Worst Breakfast Foods

In other words, think twice before adding these 10 worst breakfast foods to your diet every morning.

1. Pancakes With Syrup

Worst Breakfast Foods - Pancakes with syrup

Pancakes with syrup

When it comes to breakfast, waffles or pancakes or any other related snack food or deserts are to be avoided completely as they are usually made from white high carbohydrates refined to which salt and sugar are added.

To make the situation even more appalling, pancakes and other related foods are usually topped with syrups that are awash with sugar or a fructose based syrup.

Instead go for healthier options like maple syrup.

2. Cereals

Worst Breakfast Foods - Cereals with milk

Cereals with milk

Whether its breakfast or dinner all cereals including oats and corn should be avoided.

Most of them are genetically modified and contain gluten which can be very addictive or even lead to uncontrolled hunger pangs.

In addition, most cereals are sugar coated or contain added sugar to appeal to kid’s tastes. Instead of cereals, go for seeds or nuts.

3. Muffins

Worst Breakfast Foods - Muffins

Jaffa muffins

Although they have a misguided reputation of being nutritious, muffins are just small sized cakes.

In all the ingredients that muffin is made of (sugar, vegetable oils, refined flour) eggs are the only healthy ingredient.

To make matters worse, commercially made muffins are usually very large and a recent study show that in the US, most exceed the standard portion by over 300 percent.

There are also some commercial sold muffins that are usually filled with dried fruits or chocolate chips and additional sugar, further skyrocketing their calorie and sugar content.

4. Sweet Marmalade Or Toast With Jam

Worst Breakfast Foods - Toast with jam

Toast with jam

Sweet marmalade or toast with jam are a carbohydrate in its purest form.

So avoid them, and if you really want to have a toast for your breakfast, top it with some form of protein like eggs without sausage, bacon or any other processed protein.

If you are on a no carb diet or on high or low fat diet, there are healthy types of bread that you can eat instead of toast or white bread.

So if you want to have an appealing reading on the body fat scale, Opt for those made using almond or coconut flour.

5. Gluten-Free, Processed Foods

Worst Breakfast Foods - Gluten free bread

Gluten free bread

Although there is nothing wrong with avoiding foods that contain gluten, consuming most of the processed gluten free foods you see on supermarket shelves is not good for your health.

For instance a blend of flours made from tapioca, potatoes and rice replaces the wheat in gluten free processed foods.

Which is seems like a good idea but the flours are very high on the glycemic index and they raise blood sugar instantly.

This in turn leads to increased insulin levels that can easily cause weight gain and rebound hunger.

Even gluten free baked foods like muffins and pancakes are no better than their conventional based versions because of their low fiber and protein content.

6. Processed Meats

Worst Breakfast Foods - Processed meat

Processed meat

While they might seem like a quick and good sugar free option for breakfast, the nitrates found in sausages, ham, bacon have been linked to colorectal cancer.

So always check if the food you are buying contains nitrates, if it does just avoid it and a few years from now you will be glad you did.

7. Breakfast Smoothies

Worst Breakfast Foods - Breakfast smoothie

Breakfast smoothie

Most store bought breakfast smoothies are very sweet because they contain a lot of refined sugar.

Some even contain cream and fat milk, which makes them more of a dessert than a healthy breakfast drink.

Instead of store bought smoothies, just prepare your own version using skim milk or unsweetened almond milk, Greek yogurt and frozen or fresh fruit.

8. Donuts

Worst Breakfast Foods - Donuts

Delicious donuts

Regardless of how the manufacturer calls it, donuts are sugar coated, full of unhealthy fat and filled with jam.

They will only work to quench your thirst for sweetness and ultimately a trip to your dentist. So do yourself a favor and go for a whole bagel.

Sliced bananas or raw almond butter might also help if you are craving for anything creamy and sweet.

9. A Bagel With Cream Or Butter Cheese

Worst Breakfast Foods - Bagels

Bagels with butter

Most bagels do not have protein and a single bagel is equivalent to 5 slices of white bread.

You can make this meal nutritious by opting for a whole-wheat version, consuming half and spreading on a healthy topping like peanut butter or mashed avocado.

10. Burger On A Burn

Worst Breakfast Foods - Burgers

Tasty burger

Not all burgers are unhealthy; it all depends on how they were prepared.

A burger patty prepared with healthy meat only will not harm you.

But if you are going to lather it with a sugar packed sauce, you will be doing more harm than good to yourself.

Do not be swindled by the idea of taking it with salad or greasy chips is better either.

Bottom Line

What you eat in the morning has the potential to either make or break your day.

An unhealthy breakfast will leave you struggling to get through the day, while a healthy breakfast will set you up for a productive day of stable blood sugar and great energy levels.

So if you want to have a productive day at work or in school, opt for a morning meal that has healthy fat, protein and fiber from whole foods.

Finally, eating any of these 10 worst breakfast foods mentioned here is way better than missing your morning meal altogether.

And there is a good reason for this. You won’t get enough energy to get going in the morning and you are likely to overeat during the day, especially in the evening which is not a good time to eat a lot if you are trying to lose or maintain your weight.

Choosing between contact lenses and glasses could be a problem in itself. Contact lenses are considered a better choice during workouts, but like every other accessory, they too have certain advantages and disadvantages.

If you don’t want to use glasses or lenses, there is still a solution – a laser eye surgery performed by specialists such as eye7.in. You can check out online for more details.

Advantages Of Using Contact Lenses In The Gym

Here is a list with the most noticeable reasons you should use contact lenses instead of glasses in the gym.

1. They Don’t Fall Off

Since contact lenses are fixed, they save you the trouble of not worrying about them falling off, as in the case of glasses. You can use all kinds of machines and they would still be in there place.

You might find it difficult run on a treadmill with your glasses on, but not with contact lenses.

2. No Slipping On the Nose

They are also considered the best alternative to glasses because you have to set them again and again, as they slip more when you are working out vigorously.

3. No Fog

One other benefit associated with contact lenses is that they don’t get foggy like spectacles. So you don’t have to clean them to get a clear view.

4. Periphery

Lenses have peripheral vision, which means that you won’t have to turn around or move your head to look around during your workout.

5. No Breaking

Glasses are not cheap and they are hard to replace. There’s always a chance that your glasses may fall and break, contact lenses on the other hand do not break.

6. Comfortable

Apart from all the practical benefits of contact lenses, they are comfortable. They are easy to put on and you can wear them wherever you want.

Disadvantages Of Using Contact Lenses In The Gym

As mentioned earlier, contact lenses have cons too.

1. Handle With Care

They are delicate. They come with instructions and these instructions should be followed very carefully.

2. Dryness

Different types of contact lenses have different type of cons associated with them, although all of them make eyes dry.

Dryness may cause itching and vision problems during an exercise which could interrupt you. Once it gets dry, you need to wet your eyes and also give your eyes a little rest.

All this can ruin your workout instantly and once your lose the rhythm, it’s unlikely for you to get it back.

3. Dust

Dust is a huge disaster for lenses. If you go to your gym on foot, there are huge chances that you’d catch dust in your eyes. It can cause irritation and trouble you on the way.

Even when you choose to reach your gym via car or bus, you still have to look out for dirt. Once your lenses are harmed, they have to be taken out.

4. Infection

Another reason that goes against the use of contact lenses in the gym is that contact lenses do not allow oxygen to reach your eye.

While in gym, when you’re working out furiously, your body is consuming more oxygen due to fast movement and cardio rate. Gyms are mostly air conditioned due to close environment and the level of oxygen is already low.

The shortage of oxygen may cause infections to the eyes in case they are used on regular basis.

5. Can’t Wash With Water

The worst part is you have to carry the cleaning solution with you. Lenses cannot be washed with water. The bacteria and other germs in the water may damage the lenses and you might have to replace them.

Do you wear glasses or contact lenses in the gym? How do you manage to handle this? Leave a comment to inspire others.

Eat More Often

This is pretty straightforward and doesn’t need much explanation. If you want to gain weight, you have to eat more frequently. As a perpetually skinny guy, your body’s metabolic rate is much higher. To counteract this increased burn rate, you should eat throughout the day to ensure that your body isn’t resorting to burning off weight. Again, hard gainers can’t just eat at breakfast, lunch and dinner. Snacking throughout the day and not just when you are hungry is crucial towards gaining weight fast.

Track Your Food Intake Carefully

Chances are food tracking doesn’t occur to you because you’ve never had to worry about overeating. However, becoming meticulous about your eating schedule is one of the only ways to ensure you are consuming enough calories to satisfy your metabolism. Once you determine how many calories you need each day to gain weight, you want to plan each day’s meals out ahead of time. This gives you the opportunity to first understand how much food, as a whole, is needed each day and then see how often and how much you need to eat at each meal or snack. Without planning, it is all too easy to slack off and neglect your diet.

Double Your Intake

Similar to Tip #2 and eating more often, doubling your intake doesn’t require a ton of thought, especially considering that if you follow the previous tip and plan your meals, you are already going to have a concrete idea of how much you are going to need to consume each day. That said, doubling your intake is still important towards hitting your daily calorie needs. This is going to involve asking for seconds whenever possible and making meals with larger proportions. It may take your body, in particular your stomach, to get used to the sudden boost in intake. Don’t expect to instantly be able to eat twice as much whenever you please. Try and make the shift gradual when possible.

Drink Less Alcohol

This goes along with scarfing down fast food for every meal. Pounding back alcoholic drinks regularly can have a negative effect on your weight gaining goals. Sure, you may be happy that you can opt for a heavier beer, instead of a light beer, but at the end of the day it is all empty calories. Your body isn’t designed to store alcohol, so it aims to metabolize it right away, which puts other processes in the body on hold. This means you will be getting less from the foods you eat. It is also worth mentioning that chronic alcohol abuse can lead to malnourishment and cause your body to shed weight, instead of putting it on.

Exercise

Develop Exercise Habits that are Conducive to Weight Gain

Next to your diet, your exercise routines are the biggest factor towards your weight gain goals. While jogging and being active are certainly healthy choices, you want to add resistance and weight training to your routines. Many of these exercises are conducive to gaining muscles, which translates into more weight. By developing a comprehensive workout schedule and adding it to your meal plan from, you are more likely to stick to the routine each day. Plus, it helps you plan meals around your workout, to avoid training hungry.

 Lift Heavier Weights

The fact is lifting weights helps build muscle and more muscle growth means more weight gain. If you aren’t actively using your now-increased caloric intake, you are going to be gaining fat and not muscle. When weight training, there are a few things to take into account. First, warming up is key. If you walk into weight training cold and start trying to maximize your efforts, you have a high risk of injuring yourself, which will impede you from being able to train at all. When resistance training for weight gain, you want to shoot for 8-12 reps with each exercise. This is optimal for building muscle.

Don’t Neglect Cardio

It is typical for skinny guys looking to gain weight to shy away from cardio. We are programed to think cardio equals weight loss. Cardio just burns fat, which is a good thing. However, how you perform cardio is key. If you do too much for too long, your body will be even more fatigued than usual and that will affect your next weight lifting routine. Additionally, certain forms of cardio present a greater risk to your muscle growth. Cycling, for example, is seen as causing less muscle damage than say running or jogging.

 Avoid Training Hungry

This tip is probably the easiest one on the list because if you are following the first five tips regarding dieting, then you should really never be doing anything hungry. With all that added intake, you should never really be hungry. However, some people like to exercise as the very first thing they do in the morning, which could lead to them training while hungry. Eating before your workout will give you more energy to ensure that you don’t start to fatigue halfway through your regimen. If you don’t have time to eat, a protein supplement shake may be a sufficient alternative.

  

Follow a Workout Regimen

The concept of planning is always important, in both dieting and exercising. Following a workout regimen, especially one designed for someone in your position, ensures that you are exercising in a way that is going to maximize your efforts towards achieving your weight gain goals. You’re probably not a fitness guru, so take the advice of someone who is. A workout plan can also help ensure that each muscle group is appropriately targeted, while giving it time to rest and repair after the training. It’s okay to switch regimens if you are getting bored of the same routine or want to try new things.

If You’re Going to Run, Sprint

On the topic of cardio and increasing size, there is interesting evidence to suggest that sprinting is better than jogging. In other words, shorter but more intense cardio exercises, such as quick sprints, are more advantageous (in terms of gaining weight) than longer jogs. Sprinting all out (giving it everything you’ve got) for 10-30 seconds for 4-10 sets, as part of your exercise routine, can actually promote muscle growth. As a high intensity exercise, it is important to work at sprinting gradually. Don’t shoot for 30-second sprints on your first trial and, as always, stretch to reduce injury.

 Don’t Overlook the Benefits of Supplements

There is a variety of weight gaining supplements on the market today in the form of powders, pills and drinks. Knowing which ones to take, how to take them and when can be important. These do not take the place of actual food (remember, supplement means ‘in addition to’), but they can help promote more muscle growth during and after a workout, give you more muscle-building proteins and provide your diet with lots of essential amino acids and other helpful resources. Other changes to your daily routine, such as maintaining a healthy sleep schedule, are also imperative for a hardgainer to put on weight.

Creatine

Creatine is a popularized amino acid that is found in a lot of workout supplements. It is naturally occurring in our bodies and is found within the cells of our muscles. During a workout, it gives you and your muscles more energy, which allows you to complete more reps and maximize each day’s efforts. It is almost guaranteed that you will be gaining some amount of weight if you add a creatine supplement into your workout routine because more reps equals more muscle growth and more muscle growth means more weight gain.

 Whey Protein

Hard gainers struggle with protein intake and maintaining a high calorie diet for a variety of reasons. The biggest of these reasons are time and money. Even preparing meals ahead of time takes a lot of, well, time. If you have a busy work, school or social schedule, it won’t be easy to squeeze in extra mealtime. It also isn’t affordable for everyone. A lot of the dried fruits, nuts and proteins that are rich in healthy, wholesome calories are expensive at the grocery store. A whey protein supplement can help you reach your daily protein needs easily, especially on busy days when you’re forced to skip a meal.

 Branched-Chain Amino Acids (BCAA’s)

Similar to creatine, BCAA’s are naturally occurring amino acids found in your body, specifically Leucine, Isoleucine and Valine. Their benefits, in terms of dieting and exercising to gain weight, are numerous. They help repair damaged muscles after a workout, which not only decreases muscle soreness the following day, but also reduces fatigue the next time you hit the gym. They can also promote muscle-protein synthesis. This means a boost to your muscle growth and thereby weight gaining efforts. BCAA’s are often found in supplements for these reasons.

 Sleep Longer

Sleep is an often forgotten component to building muscles and many of us get far too little of it. When you sleep, your body will metabolize protein at a faster rate. This is a crucial step to repairing, rejuvenating and rebuilding muscles that were torn down during your workout from the day. Ideally, you should shoot for 8-10 hours of sleep each night. While this isn’t always possible, especially if you have a busy household or heavy workload, you should make extra effort to fall asleep sooner on days that you worked out.

 Don’t Neglect Post-Workout Meals

During and immediately after your workout, your blood circulation is at its peak. Getting pumped up at the gym literally pumps blood through your body quicker. When your workout is finished, your body needs two things to begin its cool down phase and replenish its stores: carbohydrates and protein. For muscle building, you should aim for at least 30 grams of protein and around 35 grams of carbs (give or take a few) and you should try and consume them right after your workout concludes; about 15 minutes is your golden window. Good post-workout meals include a sandwich or wrap (carbohydrates from the bread/wrap and protein from the meats), fruit, eggs or a protein shake, if you are really in a rush.

 Conclusions

If you are sick of being the skinny guy in the group and want to make a push to gain weight fast, then you are going to have to make some radical changes to your lifestyle. This means changing your diet, exercise routine, sleep schedule and your feelings on supplements. With your super high metabolism, gaining weight is going to be like a part time job, but reaching your weight goals will be all the reward you need for your hard work and dedication to this lifestyle change.

1. Palms-In Shoulder Press

Stand up and hold 2 dumbbells at shoulder level, palms facing each other. Push the dumbbells straight up until the elbows come close to locking and lower them back down after a short pause. You can also perform this exercise while sitting on a bench or chair. Be careful not to jerk your back in an effort to help you raise the dumbbells.

2. Palm-In Alternated Shoulder Press

Stand up and hold 2 dumbbells, one at shoulder level and the other high with your arm extended, palms facing each other. Push one dumbbell straight up until your elbow almost locks and lower it back down after a short pause. Alternate hands.Can be performed while seated.

3. Shoulder Press

Stand up and hold two dumbbells close to your shoulders, palms facing forward. Raise the dumbbells straight up until your elbows come close to locking and lower them back after a short pause. This exercise can be performed while seated, or seated with your back supported.

4. Lateral Raise

Stand up and hold one dumbbell with each hand in front of your hips, palms facing each other. Raise the dumbbells to your side until your arms are close to being parallel to the ground and lower them back down after a short pause. Try to maintain the angles in your elbows still throughout the movement. You also have the option of doing seated lateral raises.

5. Bent-Over One-Arm Deltoid Raise

Bend down and hold one dumbbell with one hand between your legs, knees slightly bent. Raise the dumbbell to your side until your arm is parallel to the ground and lower it back down slowly after a short pause. Keep your back straight.

6. Rear Deltoid Circle

Lie down on your chest on a bench and hold one dumbbell in each hand on each side of your hips, arms slightly arched. Bring both dumbbells forward until you can see both at the same time and bring them backwards slowly after a short pause. Maintain the same small arch in your elbows and keep both dumbbells at the same height from the floor.

7. Straight-Arm Front Deltoid Raise

Stand up and hold one dumbbell in each hand in front of your thighs. Raise the dumbbells to your shoulder level and continue to raise them up at arms’ length. Lower them back slowly after a pause. Keep your arm extended.

8. Shoulder Shrug

Stand up and hold one dumbbell with each hand in front of your thigh, palms facing your body. Raise the dumbbells straight up by raising your shoulder and lower them back after a short pause.

9. Front Raise

Stand up and hold one dumbbell with each hand in front of your thighs, palms facing your body. Raise the dumbbell forward then up until your arms are close to being parallel to the ground and lower them back down after a short pause.

10. Crouched Rear Deltoid Row

Crouch by bending your hips and knees and hold one dumbbell with each hand close to your knees, palms facing backwards. Raise the dumbbell straight up until your elbows form a 90 degree angle and lower them back down after a short pause. Try to focus on only moving your arms during the exercise.

Now that you have a variety of shoulder exercises to choose from, mix them up so you target all your shoulder muscles and keep things interesting.

Juicing is no longer a lengthy cleanse used by extreme dieters or health nuts. Juices are much more than thirst quenchers; they are instant energy renders. Here are 5 juice to boost your energy.Grapes JuiceThis is a quick and simple recipe to raise your energy levels by detoxifying your lymphatic system. The grapefruit juice naturally provides you with a powerful punch of vitamin C while the celery replenishes your body with electrolytes.

Carrot JuiceCarrot contains high quantities of beta carotene or Vitamin A, a powerful antioxidant. It removes free radicals from your system, which can cause a lot of damage. However, it shouldn't be consumed in huge amounts, not unless you think yellow skin is a good look on you.

Melon JuiceIt's loaded with water, it will give you the hydration you need to look and feel alive as you go about your day.

Coconut juiceThe coconut in this juice recipe delivers a dose of electrolytes similar to those that balance out our own blood. In fact, doctors have used coconuts to help fight dehydrating diseases such as cholera, dysentery, and influenza, helping save the lives of thousands of children in underdeveloped parts of the world, according to Organic Avenue founder Denise Mari.

Cherry JuiceTart cherries are the richest sources of antioxidants in the fruit and vegetable kingdom. This makes it an ideal choice as an energy boosting drink. A glass of cherry juice has a healthy amount of carbohydrates that give you instant energy without sticking around.

Muscle healing and the role of early eccentric muscle contractions

Muscle injuries are common in football practice. Lower limb muscle injuries represent around 37% of the total injuries in a football team being the hamstrings, adductors, quadriceps and calf muscles the most frequently injured muscles (Ekstrand J., Hagglund M., Walden M., 2011; Hagglund M., Walden M., Ekstrand J., 2005; Hawkins R.D., Hulse M.A., Wilkinson C., Hodson A., Gibson M., 2001; Hagglund M., Walden M., Ekstrand J., 2012). A muscle injury rehabilitation in football or any other sport should be as functional as possible and include early forms of recruitment of the injured muscle. The aim of the present article is to show the benefits of introduction of early isotonic contractions with focus on the eccentric phase instead of isometric muscle actions, and discuss which timings during the rehabilitation are appropriated for different types of stimulus to the injured muscle, after a moderate (grade 2) muscle injury.

How does a muscle heal?

After a muscle injury the damaged tissue follows a natural course of healing (Figure 1). First a destruction period takes place, with concomitant rupture and necrosis of the myofibres, formation of a haematoma, and an inflammatory cell reaction (Figure 2AB) (Huard, J., Li, Y., Fu, F.H., 2002; Hurme, T., Kalimo, H., Lehto, M., Jarvinen, M., 1991; Jarvinen, T.A.H., Jarvinen, T.L.N., Kaariainen, M., Aarimaa, V., Kalimo, H., Jarvinen, M., 2005; Kalimo, H., Rantanen, J. Jarvinen, M., 1997; Jar vinen, T.A.H., Jarvinen, M., Kalimo, H., 2013).

tissue repair phases and timescale

After this period starts simultaneously a reparative process where macrophages remove by phagocytosis the necrotized tissue, and the regenerative process of the myofibers with concomitant production of a connective tissue scar, alongside with capillary ingrowth into the injured area

(Bisciotti, G.N., Eirale, C., 2013; Jarvinen, T.A.H., Jarvinen, T.L.N., Kaariainen, M., Aarimaa, V., Kalimo, H., Jarvinen, M., 2005; Jarvinen, T.A.H., Jarvinen, T.L.N, Kaariainen, M., Aarimaa, V., Vaittinen, S., Kalimo, H., et al., 2007; Jarvinen, T.A.H., Jarvinen, M., Kalimo, H., 2013).

Macrophages also secrete growth factors activating the stem cells of the muscle tissue existent between the sarcolemma and the basal lamina of the myofibres, which will then sequentially form myoblasts, fuse into myotubes and mature into myofibres (Figure 2CDE) (Bisciotti, G.N., Eir ale, C., 2013; Jarvinen, T.A.H., Jarvinen, T.L.N, Kaariainen, M., Aarimaa, V., Vaittinen, S., Kalimo, H., et al., 2007; Jarvinen, T.A.H., Jarvinen, M., Kalimo, H., 2013).

The last stage of a muscle healing is the remodelling phase, which despite overlapping with the reparative and regenerative processes that last up to the third or fourth weeks after injury, remodelling can extend itself up to four or six months (Arrington, E.D., Miller, M.D., 1995; Tidball, J.G., 2005; Kalimo, H., Rantanen, J., Jarvinen, M., 1997). This stage is characterized by the maturation of the fibers recently repaired, and the re-organization of the scar tissue (Figure 2F) (Bisciotti, G.N., Eirale, C., 2013; Jarvinen, T.A.H., Jarvinen, M., Kalimo, H., 2013). Knowledge of this healing sequence and general aspects of each process is fundamental for rehabilitation´s strategies we implement at Football Medicine.

regeneration of a muscle injury 

  

How does the tensile strength of the injured area progresses through the course of healing?

Before answering this question it is relevant to understand when does actually new tissue is being formed, because hypothetically the injured area will be capable of sustaining some level of tension after fulfilled with some scar tissue. As stated in the section above, the first stage after the traumatic event is mainly characterized by a destruction and re-organization of the injured area. New tissue will hardly be formed in the first day after the injury. As it was shown in a study by Best et al. (2001), in which a stretch injury was induced to the tibialis anterior muscle of rabbits, focal fibrotic tissue constituted by deposits of collagen I and III were only noticeable after three days of the initial injury and were significant present after seven days.

The healing progression and its histological changes might be directly related with the capability of the tissue to deform to stimulus in terms of changes in its length but also the amount of load it can be absorbed by the muscle, which ultimately will determine the rehabilitation protocol. Considering this, it is interesting to verify that a study carried out by Corr et al. (2003) using the same laboratorial injury method in rabbits from Best et al. (2001), in which elongation to failure was analysed, concluded that the muscle compliance return to non-injured values after seven days from the injury date.

It will only be after ten to fourteen days of the injury that the healing scar presents some consistency, and this region will become no longer the weakest point of the healing area when subject to tensile forces. Around the scar tissue new mini muscle tendon junctions will be formed and become at this point the weakest region in the healing area in what concerns tensile resistance (Kaariainen, M., Kaariainen, J., Jarvinen,T.L.N, Sievanen, H., Kalimo, H., Jarvinen, M., 1998; Kaariainen, M., Jarvinen, T., Jarvinen, M., Rantanen, J., Kalimo, H., 2000).

As shown in previous studies, changes in the healing of the injured muscle are present through radiologic examination, using either ultrasound or Magnetic Resonance Imaging (MRI), with noticeable changes throughout time (Figure 3) (Connel DA, Schneider-Kolsky ME, Hoving JL, Malara F, Buchbinder R, Koulouris G, Burke F, Bass C, 2004 ). However, despite imaging such as MRI and ultrasound have been used to establish return to play prognosis after muscle injuries, (Peterson J, Thorborg K, Nielsen MB, Skjodt T, Bolvig L, Bang N, Holmich P, 2013; Moen MH, Reurink G, Weir A, Tol JL, Maas M, Goudswaard J, 2014; Kassarjan, A., Rodrigo, R.M., Santisteban, J.M., 2012), a recent review from Reurink et al. (2015) suggests no strong evidence for any MRI findings at baseline and return to play time to establish return to play time in hamstring injuries. A correlation between imaging features changes throughout time and the functional performance of the muscle is yet to be determined, as well features on the MRI after return to play and potential re injury risk. As it was observed in a study by Reurink et al. (2014), even when players are clinically recovered and cleared to return to play following hamstring injury, MRI changes are still present, and any risk of recurrence associated with them is still unknown. Therefore imaging should not be the main marker for rehabilitation progression.

How does the tensile strength of the injured area progresses through the course of healing?

Before answering this question it is relevant to understand when does actually new tissue is being formed, because hypothetically the injured area will be capable of sustaining some level of tension after fulfilled with some scar tissue. As stated in the section above, the first stage after the traumatic event is mainly characterized by a destruction and re-organization of the injured area. New tissue will hardly be formed in the first day after the injury. As it was shown in a study by Best et al. (2001), in which a stretch injury was induced to the tibialis anterior muscle of rabbits, focal fibrotic tissue constituted by deposits of collagen I and III were only noticeable after three days of the initial injury and were significant present after seven days.

The healing progression and its histological changes might be directly related with the capability of the tissue to deform to stimulus in terms of changes in its length but also the amount of load it can be absorbed by the muscle, which ultimately will determine the rehabilitation protocol. Considering this, it is interesting to verify that a study carried out by Corr et al. (2003) using the same laboratorial injury method in rabbits from Best et al. (2001), in which elongation to failure was analysed, concluded that the muscle compliance return to non-injured values after seven days from the injury date.

It will only be after ten to fourteen days of the injury that the healing scar presents some consistency, and this region will become no longer the weakest point of the healing area when subject to tensile forces. Around the scar tissue new mini muscle tendon junctions will be formed and become at this point the weakest region in the healing area in what concerns tensile resistance (Kaariainen, M., Kaariainen, J., Jarvinen,T.L.N, Sievanen, H., Kalimo, H., Jarvinen, M., 1998; Kaariainen, M., Jarvinen, T., Jarvinen, M., Rantanen, J., Kalimo, H., 2000).

As shown in previous studies, changes in the healing of the injured muscle are present through radiologic examination, using either ultrasound or Magnetic Resonance Imaging (MRI), with noticeable changes throughout time (Figure 3) (Connel DA, Schneider-Kolsky ME, Hoving JL, Malara F, Buchbinder R, Koulouris G, Burke F, Bass C, 2004 ). However, despite imaging such as MRI and ultrasound have been used to establish return to play prognosis after muscle injuries, (Peterson J, Thorborg K, Nielsen MB, Skjodt T, Bolvig L, Bang N, Holmich P, 2013; Moen MH, Reurink G, Weir A, Tol JL, Maas M, Goudswaard J, 2014; Kassarjan, A., Rodrigo, R.M., Santisteban, J.M., 2012), a recent review from Reurink et al. (2015) suggests no strong evidence for any MRI findings at baseline and return to play time to establish return to play time in hamstring injuries. A correlation between imaging features changes throughout time and the functional performance of the muscle is yet to be determined, as well features on the MRI after return to play and potential re injury risk. As it was observed in a study by Reurink et al. (2014), even when players are clinically recovered and cleared to return to play following hamstring injury, MRI changes are still present, and any risk of recurrence associated with them is still unknown. Therefore imaging should not be the main marker for rehabilitation progression.

Early stage of rehabilitation

After the injury episode an immediate protective phase should take place in the first few days (until day 5-6 after injury). Rest is fundamental, especially in the activities where pain is present along with the injured muscle recruitment, and it will contribute to prevent excessive scar formation. There seems to be a positive association between active mobilization immediately after injury and recurrence of the injuries in the original site, reinforcing the need for this protection phase (Jarvinen M., Lehto M.U., 1993). Nevertheless this remark, early pain free active mobilization after a few days, when the proliferative stage of the healing process begins, will induce capillary ingrowth into the injured area, better regeneration of the muscle fibers and more parallel orientation of the regenerating myofibers, improving the rehabilitation outcomes (Jarvinen,T.A.H., Jarvinen, T.L.N., Kaariainen, M., Kalimo, H., Jarvinen, M., 2005).