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Hamstring injuries

The hamstring is comprised of three muscles; semitendinosus, semimembranosus and bicep femoris at the back of the thigh. Its main job is to bend the knee, aid extension of the hip and deceleration of the lower leg when it swings forwards in running and other movements.

The hamstrings are usually injured while running fast and over stretching the leg, (Bryan et al, 2010).

If you have injured your hamstring the symptoms are usually a sudden sharp pain in the back of the thigh. You may feel a ‘popping’ sensation with a more severe tear. (NHS, 2016)

Grades of strain

There are 3 grades of muscle strain from 1 being mild to 3 being more severe or a complete tear. Healing times can vary from a few days, to weeks or months depending on the grade of tear.

Treatment

Initial treatment should be PRICE Protection, Rest, Ice, Compression and Elevation. For 2-4 days depending on severity of the injury.

Ice for 10-15 mins wrapped in a towel to protect the skin. Always check the skin regularly to make sure you are not getting ice burn to the skin. This can be applied regularly through the day for the first few days and then less often as swelling reduces.

You may wish to apply a compression bandage to reduce the swelling. It is advised to remove the compression at night and seek medical advice if you are unsure how to apply the bandage. (NHS, 2016)

The acute phase can last for 6 weeks so best to stop sports to allow the tissues to heal fully before returning to sports. The time it takes to return to sport will vary with the degree of injury. You can bend and straighten the knee, hip and ankle to maintain range of motion and promote circulation after the initial rest period of 2-4 days (Mendiguchia & Brughelli, 2010).

Exercise rehabilitation

It is best to consult a registered physiotherapist or other qualified professional to assess and prescribe the correct level of exercises for you and your activity level. This will prevent re injury and get you back to your previous activity level quickly. The physiotherapist will make sure your muscles are strong enough for your chosen activity. A lot of sporting performance requires the individual to have confidence in their body so that it won’t let you down.

A physiotherapist will make sure your exercises are progressed at the correct level for your injury and to train your muscles to withstand the particular demands your lifestyle and activity level needs.

Strengthening can start once the inflammation and pain has settled. The exercises should be pain-free and can start with isometric or static exercises to activate the muscle fibres in a controlled way that won’t strain them while they are recovering. Other local muscles around the back and pelvis may need strengthening also. (Bryan et al, 2010).

Exercises can be performed to eccentrically strengthen the muscle which is important after an injury to get the muscle back to its previous level of strength, control of the lower limb and to prevent re injury. Soft tissue massage can also help improve the muscles flexibility but be guided by a physiotherapist on when and how to do this. (Mendiguchia & Brughelli, 2010).

The next stages are sports or activity specific strengthening to get you back to full strength. There are many exercises to facilitate this. An ongoing hamstring programme would be beneficial to your training as re injury can be common once you have injured your hamstring muscles. Preventative exercises can help reduce this.

It is best to seek medical advice if you are unsure about your injury, how to treat it or if you suspect there maybe a bone injury e.g. fracture or severe pain and or excessive swelling or bruising. You will then be guided to the best treatment.

 

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    Have you read our free exclusive E-BOOKs available to download?

    We have a variety of e-books available to download straight to your inbox, from exercise and sports advice sheets to specialist and general conditions. Please click here to visit the full page and take your pick!

     

    References:

    NHS choices 2016. http://www.nhs.uk/conditions/hamstring-injury/Pages/Introduction.aspxBryan C. Heiderscheit, PT,

    Bryan C. Heiderscheit, PT, PhD, Marc A. Sherry, PT, DPT, LAT, CSCS, Amy Silder, PhD, Elizabeth S. Chumanov, PhD4, Darryl G. Thelen, PhD. (2010). Hamstring strain recommendations for diagnosis and rehabilitation and injury prevention. Journal of Orthopaedic & Sports Physical therapy. Vol. 40. Issue 2, Pages 67-81Mendiguchia, J., Brughelli M, (2010). A return-to-sport algorithm for acute hamstring injuries. Physical therapy in sport. doi:10.1016/j.ptsp.2010.07.003

    Mendiguchia, J., Brughelli M, (2010). A return-to-sport algorithm for acute hamstring injuries. Physical therapy in sport. doi:10.1016/j.ptsp.2010.07.003

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