I am the strength trainer fore a Womens handball team (Olympic-style handball) and one of my players has what's called a jumpers hip. The team phsyio says he cant help her. We have been trying with drop jumps cause we have had good results, with them when it come´s to jumper knee.
The idea was to use drop jumps is to get the eccentric moment and not use the concentric part. She tries to do about 10-15 rep, 3-4 time per week. We have been doing this for about 2 weeks and there hasn´t been much Improvement. The challenge is that she is still playing and doesn´t get a break really. They are training 6 days a week and strength training 2 times a week. Any suggestions about what might help and not hurt?
To really get to the root of the problem, we need to dig a little into some KINETIC CHAIN (KC) CONCEPTS. The KC basically refers to the body as one functional unit (bones, muscles, nerves, organs, etc.). All of these components must work in an optimal SYNERGY to achieve a high and injury-free performance Athletes are highly subject to REPETITIVE STRESS. By this, I mean, repeating the same TYPES, RANGES, INTENSITIES, and SPEEDS of motion, chronically over and extended period of time (i.e. days/weeks/years/careers/etc.). Sports are repetitive stress. When this repetitive stress goes unchecked and unaddressed, muscular imbalances can/will occur. These muscular imbalances weaken the core, and eventually lead to faulty movement patterns. These faulty movement patterns over time can expose themselves as injury and pain (possibly "jumper's hip" in this case). So, what's being stated is that ultimately you are probably dealing with a repetitive stress/flexibility based injury. Muscular imbalances occur by way of:
- RECIPROCAL INHIBITION: The concept of muscle inhibition caused by a tight agonist, which decreases the neural drive of its functional antagonist (i.e. short/tight overactive psoas = long underactive glute). This results in altered force couple relationships, synergistic dominance, and leads to the development of faulty movement patterns and poor neuromuscular control. (1, 2)
- SYNERGISTIC DOMINANCE: The neuromuscular phenomenon that occurs when synergists take over for a weak or inhibited prime mover (i.e. the hamstrings take over for the weak glute above). This causes faulty movement patterns, which leads to tissue overload, decreased neuromuscular efficiency and injury ("JUMPER'S HIP"). (1, 2)
- ARTHROKINETIC DYSFUNCTION: A biomechanical dysfunction in two articular partners, resulting in abnormal joint movement (arthrokinematics) and proprioception (i.e. increased excessive pronation of the lower extremity(s) during functional movement patters). (1, 2)
The "drop jumps" or depth jumps you're referring to are POWER TRAINING as you are emphasizing deceleration or the ECCENTRIC phase of muscular contraction. This is probably a future progression for the athlete, but for now, it is not specifically addressing the flexibility issues which have created the problem in the first place. IN FACT, this type of training, as well as the rigorous playing schedule, are most likely encouraging and manifesting the problem of poor mechanics even further, hence, KEEPING THE ATHLETE INJURED.
- I would recommend first conducting at least a basic Kinetic Chain Assessment so as to locate the gross muscular imbalances which may be precipitating the athlete's hip pain. Use the following PTontheNET articles:
- Implement a corrective flexibility protocol (static stretching, SMFR- Self Myofascial Release), to begin correcting the imbalances. Muscle prone to tightness you may want to begin with are: (All can be found in PTontheNET's Library of Stretches)
- Hip flexors
- Latissimus dorsi
- Proceed to a core stability program. All motion begins at the core, when poor quality motion is occurring regularly (such as in your athlete's case of "jumper's hip"), and allowing poor arthrokinematics (join movement), you can bet the core is not doing its job. Some beginning progressions may be: (All can be found in PTontheNET's Library of Exercises)
- Quadruped TVA trainer
- 2 Leg floor bridge
- Supine knee to chest (SL, DL)
- Quadruped opposite arm/leg raise
- Single leg progressions (Multi-planer Reach, Squats, Squat Touchdowns, etc.)
- Integrated strength training and low level stability-based RNT (Reactive Neuromuscular Training - POWER) may be added and must be performed PAIN FREE! (All can be found in PTontheNET's Library of Exercises)
- Multi-planer weight shifts/hops (DL, SL)
REMEMBER, stress occurs exponentially, meaning, adding further stress to injury will only result in a failure of sorts. Your athlete may need to STOP ALL CURRENT WEIGHT TRAINING AS WELL AS ATHLETIC PARTICIPATION for this injury to be fully resolved. Good luck.
RESOURCES & RECOMMENDED READING:
- Clark, MA. (2001) "Integrated Training for the New Millennium." NASM.
- Clark, MA. Russell AM. (2001). "Optimum Performance Training for the Performance Enhancement Specialist." NASM.
- Parracino, Lenny. (2002). "Low Back Pain with Ab Work." (http://www.PTontheNET.com).
- Chek, Paul. (2001). "The Inner Unit." (http://www.PTontheNET.com)
- Chek, Paul. (2002). "Scientific Balance Training Series." (http://www.PTontheNET.com).