Management of Hamstring Strains
Hamstring injuries are common in sports involving sprinting and kicking. They are one of the most common injuries in elite football, representing about one-third of all time-loss injuries.
The hamstring muscles run down the back of the leg from the pelvis to the back of your knee. The hamstrings consist of 3 muscles
- Biceps femoris
- Semitendinosus
- Semimembranosus
An injury can range from minor strains to total rupture of the muscle. Early treatment of an injured hamstring can help to speed recovery and minimise the symptoms.
There are two main types of hamstring injuries:
- Sprint/force related
- These are the most common mechanisms of hamstring injuries.
- They occur during high speed running when accelerating, decelerating or running close to maximal speed.
- Stretch related
- Occur from a combination of hip hyperflexion and/or knee extension.
- Usually occurs close to ischial tuberosity (sit bone) and involved the proximal tendon.
- Typically occurs from kicking, dancing, gymnastics, slide tackle or forced position in a tackle.
What are the Symptoms of a Hamstring Tear?
- A sudden sharp pain in the back of the leg during exercise, most commonly sprinting.
- Pain on stretching the muscle.
- Pain on contracting the muscle against resistance.
- Swelling and bruising.
- Tenderness to touch the back of the thigh.
- Discomfort with walking.
- If the rupture is severe, a gap in the muscle may be felt.
What is the Acute Management of a Hamstring Tear?
It is vitally important that treatment for a hamstring strain starts immediately following injury. The most important phase for treatment is the first 48 hours post-injury. Early management will have you back on the field faster. Suggestions for immediate treatment of a pulled hamstring include:
- Stop your activity.
- Unload the injured tissue with relative rest.
- Avoid exercise, heat and alcohol in the first 48 hours, as these can all exacerbate swelling and tissue damage.
- Early strengthening exercises have been shown to reduce time lost from sports.
Physiotherapy Provides Rehabilitation and Support
Physiotherapy treatment will depend upon the severity of the injury. The success rate of treatment is largely dictated by patient compliance. Treatments may include:
- Manual therapy- soft tissue therapy is excellent for reducing inappropriate scar adhesions while promoting faster healing conditions.
- Management primarily involves rehabilitation and strengthening exercises to rebuild the strength of the injured muscle.
- A progressive speed, agility and power program that prepares you for your sport is the best chance to ensure a successful outcome and full return to your pre-injury status.
- Correction of any predisposing biomechanical stressors and muscle imbalances.
Inadequate rehabilitation commonly results in recurrent injury.
Preventing a Hamstring Strain
Suggestions to prevent hamstring strains:
- It is important to warm up appropriately before training or competition. This should consist of some light aerobic exercise followed by dynamic, sports specific drills, e.g.Football Australia Perform +
- One of the most important methods of preventing a hamstring tear is to increase the strength of the hamstring muscles. Consult with one of our physiotherapists for a suitable hamstring strengthening program. A hamstring tear is far more likely in athletes who have weak hamstring muscles that don’t meet the demands of their sport or activity.
- Adequate load progression with training/competition has been highly indicated for injury reduction, that is, not doing too much too quickly. Our physiotherapists can guide your training program to limit the effects of inappropriate load management.
- Include hamstring muscle maintenance in your workout routine (e.g. massaging, stretching, foam roller).
If you would like further information on management of a hamstring strain contact one of the physiotherapists at Jubilee Sports Physiotherapy who can guide you in your rehabilitation.
