Explaining Harry Kane’s left hamstring tear, return timeline, rehab, and re-injury risk

Explaining Harry Kane’s left hamstring tear, return timeline, rehab, and re-injury risk

Hey there, it’s Raj from 3CB Performance. Tottenham and England star striker Harry Kane
injured his left hamstring during the team’s New Year’s day match vs Southampton, limping
off the field while clutching at the back of his leg. To add insult to injury, his set-piece
goal was ruled offside by VAR. In this video, I’ll explain why VAR is to
blame for the injury, Brexit, and world famine… But seriously, I’ll explain Kane’s hamstring
tear, return timeline, physio process, and re-injury risk. The hamstrings are a group of three muscles
on the backside of the upper leg that begin at the ischial tuberosity and travel down
to the knee. The three muscles are the semimembranosus, semitendinosus, and biceps femoris which has
a long and short head. The most common site for hamstring tear is
the musculotendinous junction of the long head of the biceps femoris muscle. This junction
is the transition point between the muscle belly and thinner, coiled tendon. Kane’s kick placed his left leg into hip
flexion and knee extension. This places a double stretch on the hamstring muscles and,
additionally, the kicking motion places what’s called an “eccentric stress” on the muscles
where they’re contracting while lengthening to decelerate and control the high speed kick. This triple stress movement is a common cause
for hamstring tears in football and Kane immediately pulled up in discomfort and grabbed at his
left hamstring. Additionally, the hectic and busy Premier
league holiday schedule did Kane – or any EPL players – no favors as the research clearly
shows heavy jumps in activity can increase soft tissue (muscles, ligaments, tendons,
bones, etc) injury risk by as much as 5x. At this point, I’m more surprised when I
don’t see a slew of injuries during the holiday slate of games. Kane’s return to play (RTP) timeline depends
on the severity of the tear which is categorized into three grades. Based on comments from Tottenham manager Jose
Mourinho and additional follow-up reporting indicating Kane could be out for up to eight
weeks, this sounds very much like a grade 2 tear which typically has a RTP of four to
eight weeks. That variability in recovery is primarily
attributed to two key factors. Firstly, tears occurring at either end of the hamstrings
are considered more serious than tears occurring in the belly of the muscle and, secondly,
tears occurring due to over-stretch are considered more serious as well. In Kane’s case, we’ll likely never know
the specific location of the tear but the mechanism does line up with a stretch injury
which could indicate a longer recovery timeline. Kane’s hamstring protocol will work on eliminating
pain, restoring normal pain-free knee range of motion, normalizing gait (walking), gradual
progressive strengthening with an eventual emphasis on eccentric strengthening, neuromuscular
and postural control, maintaining some level of overall fitness, and normalizing key ratios
such as quadriceps to hamstring strength and side to side lower body symmetry. The hamstring is heavily involved in football
activities – which may be why it’s the most commonly injured muscle in football, with
some studies showing up to a 50% prevalence rate in elite footballers – and therefore
you have to be very methodical with rehab. Once Kane has met key metrics and the physio
team feel he’s ready, he’ll be cleared for higher intensity return to sport with
increased sport-specific activity, team training, and then reintroduced into games. The trickiest part with hamstring injuries
– far more than the rehab – is avoiding re-injury. A previous hamstring injury is the most predictive
factor of future hamstring injury with research showing nearly a 30% rate of reinjury, most
occurring within the first two weeks, and nearly 3x higher risk of hamstring injury
for up to a year following the initial tear. For a stark reminder of that, Kane need not
look any further than teammate Delle Alli who suffered four recurrent left hamstring
tears in a two year period. Further, for Kane who is now 26 years old
and has been playing consistent top flight football for nearly six years, there’s additional
risk as the research shows athletes older than 25 are up to 4.4 times more likely to
injure a hamstring compared to younger players and data suggests that the overall risk of
hamstring injury increases by 30% year over year after a pro footballer starts his or
her career. For these reasons, it behooves Tottenham to
be careful with Kane’s recovery and unfortunately even when he does get back to the pitch, there’s
a significant chance for re-injury. In sum, hamstring tears suck. That’s a wrap for this video. Thanks for
watching. My goal is to provide you with in-depth, evidence based, narrative free analysis and
you can always find me on IG and Twitter @3CBPerformance. Make sure to sub to the channel and follow
along on all social media for the latest updates. 3CB out.

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About the Author: John Markowski


  1. What about comparing Lewandowski's physique with Kane? Kane appears bulky to me in this comparison. Could a more leaner body help in this regard to prevent ham string injuries?

  2. Update: Tottenham just said he’s having surgery so it was likely a grade 2/3 tear and severe enough it they feel surgery is warranted. Out until April at least. Timeline is changed but the rehab process & re-injury risks remain the same.

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