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Hamstring Training and Injury Management in Team Sports, Episode 4: Conversation with Gustavo Pérez

For the fourth episode of the Hamstring Management series i'm happy to introduce Gustavo Pérez Solano, which is currently the Head Fitness Coach at River Plate 2nd Team.

I have known Gustavo for several years, he is one of the smartest and respected professionals in football in Argentina and he has worked with all the best Argentinian players the River Plate has been producing for the past 20 years.

AR: Gustavo, you've been working with River Plate for a long time now. Can you explain how your role has evolved over time and what is your current role within the club?

Gustavo Pérez Solano: My role as a Fitness Coach in River Plate has changed over the years. I have worked with different players ages, starting from 14 years old in Youth Soccer, going through different categories and ages, up to 23 years old in the Second Team, where I am currently working as the Head Fitness Coach.

I have worked with different Head Coaches over the years and we have formed a large number of players who compete today in the best leagues in the world. All of them have accepted my ideas and they allowed me to train them with the desire to achieve the best goals in their career.

AR: Hamstrings injury still seems to have a large impact on football players. Do you think there is still the need to emphasize hamstrings training over a more comprehensive performance program? What is your approach in pre-season and during season?

Gustavo Pérez Solano: Hamstring injury is the most frequent type of injury in soccer players. All the preventive work we do in terms of strength training involves all those muscle groups that we consider most injury-prone in football. Although hamstrings have a higher frequency of injury rates than other muscles, it does not make us focus more on them than on the rest of the body. From the beginning of the preseason and even in the competitive period we seek to develop and increase maximum strength. We also emphasize the eccentric strength as we consider it of great importance to avoid injuries in our players.

We work in a multidisciplinary way with the kinesiologists to improve both general and specific weaknesses and muscle imbalances that could lead to an increase in injury risk.

The volume in preseason is higher and it decrease in the competitive phase, although I do not give it up completely as I consider it to be vitally important.

AR: Most performance and rehab professionals doesn't make a proper distinction between training for hamstrings health and training for hamstrings rehab. The different situation in muscle physiology between a previous injured and a non-injured athlete leads to different methods and training variables. How do you manage the rehab process and what baseline testing and metrics you use for return to play decision?

Gustavo Pérez Solano: The focus on a player returning from injury is more important. The specific workload for that muscle group increases: concentric and eccentric work, strengthening the abdominal muscles, core and glutes. Strengthening the core and working on pelvis stability is fundamental in order to maintain an adeguate hamstring tension and to avoid the occurrence of imbalances.

In the rehabilitation phase we try to get the player to return to train in the group with the same abilities of the pre-injury condition. This causes the number of exercises to increase depending on the need of the injured muscle to get back in symmetry with the opposite leg.

Once back to training we start working on the field with progressions of 40/50 meters and trying to correct running mechanics by constantly looking at movement coordination. The progressions must keep into account stride length to be sure that no discomfort is present in the eccentric phase, which is where most injuries occur.

Then we add to the program different small-sided games as well as coordination and speed drills to complete the last stage of the rehabilitation phase.

AR: An holistic approach to hamstrings training seems to be supported by some recent researches as well as what we see in daily practice. How important is a proper speed and coordination training into the hamstrings conditioning process?

Gustavo Pérez Solano: No doubt that coordination and speed have a major role in the training process and that the hamstring muscles have a large involvement in this. In fact we are used to train coordination and speed often in a microcycle of work. The goal is to improve inter and intramuscular coordination and try to activate the nervous system quickly by stimulating fast fibers with as much variety and directions as possible.

Anyway, i would like to stress out that players must have adequate levels of strength to sustain the effort that speed training demands: eccentric strength to avoid hamstring injuries during high intensity speed and concentric strength to provide adeguate strength levels to the muscles involved in the push phase (hamstrings, glutes and calves).

I have my players perform running mechanics drills and i look at correcting foot strike dynamics by teaching them to consciously use the right muscles essential for the push phase to develop a faster displacement and the movement patterns automatization.

AR: Eccentric strength and fascicles length are two fundamental parameters related to the risk of hamstrings injuries. Nordic exercise as well as flywheel eccentric can have their place into a training plan but overemphasizing a single exercise or method is a big problem in professional sport. What is your opinion about the way eccentric exercises are being used today?

Gustavo Pérez Solano: Of course increasing eccentric strength can help us to prevent in some way the occurrence oh hamstring injuries. The Nordic exercise has become the primary prevention exercise today: in fact, we use it frequently but we also look for variables within its execution through loading of different angles and segments of the hamstring muscles.

Anyway I do not think that this particular exercise and eccentrics in general are the only way to reach the goal of reducing and avoiding injuries. This does not implies that we stop loading the concentric phase as well. Although today the eccentric strength is preponderant, we do not stop working concentric strength.

When prioritizing one aspect in training, the eccentric portion in this case, i always ask myself if we are underestimating the value of some other aspects.

AR: Technology application is growing today and professional teams are starting to invest in high-end equipments to best assist the health of the players. Neuromuscular diagnostics systems as well as eccentric strength asymmetry testing are growing in popularity both in USA and Europe. What is your approach to monitoring hamstrings condition during the season?

Gustavo Pérez Solano: We are trying to explore all the possibilities offered by technology today. The use of GPS systems allows us to know if there is any imbalance in mechanics that produces an overuse of a specific limb, then we evaluate mechanics and movement patterns in order to find the root cause of the imbalance.

We apply a test with isoinertial machines transmitting data to a software that provides us with useful info about different levels of strength and power. We observe if there is any strength deficit to be addressed and we use this info to design individual training strategies.

Through the data about accelerations/decelerations and metabolic load obtained by GPS we can know more about the intensities of work for each player and thus be able to manage the recovery phase with more criteria as well as individualization.

When a player returning from an injury shows a significant contralateral strength difference then we prescribe an isokinetic test: this test is the most accurate when it comes to knowing the percentages of strength deficit in knee extensor respect to knee flexor in both legs, allowing us to make better decisions in program design.

AR: The last topic i want to address is the difference between weight-bearing and non weight-bearing exercises for hamstrings function. Muscle activation as well as timing and coordination are highly influenced by foot strike dynamics and overall foot/ankle function: what is your opinion about the ratio between weigh-bearing and non weight-bearing hamstrings exercises in a specific training program?

Gustavo Pérez Solano: I use both but this depends on the main goal of each microcycle. Weight-bearing exercises are fundamental for me: it is my opinion that a muscle must be strong enough to not hurt itself. A player feels different depending on whether strength is present or not: if there is strength, there is more self-awareness and more confidence in crashing or disputing the ball with the opponent. And the risks of injuries are lower as well.

In recent years strength development has been underestimated in my opinion. The only way to develop strength is by using weight-bearing exercises (free weights, isoinertial machines, bilateral and unilateral exercises, proprioception training etc.) with an appropriate stimulus for each player to allow the development as well as the maintenance of strength gains throughout the duration of the competition phase.

I use exercises that support body weight as well (nordic, quadriceps, adductor) as a second weekly stimulus trying to stimulate and maintain the eccentric strength.

If during a high speed deceleration a joint supports more than 400 kg of weight how can we pretend that there would be no risk of injury? I go through all the possible ways to stimulate strength, but weight-bearing exercises are the best way to develop it through a progressive increase in load.

The low injury rate of my players certify that developing strength is fundamental to obtain good results in the process of injury prevention and reduction.

#hamstringtraining #injuryprevention #conditioning #sportscience #football #strength

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