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Learn About Jozy Altidore’s Hamstring Injury, the Motion Stability way.

Post by Ryan Balmes, PT, DPT, OCS, SCS, FAAOMPT

Have you been watching the World Cup lately?

Whether you’re into soccer or not, its hard to avoid all the World Cup news and updates. One of the recent updates is that Jozy Altidore, the US team’s premier striker alongside Clint Dempsey, will not be able to participate in tomorrow’s match versus Germany.

This is the World Cup, the top competition for soccer worldwide, and so the conditions are no doubt intense. The weather’s heat and humidity has played a factor, as evident from the water break needed during US match versus Portugal this past Sunday. The level of competition and expectations from worldwide fans are also intense as well.

With such conditions, Altidore’s return would require him feeling 100% again, but given the short-time frame from his initial injury last week to now, his absence from the Germany match makes sense. Here’s why.

To refresh your memory, Jozy Altidore suffered a hamstring injury while sprinting towards the ball. You can see his injury below:

His mechanism of injury is typical of most hamstring injuries. Someone is running at full speed, and a majority of hamstring injuries occur when the leg is outstretched forward. At this moment, the hamstring is lengthening to allow his leg to sprint forward, but at the same time contracting to control and stabilize his sprint.  Clinically, this is what I listen for during the patient interview when I have a new patient coming in with a hamstring injury.

Interesting to note is when Altidore is approaching the ball. Notice there that he attempts to do a header to the ball as he’s sprinting full speed. The moment he bends his trunk and head forward to reach the ball, he experiences his hamstring injury.

For you anatomists out there and big physical therapy nerds like myself, this is a unique element of his injury. Why? Well because his injury is likely due to tightening of his nervous system.

Try this right now in your chair to experience what I’m talking about.

  1. Scoot forward and sit at the very edge of your chair.
  2. Take one leg and straighten out your knee and bend your ankle up so that your toes point towards you.
  3. Now with both hands reach towards your outstretch leg until you feel at stretch at your leg and at the same time with just your head look up to the sky. Keep your knee straight.
  4. Ready? Now look straight down, bringing your chin towards your chest.

If you did all the steps correctly, you should feel an increase in stretch sensation to your leg. But think about it, you didn’t change any angles at your leg, only your head position.

Bringing your head down induced a further stretch of your nervous system, more specifically, dura. Dura is the membrane that covers your spinal cord and outgoing nerves.

That position you just did in the chair is similar to Altidore’s mechanism of injury. Now you were sitting quietly in your chair. He was sprinting full speed. I’d hypothesize that the moment he brought his head forward to head the ball, he placed an excessive stretch onto his nervous system, in which the hamstrings contracted immediately to protect against any further nerve injury at his leg.

Unfortunately, in the mainstream media, most reports will say hamstring injury. This still holds true, but given Altidore’s mechanism of injury he’s also likely experiencing a nerve tightness as well. Most of the cases I see here at Motion Stability are persistent pain presentations, and unfortunately, a closer look at nerve mobility is often overlooked from most healthcare professionals. I find that when properly recognized and treated, life for the patient improves pretty dramatically.

So what’s the outlook for our beloved striker Jozy Altidore? Early reports say that he is making progress, which is great news. Projections have him to possibly return for the first game in the knock-out stage of the tournament. Rehab would focus on strengthening his hamstring to handle the lengthening and contraction action, progressing from light jog to full sprint. Nerve glide exercises and manual therapy techniques would help improve overall nerve mobility as well. Having Altidore ready for the first game in the round of 16 is possible, given it will be about 2 weeks after his initial injury. This should be just enough time to allow for the initial injury’s inflammatory process to come down as well.

The US team has been doing well so far without Altidore, but having him back in the lineup would definitely help our team make a deep run in the World Cup!

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