Hamstring strains often recur, so it is an injury that is often discussed amongst sportspeople and one that needs to be better understood. In the case of a minor hamstring strain, it is usual for people to rest for a while but return to playing sport too early.
Hamstring strains are the most common injury amongst soccer and football athletes and having them recur can lead to a more severe injury, and definitely more time off the field. So, it pays to know exactly what they are, how to treat them and how to help prevent them from happening again.
Minor strains can be just a small pull or tweak, but strains can range in severity up to a high grade tear of the muscle. In too many instances, people only seek professional treatment for a major injury or ongoing issue.
The hamstring is a group of muscles that run down the back of the thigh, from the hip to just below the knee. The hamstring muscles enable the knee to bend and the hip to straighten and the leg to extend back.
There are 4 muscles that make up the hamstring – the semimembranosus and semitendinosus are on the inside of the thigh, while the biceps femoris long head and biceps femoris short head are on the outside of the thigh.
As with any muscle injury, overloading or stretching beyond its limit can pull or tear a hamstring muscle. The majority of hamstring injuries that occur while running are to the biceps femoris long head muscle, which is on the upper part of the outer thigh.
A hamstring strain will be felt as a sudden, severe pain while moving. There may be a pop or snap in the back of the thigh. Swelling and tenderness is likely to develop following the tear and there may be some weakness in the leg.
There are 3 grades of hamstring strains, with most of them being a grade 1 or grade 2 injury.
A small number of the muscle fibres are torn. This will feel like a tightness, or there may be some pain, but there is no loss of function.
A significant number of muscle fibres will be torn. There will be some loss of function and it may be painful to walk.
All the muscle fibres are ruptured which results in major loss of function and significant pain.
Different exercises that can strengthen and stretch the hamstring muscles and keep them from becoming too tight are believed by many to reduce hamstring strains. However, there have been studies that show stretching and hamstring flexibility may not provide any benefits in preventing injury. 1
Perhaps it is time to seek the advice of a sports physiotherapist who is experienced in recurring hamstring strains. Melbourne Sports Physiotherapy believes there are a number of things you can do to protect your hamstrings!
If you have suffered a hamstring strain, there are steps you can take once a little time has passed and the pain is manageable. There are 5 components of management that when performed regularly will help prevent hamstring strains.
When the muscle contracts whilst lengthening, it is known as eccentric strength, and it can improve the health of the hamstring muscle group. Eccentrically weaker hamstrings are more prone to injury.
The Nordic Hamstring Curl is an excellent exercise that is easy to perform and only requires a few sets once or twice a week. It involves kneeling on a pad while the ankles are held in place by a partner. Slowly lower the torso, with control, then put your hands down.
A fascicle is a single unit of muscle fibre and it takes thousands of fascicle bundles to make up a muscle. Longer fascicles are able to absorb load better and can reduce the risk of hamstring injury.
You cannot increase the length of fascicles with stretching, only with eccentric exercise so the Nordic Hamstring Curl is also a favoured exercise for this.
If the lower limbs are weak then more stress will be put on the hamstrings and therefore increase the chance of injury. It is shown that previous injuries to the calf, knee or lower back can increase the risk of a hamstring strain.
Strengthening these parts of the body with suitable exercises is an important step and your physio can recommend what will work best.
The hamstrings work at high speed and in fact are hardly used at a jogging pace. They work hardest at a sprint! So, returning to running is the best way to return to sprinting. Many athletes will begin jogging within just days of a hamstring injury to prevent deconditioning. Gradually returning to sprinting over time will expose your hamstrings to the load and get them back to where they work best.
It is critical to manage the load on the hamstrings by avoiding huge spikes in sprint and change of direction volume. As always, too much too soon is asking for further damage, so slowly build up your return to training and running for safe and effective rehab.
Melbourne Sports Physiotherapy strives to get you moving pain and injury free as soon as possible. If your hamstrings are suffering, give their expert team a call or book an appointment online to move better and live a more active life.