hamstring cramps after acl surgery

Med Sci Sports Exerc. Clin J Sports Med. The Football Association Medical Research Programme: an audit of injuries in professional football- analysis of hamstring injuries. Abnormal frontal plane knee mechanics during sidestep cutting in female soccer athletes after anterior cruciate ligament reconstruction and return to sport. Generally, it takes at least 9 months to recover after ACL reconstruction surgery. 2018;28(2):65866. 2010;26(4):4629. Once youve torn your ACL, you cannot sew the end of the ACL back together. J Appl Biomech. Resistance training volume enhances muscle hypertrophy but not strength in trained men. Your email address will not be published. J Orthop Sports Phys Ther. Prevention of hamstring strains in elite soccer: an intervention study. Med Sci Sports Exerc. One important consideration after ACLR is the recovery of hamstring muscle function, particularly when using ipsilateral hamstring autograft. WebIf you develop a fever, intense calf pain, excessive drainage from the incision, uncontrolled pain or any other symptoms you have concerns about you should call your doctor. Strength deficits identified with concentric action of the hip extensors and eccentric action of the hamstrings predispose to hamstring injury in elite sprinters. Strains and tears happen when the muscle is lengthening as it contracts or shortens. Arthroscopy. McDonagh MJ, Davies CT. Adaptive response of mammalian skeletal muscle to exercise with high loads. ACL Recovery After an ACL injury or ACL surgery, many athletes report experiencing increased frequency of muscle cramping. 2020;54(9):5129. 2015;43(11):266370. Mechanisms of anterior cruciate ligament injury. 2019;53:44956. WebAnterior cruciate ligament (ACL) surgery replaces the damaged ligament with a new ligament called a graft. Assessing and treating gluteus maximus weaknessa clinical commentary. Isokinetic strengths of the quadriceps and hamstring muscles and endurances were compared between a group of 20 patients undergoing PCLR using a tibialis anterior allograft and a 1:2 matched control group of 40 patients undergoing ACLR using a hamstring autograft at 2 years after the operations. 2009;19(3):e197-205. 2006;36:73345. Barber-Westin SD, Noyes FR. J Orthop Sports Phys Ther. Br J Sports Med. An in vitro study. 2013;45(11):215865. 2010;40(3):A116. Click To Apply For A 2 Day Trial With Accelerate ACL Technology, And Our Performance Specialists To See How Quickly You. Knee strength deficits after hamstring tendon and patellar tendon anterior cruciate ligament reconstruction. Published 2015 May 4. 2005;33(4):492501. Deficits in neuromuscular control of the trunk predict knee injury risk: a prospective biomechanicalepidemiological study. Sci Rep. 5, 2015. 2009;105(6):93944. Petersen J, Thorborg K, Nielsen MB, et al. Am J Sports Med. Goerger BM, Marshall SW, Beutler AI. Accumulated workloads and the acute: chronic workload ratio relate to injury risk in elite youth football players. Every time the quarterback drops back to pass, he only has a second or two before a defensive lineman is on top of him, hitting him harder and harder every snap. 1996;24(2):917. Neufit. Buckthorpe M, Wright S, Bruce-Low S, et al. Sports Health. Intrinsic and extrinsic risk factors for muscle strains in Australian football. All other authors provided intellectual contribution as part of the redrafting process within their clinical areas of expertise. Ardern CL, Webster KE, Taylor NF, Feller JA. Eccentric hamstring strength and hamstring injury risk in Australian footballers. The adaptations to strength training: morphological and neurological contributions to increased strength. Engebretsen AH, Myklebust G, Holme I, et al. J Strength Cond Res. 2007;40:355562. To achieve this requires consideration of many factors including the types of strength to recover (e.g., maximal and explosive, multiplanar not just uniplanar), specific programming principles (e.g., periodised resistance programme) and exercise selection. J Orthop Sports Phys Ther. A ligament needs to be reconstructed. 2018;48(8):60712. 2003;33(11):6716. WebSure: Muscle and calf discomfort is normal a week after acl surgery, esp. Exploring the high reinjury rate in younger patients undergoing anterior cruciate ligament reconstruction. Am J Sports Med. J Biomech. Orthopedics. Ristanis S, Tsepis E, Giotis D, et al. Med Sci Sports Exerc. Psychological aspects of anterior cruciate ligament injuries. Patients can expect a 70% return-to-sport within seven years after ACL Reconstruction. FOIA CAS Clin Biomech. 2019;14(4):65569. Bennell K, Wajswelner H, Lew P, et al. Generally, it takes at least 9 months to recover after ACL reconstruction surgery. Goto K, Ishii N, Kizuka T, et al. PubMedGoogle Scholar. Glasgow P, Phillips N, Bleakley C. Optimal loading: key variables and mechanisms. In turn, the nervous system becomes much more sensitive to various loads placed on the knee. A 10-week randomized trial comparing eccentric vs. concentric hamstring strength training in well-trained soccer players. 2010;20(1):e1629. PHASE I: IMMEDIATE POST-OP (0-2 WEEKS AFTER SURGERY) PHASE II: INTERMEDIATE POST-OP (3-5 WEEKS AFTER SURGERY) PHASE III: LATE POST-OP (6-8 WEEKS He or she may also move your knee into a variety of positions to assess range of motion and overall function of the joint. Diagnosis. The more revision surgeries, the fewer sports. J Electromyogr Kinesiol. Clark R, Bryant A, Culgan J, et al. Biomech. van Melick N, van Cingel RE, Brooijmans F, et al. Duhig S, Shield AJ, Opar D, et al. A systematic review of clinical practice guidelines (CPGs) with a focus on quality appraisal (AGREE II). Am J Sports Med. 2017;57:2707. 1990;8:5763. It is important to optimise the functional recovery process to enhance patient outcomes after major injury such as anterior cruciate ligament reconstruction (ACLR). 2006;40:76772. 2010;11(2):505. 2007;40:355562. Changes in muscle architecture of biceps femoris induced by eccentric strength training with Nordic hamstring exercise. You will feel tired for several days. van der Horst N, Smits DW, Petersen J, et al. WebSure: Muscle and calf discomfort is normal a week after acl surgery, esp. Grindem H, Snyder-Mackler L, Moksnes H, et al. Br J Sports Med. Hamstring stretch The first goal of treatment is to reduce pain and swelling. Biol Open, 7(9), 2018. Timmins RG, Bourne MN, Shield AJ, et al. Public Health Rep. 2012;127(2):14755. Skeletal muscle and hormonal adaptations to circuit weight training in untrained men. Ardern CL, Kvist J, Webster KE. 2019 Mar;53(5):289-298. The relationship between static posture and ACL injury in female athletes. Differences in hamstring activation characteristics between the acceleration and maximum-speed phases of sprinting. He could take his time, go through his progressions, and find the open receiver. Has the athlete trained enough to return to play safely? Strains and tears happen when the muscle is lengthening as it contracts or shortens. The effects of neuromuscular training on knee joint motor control during sidecutting in female elite soccer and handball players. 2019;47(1):8590. Most ligament reconstructions use the semitendinosus and gracilis tendons. Muscular reflexes elicited by electrical stimulation of the anterior cruciate ligament in humans. Sonnery-Cottet B, Saithna A, Quelard B, Daggett M, Borade A, Ouanezar H, Thaunat M, Blakeney WG. Williams GN, Snyder-Mackler L, Barrance PJ, Axe MJ, Buchanan TS. Binkley JM, Stratford PW, Lott SA, Riddle DL. Am J Sports Med. Escamilla RF, Macleod TD, Wilk KE, et al. Faltus J, Criss CR, Grooms DR. Res Sports Med. Morphologic characteristics and strength of the hamstring muscles remain altered at 2 years after use of a hamstring tendon graft in anterior cruciate ligament reconstruction. Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study. Altered knee and ankle kinematics during squatting in those with limited weight-bearinglunge ankle-dorsiflexion range of motion. 2013;41(4):91823. 2014;24(6):e5019. After ACLR and the early post-operative period, there are often considerable deficits in hamstring function which need to be overcome as part of the functional recovery process. 2016;24(1):7783. 2018;36:131328. 2007;35(7):112330. 2018 Mar 1;100-B(3):271-284. Google Scholar. Current concepts for anterior cruciate ligament reconstruction: a criterion-based rehabilitation progression. PLoS ONE. 2017;45:131525. Herman DC, Weinhold PS, Guskiewicz KM, Garrett WE, Yu B, Padua DA. 2017;5(5 suppl 5):2325967117S00181. Deficits in knee flexor function after ACLR are associated with increased risk of knee osteoarthritis, altered gait and sport-type movement quality, and elevated risk of re-injury upon return to sport. 2012;33(12):10004. 2016;48:33745. If you are using crutches and not fully weight bearing on the operative side.Pain Read More. Morgan DL. 2012;42(7):60114. Shelbourne KD, Freeman H, Gray T. Osteoarthritis after anterior cruciate ligament reconstruction: the importance of regaining and maintaining full range of motion. Exploring the high reinjury rate in younger patients undergoing anterior cruciate ligament reconstruction. 1998 Apr-Jun;11(2):131-9. Although informative, it lacks a systematic approach to article selection and does not carry statistical power. 2000;89(6):21915. -, Waldn M, Hgglund M, Magnusson H, Ekstrand J. ACL injuries in mens professional football: a 15-year prospective study on time trends and return-to-play rates reveals only 65% of players still play at the top level 3 years after ACL rupture. A similar sequence of events occurs after an ACL injury and/or after ACL surgery. 2016;44(4):87483. 2016;50:4715. Br J Sports Med. The most common graft used for ACL reconstructions is a hamstring tendon graft. 2008;36(4):73340. 2011;39:53843. National Library of Medicine Loudon JK, Jenkins W, Loudon KL. Br J Sports Med. 2012;215(Pt 11):194456. Impact of exercise selection on hamstring muscle activation. Pain in the front of the knee occurs in 2019;51(1):94103. Acta Physiol Scand. Med Sci Sports Exerc. Br J Sports Med. Med Sci Sports Exerc. Bowen L, Gross AS, Gimpel M, et al. Nonuniform muscle hypertrophy: its relation to muscle activation in training session. Am J Sports Med. A recent study aimed to outline evidence-based recommendations for the recovery of hamstring muscle function after ACL reconstruction. WebSure: Muscle and calf discomfort is normal a week after acl surgery, esp. Oftentimes, this cramping occurs in the toes, calf, or hamstring. If you have a question, suggestion or a link to some related research, share below! 2016;44(8):211221. J Biomech. Created for people with ongoing healthcare needs but benefits everyone. Strains and tears happen when the muscle is lengthening as it contracts or shortens. J Sports Med. If you have suffered a muscle tear as a result of a hamstring cramp then wait until the initial acute phase has passed. 2018;52(13):8167. 2017;51:4529. 2023 Springer Nature Switzerland AG. Muscle strain is the most common cause of cramps. Guex K, Degache F, Gremion G, Millet GP. The preventive effect of the Nordic hamstring exercise on hamstring injuries in amateur soccer players: a randomized controlled trial. Int J Sports Phys Ther. MeSH 200(3), 1977. Br J Sports Med. This may explain why some studies find weakness when the hamstring muscles are tested after this kind of ACL repair. Zakulak BT, Hewett TE, Reeves NP, et al. 2007;17(4):25862. Baumgart C, Welling W, Hoppe MW, Freiwald J, Gokeler A. Angle-specific analysis of isokinetic quadriceps and hamstring torques and ratios in patients after ACL-reconstruction. Fernandez-Gonzalo R, Tesch PA, Linnehan RM, et al. Musculotendon variability influences tissue strains experienced by the biceps femoris long head muscle during high-speed running. Harput G, Kilinc HE, Ozer HE, et al. Am J Sports Med. 2015;47(4):85765. Identification of athletes at future risk of anterior cruciate ligament ruptures by neuromuscular screening. Hu, W.W., Chen, T.C., Tsao, C.W., Cheng, Y.C., The effects of substrate-mediated electrical stimulation on the promotion of osteogenic differentiation and its optimization. Am J Sports Med. Buckthorpe M, Frizziero A, Roi GS. Only one patient out of five achieves symmetrical knee function 6 months after primary anterior cruciate ligament reconstruction. ACL Recovery After an ACL injury or ACL surgery, many athletes report experiencing increased frequency of muscle cramping. Hanson DW, Finch CF, Allegrante JP, et al. Hexter AT, Thangarajah T, Blunn G, Haddad FS. Higashihara A, Nagano Y, Ono T, et al. J Sci Med Sport. For a long time after this surgery, can easily be three months, six is not out of the question, there will be some swelling. 2016;50:94651. Eccentric hamstring strength and hamstring injury risk in Australian Footballers. J Biomech. That will initially be from the surgery. Am J Sports Med. 2014;47:332533. This is usually 24 to 48 hours. Scand J Med Sci Sports. Effects of eccentric exercise on optimum length of the knee flexors and extensors during the preseason in professional soccer players. Strength and architectural risk factors for hamstring strain injury in elite Australian soccer: a prospective cohort study. 2009;9(1):38. That will initially be from the surgery. Early emphasis on quadriceps strengthening in ACL rehabilitation has potential to overshadow the need for hamstring strengthening. Predicting maximum eccentric strength from surface EMG measurements. J Orthop Sports Phys Ther. 2002;34(4):6626. A ligament needs to be reconstructed. 2016 Oct;44(10):2608-2614. Scand J Med Sci Sports. Quadriceps strengthening with and without blood flow restriction in the treatment of patellofemoral pain: a double-blind randomised trial. Clin J Sport Med. 2016;44(11):282732. Waldn M, Krosshaug T, Bjrneboe J, et al. Careers. Then deep tissue massage can be done to encourage healing. Save my name, email, and website in this browser for the next time I comment. 2016;50:8048. 2014;48:13649. Giles L, Webster KE, McClelland J, et al. PubMed Phys Ther Sport. Potier TG, Alexander CM, Seynnes OR. 2005;6:6773. Bourne MN, Bruder AM, Mentiplay BF, et al. Muscle strain is the most common cause of cramps. Am J Sports Med. Leppik L.P., Froemel D., Slavici A., Ovadia Z.N., Hudak L., Henrich D., Marzi I., Barker J.H., Effects of electrical stimulation on rat limb regeneration, a new look at an old model. Ono T, Okuwaki T, Fukubayashi T. Differences in activation patterns of knee flexor muscles during concentric and eccentric exercises. Sports Med. Hamstring muscle activation and morphology are significantly altered 16 years after anterior cruciate ligament reconstruction with semitendinosus graft. However, the changes seem to mainly occur if both the semitendinosus and gracilis tendons were used. Oxford: Elsevier Health Sciences; 2013. 2014;35(6):52833. Effects of muscle strengthening on vertical jump height: a simulation study. Br J Sports Med. 2015;25(3):3017. Recurrent hamstring muscle injury: applying the limited evidence in the professional football setting with a seven-point programme. American College of Sports Medicine. Res Sports Med. Schuermans J, Van Tiggelen D, Palmans T, et al. Hamstring injury prevention in soccer: before or after training? Critical Review of the Biopsychosocial Model, Effect of Manipulation on Sacroiliac Joint Position, Return to Play Following Patellar Instability, Dry Needling vs Sham Dry Needling for Neck Pain, Motion Control Shoes for Pronation in Runners, Effect of Kinesiophobia on Patellofemoral Pain, Achilles Tendinopathy Prognosis in Runners, Physical Activity Promotion Among Physiotherapists. The effects of sprint training and the Nordic hamstring exercise on eccentric hamstring strength and sprint performance in adolescent athletes. Knee Surg Sports Traumatol Arthrosc. Your favorite (American) football team suddenly develops offensive line problems. Learn more about this service here. Med Sci Sports Exerc. Wakahara T, Miyamoto N, Sugisaki N, et al. Google Scholar. Complex systems approach for sports injuries: moving from risk factor identification to injury pattern recognitionnarrative review and new concept. Konrath JM, Vertullo CJ, Kennedy BA, et al. 2015;3(5):2325967115583632. Integration of strength and conditioning principles into a rehabilitation program. and transmitted securely. The use of MRI to evaluate posterior thigh muscle activity and damage during Nordic Hamstring exercise. Med Sci Sports Exerc. Neubie. 2015;49:2789. Noorkoiv M, Nosaka K, Blazevich AJ. Article Mendiguchia J, Arcos AL, Garrues MA, et al. Messer DJ, Bourne MN, Williams MD, et al. PubMed Recommendations for Hamstring Function Recovery After ACL Reconstruction. Scand J Med Sci Sports. Neural adaptations to resistance training. Deficits in knee flexor function after ACLR are associated with increased risk of knee osteoarthritis, altered gait and sport-type movement quality, and elevated risk of re-injury upon return to sport. HHS Vulnerability Disclosure, Help J Orthop Sports Phys Ther. 2017;12:71827. Br J Sports Med. Freeman BW, Young WB, Talpey SW, et al. Knee extensor and flexor strength before and after anterior cruciate ligament reconstruction in a large sample of patients: influence of graft type. In most cases, the graft is a tendon taken from your own knee or hamstring. Position stand: progression models in resistance training for healthy adults. Br J Sports Med. Int J Sports Med. Sprinting is arguably the most effective hamstring exercise there is, as it incorporates rapid angular velocities and high demands of both hip extension and knee flexion and has the greatest carryover to sport performance for field athletes. April 30-May 2, 2009, Fells Point, Baltimore, MD. 2013;31(14):154552. Thus, the hamstring muscles are considered ACL-agonists. WebAnterior cruciate ligament (ACL) surgery replaces the damaged ligament with a new ligament called a graft. The effects of isometric and isotonic training on hamstring stiffness and anterior cruciate ligament loading mechanisms. ACL injury, the resultant surgery and reduced functionality after surgery significantly impact on hamstring function, with deficits of nearly 50% reported at 4 weeks after ACLR with hamstring tendon autograft (HG) [ 19 ]. 2012;4(1):1724. Beneke R, Taylor MJ. Decker MJ, Torry MR, Noonan TJ, Riviere A, Sterett WI. J Athl Train. Int J Sports Med. Part of Springer Nature. Chumanov ES, Heiderscheit BC, Thelen DG. PHASE I: IMMEDIATE POST-OP (0-2 WEEKS AFTER SURGERY) PHASE II: INTERMEDIATE POST-OP (3-5 WEEKS AFTER SURGERY) PHASE III: LATE POST-OP (6-8 WEEKS The second the ACL tears, the nervous system recognizes the body has experienced a severe trauma. Chumanov ES, Heiderscheit BC, Thelen DG. During the physical exam, your doctor will check your knee for swelling and tenderness comparing your injured knee to your uninjured knee. Sports Med. Systematic video analysis of ACL injuries in professional male football (soccer): injury mechanisms, situational patterns and biomechanics study on 134 consecutive cases. 2014;95(3):55261. More RC, Karras BT, Neiman R, et al. 2002;34(9):140813. WebACL Reconstruction Rehabilitation Guidelines- Hamstring graft The following rehabilitation guidelines are based upon current scientific literature and our clinical experience in rehabilitation of athletes following Anterior The younger hamstring graft is too stiff Younger patients have worse surgical outcomes. A less effective offense, more passes thrown away, and more interceptions. Borgens R.B., Vanable J.W., Jaffe L.F., Bioelectricity and regeneration. WebACL Reconstruction Rehabilitation Guidelines- Hamstring graft The following rehabilitation guidelines are based upon current scientific literature and our clinical experience in rehabilitation of athletes following Anterior Federal government websites often end in .gov or .mil. Required fields are marked *. Scand J Med Sci Sports. Best Pract Res Clin Rheumatol. PubMed Central 2016;44(2):35561. Eur J Appl Physiol. Med Sci Sports Exerc. Buckthorpe M, Della VF. Periodization: current review and suggested implementation for athletic rehabilitation. J Orthop Sports Phys Ther. 2002;18(2):17782. New insights into the behavior of muscle during active lengthening. Deficits in knee flexion strength can play a large role in ACL re-injury and should be more carefully measured during the return to sport decision-making process. II. Wright AR, Richardson AB, Kikuchi CK, Goldberg DB, Marumoto JM, Kan DM. 2019;27(11):346170. Scand J Med Sci Sports. Eccentric knee flexor weakness in elite female footballers 110 years following anterior cruciate ligament reconstruction. Koga H, Nakamae A, Shima Y, et al. Previous injury as a risk factor for injury in elite football: a prospective study over two consecutive seasons. Hamstring cramps may result from improperly warming up for an activity or doing too much activity. Br J Sports Med. 1998;79(1):4957. Am J Sports Med. Once youve torn your ACL, you cannot sew the end of the ACL back together. Predictors of hamstring injury at the elite level of Australian football. Huber R, Viecelli C, Bizzini M, et al. Sports Med. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 2011;39:53843. Three distinct mechanisms predominate in non-contact anterior cruciate ligament injuries in male professional football players: a systematic video analysis of 39 cases. Faculty of Sport, Health and Applied Science, St Marys University, Twickenham, London, TW1 4SX, UK, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Education and Research Department, Bologna, Italy, Matthew Buckthorpe,Giovanni La Rosa&Francesco Della Villa, Isokinetic Medical Group, FIFA Medical Centre of Excellence, London, UK, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Milan, Italy, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy, You can also search for this author in 2014;46(8):152537. Muscle and tendon morphology after reconstruction of the anterior cruciate ligament with autologous semitendinosus-gracilis graft. Am J Sports Med. 2012;94:127482. Generally, it takes at least 9 months to recover after ACL reconstruction surgery. The effect of speed and influence of individual muscles on hamstring mechanics during the swing phase of sprinting. Once youve torn your ACL, you cannot sew the end of the ACL back together. Askling C, Karlsson J, Thorstensson A. Hamstring injury occurrence in elite soccer players after preseason strength training with eccentric overload. His feet sped up, he was panicky, and even when the offensive line did give him a little bit of time, he was getting the ball out as fast as humanly possible. Biceps femoris architecture and strength in athletes with a previous anterior cruciate ligament reconstruction. Lovell R, Knox M, Weston M, et al. Harber MP, Fry AC, Rubin MR, et al. So why does it happen? He or she may also move your knee into a variety of positions to assess range of motion and overall function of the joint. If you have suffered a muscle tear as a result of a hamstring cramp then wait until the initial acute phase has passed. Factors used to determine return to unrestricted sports activities after anterior cruciate ligament reconstruction. WebThere is limited information in the literature regarding hamstring pain and muscle strains in patients following anterior cruciate ligament (ACL) reconstruction using hamstring autograft. Maximal and explosive strength training elicit distinct neuromuscular adaptations, specific to the training stimulus. Sahrmann S. Diagnosis and treatment of movement impairment syndromes. J Biomech. During the physical exam, your doctor will check your knee for swelling and tenderness comparing your injured knee to your uninjured knee. It locks down muscles responsible for generating forces around the knee joint by rapidly shortening the muscle what we know as cramps. 2012;112(4):156976. 8(8), 2013. There is a need to know how to train the hamstrings, but also apply this to the ACLR athlete. 2006;9:39. Phys Ther Sport. Nagano A, Gerritsen KGM. 2019;78(11 Suppl 2):41-46. Anderson K, Behm DG. WebOne important consideration after ACLR is the recovery of hamstring muscle function, particularly when using ipsilateral hamstring autograft. The relationship of hamstrings and quadriceps strength to anterior cruciate ligament injury in female athletes. 2018;28:177583. Orchard JW. Della Villa S, Boldrini L, Ricci M, et al. 2010;43:257481. Resistance training intensity and volume affect changes in rate of force development in resistance-trained men. 2017;20:2504. 2015;25:6409. This is a preview of subscription content, access via your institution. Optimising the 'mid-stage training and testing process after ACL reconstruction. In some cases, the graft comes from a donor. Am J Sports Med. Diagnosis. J Athl Train. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. 2016;50:27380. Failla MJ, Logerstedt DS, Grindem H, Axe MJ, Risberg MA, Engebretsen L, Huston LJ, Spindler KP, Snyder-Mackler L. Does Extended Preoperative Rehabilitation Influence Outcomes 2 Years After ACL Reconstruction? 2016;144(34):1517. 2019;9(40):108. J Sci Med Sport. Snow BJ, Wilcox JJ, Burks RT, Greis PE. Shifting Focus: A Clinicians Guide to Understanding Neuroplasticity for Anterior Cruciate Ligament Rehabilitation. Int J Sports Phys Ther. Hamstring cramps may result from improperly warming up for an activity or doing too much activity.

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