the Albion medics say is right. Incidentally, so powerful can the tug be on the pelvis when a hamstring goes, it has been known to cause a condition called an ?avulsion fracture?, where it?s the pelvic bone that gets broken and pulled away first, rather than the hamstring itself. Ouch.

It?s the incredibly strong force that?s put on the hamstring whenever a player runs that is the cause of the problem. If the hamstring is weak, then you?re an injury waiting to happen. It?s increasingly liable to tear, and at any point throughout its length, too. Interestingly enough, if nervous impulses to the muscle are not properly in tune with what the player?s legs are actually doing ? pain from old spinal injuries can do this, for example ? then that will cause hamstring problems as well. Lack of proper rehabilitation after injury, also preventing proper coordination of nerves and muscles, can contribute to the problem too. As it?s only a matter of weeks since Ish was last in dry dock, I?m now wondering how much of a factor this was in yesterday?s setback.

Treatment? He?ll need both X rays and some kind of scan to work out what?s actually gone wrong, before attacking the problem properly. Sometimes, determining the cause, be it lack of proper nerve-muscle co-ordination, or simple strain, can be a real sod. Once the root cause has been spotted, though, treatment can be targeted on that. Any disruption to the muscle can be sorted by the physio, with electrotherapy, if thought necessary. If there is a spinal problem showing up, that will need to be sorted out by various means before any real progress can be made. The pain and swelling can be helped by aspirin-like drugs. Sometimes, steroid injections, done with the aid of a CT scan, are needed. In some cases, surgery might be necessary. No wonder Ish is looking at six weeks out of commission, max.

Now for my ?Not Many People Know This!? bit! In 2004, a study was undertaken of hamstring injuries in English professional football (British Journal Of Sports Medicine, ?The Football Association Medical Research Programme: An Audit Of Injuries In Professional Football ? An Analysis Of Hamstring Injuries, Hawkins et. al.). This ran over two seasons, and involved all but one of the 92 Premiership and League clubs. It found that hamstring strains accounted for 12% (796 hamstring strains) of the total injuries sustained over the two seasons. 67% occurred during matches. Nearly half occurred during the last third of the first and second halves of the game. Most occurred in Premier League players.

Of those who experienced a hamstring strain during the year, 12% re-injured them during that same year. Players were 2.5 times more likely to sustain a hamstring strain than a quadriceps (muscle in front of thigh) strain during a game. A similar study involving 146 Belgian professionals (American Journal Of Sports Medicine, Muscle Flexibility As A Risk Factor For Developing Muscle Injuries In Male professional Soccer Players, Witvrouw et. al. 2003) found that players with less flexibility in the hamstrings or quadriceps had significantly more injuries to these muscle groups.

Imbalances in these muscles may also contribute to thigh problems: another study (American Journal Of Sports Medicine, Pre-season Strength And Flexibility Imbalances Associated With Athletic Injuries In Female Collegiate Athletics Knapik et.al, 1991) found that there was a greater chance of a leg injury if the if the right hamstrings were 15% or more stronger than those on the left, or if the right gluteals (the muscles located at the back of your bum) were 15% stronger than the left gluteals, or if there was a relative weakness of the hamstrings to the quadriceps of 25% or more. Another study, a Swedish one (Scandinavian Journal Of Medicine And Science In Sports, Hamstring Injury Occurrence In Elite Soccer Players After Pre-Season Strength Training With Eccentric Overload, Askling et.al. 2005) strongly indicated that strength work will reduce leg injuries.

Oh ? and, just in case you were wondering, ?Eccentric Exercise? is NOT defined as a training session conducted by Barmy Bobby Gould, it?s a form of exercise where the muscles are lengthening, such as when the thigh is brought forward during a running stride. It?s that sort of exercise that?s critical to preventing hamstring pulls, apparently, especially when the quadriceps are stronger than the hamstrings. In between copious draughts of Fosters, no doubt, another lot of researchers, Australian this time, worked out that the muscle damage done during eccentric exercise was made worse when the action was really forceful.

Their recommendations? They proposed that a mild course of eccentric exercise should be undertaken, not only by those prone to such problems, but also by those who weren?t troubled at all. And, according to those lovely Swedes, it?s been proven that that such an exercise programme can reduce the number of hamstring pulls. A study of two sides from their top domestic league showed that such injuries were reduced by 66%, and the speed of the trained group was increased. Another study, French this time, demonstrated that when the eccentric strength of the hamstrings was 60% or less of the concentric strength of the quadriceps, there was a 77% chance of hamstring strain.

There ? you always get a better class of scientific education courtesy my little piece! On to other matters, now?. In the wake of Ish?s enforced absence from the side, you can expect Roman Bednar to be a very busy Baggie from here on in. Poor lad, there he was, sitting contentedly on the sub?s bench, having run his wotsits off on Tuesday night, and enjoying the rest, only to find himself having to slog away once more. Perhaps it?s just as well that we don?t have another game until next Saturday! The good news is that we will have Craig Beattie back from injury by then: the only thing is, will we finally get some added-value from him, given the fact he?ll very likely have to take up the striking reins at some point or other in the near future?

It was awfully nice of Mogga to give our supporters such a great big hug and cuddle for making so much noise on Saturday, but the cynic within me can?t help but feel that it was the earsplitting racket made by the Cardiff mob that shamed our people into getting behind the lads in such a positive way. Past experience has shown that when we?re behind and chasing a game, it?s normal SOP for our followers to moan their collective bags off, rather than be a tad more positive about things. All to do with the almighty weight of expectation that?s descended upon the place with the coming - and considerable success, of course ? of Mogga, I suppose, a situation exacerbated considerably by our Christmas move into pole position.

Still, whatever was the motivational factor involved, it didn?t half make for an electric atmosphere in the Shrine, especially during those agonising closing minutes, after we?d equalised! And Mogga was dead right: our game WAS a ?good advert for the division?. A time when the old Sixties Brummie Road chant ?Score, Albion score/If you get one you?ll get more, etc.?.? has never been so apposite. Given the fact we?re once more playing the kind of football Messrs Astle, Hope, Chippy Clark and Bomber Brown would have murdered for, any chance of a choral reprise for that particular ?number?, I wonder?

Trolling through various press reports of our game, I discovered that The Independent?s football correspondent had practically achieved orgasm after watching the Cardiff caper (Oh, dear, these intellectual hacks, they don?t get out much, do they?) Well, I ask you ? how many burly Black Country blokes of the Albion persuasion do you know who?d call our side ?the Arsenal of the Championship?? ? and I quote: ?The small matter of 170 league and cup goals and, increasingly, they come via delightful attacking; silky smooth through midfield, into feet, round the corner to wingers or overlapping full-backs and often with a stunning end product?..? Coo.

I?d certainly agree with this guy?s assessment that it was Bednar and Zoltan Gera wot drawed it for us, though: working on the principle that every cloud has a silver lining, had it not been for Ish Miller?s hamstring, we probably wouldn?t have had him on the park as soon as we actually did. And I also heartily concur with his assertion that Chris Brunt is probably the best crosser of the ball in the entire Championship. The proof of the pudding lay in the sheer quality of the cross that led to Alby?s successful strike. Apart from that, just about every time he launched the ball forth from the flanks, there was clear consternation in the Cardiff ranks.

As for The Guardian, there was a pretty telling quote from our captain Jonathan Greening in there, which certainly produced a bit of a hollow laugh from me. ?"All week we've been defending in training. The main aim today was to keep everything tight at the back and not concede anything stupid. We let the gaffer down in the first minute." Oh, whoops. Oh ? and lest I forget, I loved the Grauniand hack?s comparison of the poorly performing Pele with the lad Boumsong. As I did their underwhelming description of our manager as ?a dour cavalier, (Mowbray) represents a paradox, a footballing purist yet with the joie de vivre of Leonard Cohen and the charisma of Iain Duncan Smith?. Blimey, a sure-fire recipe for suicide, if you ask me: ever listened to an overload of Leonard Cohen albums? I have. Not recommended unless you?ve kept a stash of strong antidepressants handy beforehand. As for the Iain Duncan Smith bit ? sue, Mogga, SUE!

And that?s yer lot for tonight. See you again on Friday night, by which time we?ll know a little bit more about young Miller?s hamstring problem. Hopefully, Albion?s assessment of ?six weeks? is worst case scenario only.

AND FINALLY??You really know you?ve arrived when people start spreading rumours ? completely untrue ones ? about you, and that?s what happened to The Noise?s offspring, young Carly, very recently. Talk about getting your wires crossed: any sitcom writer worth their salt would have lapped up the story like gravy, so, without further ado, I?ll let you in on the secret.

It all happened because of an assignment Carly was given as part of what my generation used to call General Studies, but is given some other fancy-dan name these days. What The Noise?s eldest had to do was give a short talk to the rest of the class, subject-matter entirely up to her, so, after a bit of thought, she chose ?Teenage Pregnancy? (As Stoke currently has one of the highest teenage pregnancy rates in Europe, it sure as hell was relevant, not to mention highly topical.)

Being the diligent researcher she is, she prepared for the coming ordeal by trolling through numerous websites offering advice and assistance to girls landing in that unfortunate situation, making copious notes as she went along. Big Mistake, that, using the college?s PC?s and not her own, for it was while she was working on this project that one of her friends must have looked over her shoulder, spotted what she was doing, added two and two ? and made about six million!

Result? Within a matter of hours, the word swept around the college that young Carly had a pot firing in the kiln (well, it IS Stoke, after all said and done!): before you could say ?failed condom?, hordes of concerned friends and fellow-students were rushing to offer their commiserations, and the more Carly vehemently denied she was in a gravid state, the more her mates refused to believe it! One of them even accused Carly of being in complete and utter denial over the whole thing! Oh, whoops?. Will the ?scandal? eventually die a decent death, or is the resultant embarrassment factor set to run and run, like ?The Mousetrap?? Watch this space!

 - Glynis Wright

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