Article by John Miller
What is a Hamstring Strain?
A hamstring strain is a common leg injury involving a tear in one or more of the hamstring muscles. A hamstring strain can range from mild to very severe involving a complete tear of the hamstring muscle.
You have four hamstring muscles: semimembranosus and semitendinosus (medially) and biceps femoris - short and long heads (laterally).
What Causes a Hamstring Strain?
Common reasons for hamstring strain or injury can be categorised as primary or secondary.
Poor timing-intermuscular coordination and eccentric strength in the hamstring muscles during the switch between late leg recovery and initial leg approach in the swing phase of sprinting (Woods et al. 2004).
Lack of “stiffness” and eccentric strength in the hamstring muscles during the ground contact phase of running (Bosch and Klomp 2005). “Stiffness” refers to the ability of the hamstring muscle to absorb shock and rebound. Dropping a golf ball onto concrete is an example of stiffness, it immediately rebounds off the surface.
Previous hamstring strain is a very good indicator of potential for future injury (Crosier 2004).
Research is based on an article available at: Hamstring Strain
What are the Symptoms of a Hamstring Strain?
Mild hamstring strains may feel more like a tightness or low grade ache in your hamstring. Severe hamstring strains can be extremely painful, making it impossible to walk or even stand.
Other possible symptoms of a hamstring strain are:
How is a Hamstring Strain Diagnosed?
On examination, your physiotherapist or sports doctor will look for signs of pain on hamstring contraction, reduced hamstring flexibility, tenderness or a palpable lump or gap within the hamstring muscle bulk. Pulled hamstrings are graded 1, 2 or 3 depending on severity.
Ultrasound scan and MRI are able to identify the location and extent of your hamstring tear.
Grade 1 Hamstring Strain
With a grade 1 hamstring strain you may have tightness in back of the thigh but will be able to walk normally. You will be aware of some hamstring discomfort and unable to run at full speed. There will be mild swelling and spasm. Bend your knee against resistance is unlikely to reproduce much pain.
Grade 2 Hamstring Strain
With a grade 2 hamstring strain your walking pattern will be affected and you will most likely be limping. Sudden twinges of hamstring pain during activity will be present. You may notice some hamstring muscle swelling and your hamstring will be tender to palpate. It will also be painful for you to bend your knee against resistance.
Grade 3 Hamstring Strain
A grade 3 hamstring strain is a severe injury involving a tear to half or all of the hamstring muscle. You may need crutches to walk and will feel severe pain and weakness in the muscle. Swelling will be noticeable immediately and bruising will usually appear within 24 hours.
Diagnostic MRI may also be used to specifically identify the grade of hamstring tear and its exact location.
Beware of Referred Hamstring Pain!
Due to your sciatic nerve passing through the hamstring muscle group, a lower back injury or some other injury that pinches the sciatic nerve can replicate the symptoms. It is therefore vital that you seek a professional diagnosis from an expert in hamstring and back injuries.
Hamstring Strain Treatment
Many patients with a hamstring start to feel better within a few days of the injury. However, there is an extremely high hamstring re-injury rate due to a poor rehabilitation process.
Hamstring strains are one injury that professional guidance is highly recommended for both an accurate diagnosis but also provide you with the best chance of avoiding repeat hamstring injuries.
Repeat hamstring injuries have unfortunately curtailed many a bidding athlete’s career.
Hamstring Physiotherapy Treatment
Image: Dry needling performed by a physiotherapist under ultrasound guidance.
Your physiotherapy treatment will aim to:
Hamstring Strain Treatment Options
Kinesio Taping for a Hamstring Strain
Many patients will try a thigh support or kinesio taping for hamstring strains. They provide confidence, warmth and proprioceptive feedback, which should reduce your likelihood of hamstring re-injury.
More info here... kinesio taping
Hamstring surgery is rarely required. It appears limited to complete ruptures or to remove scar tissue from chronic hamstring tears.
Hamstring Strain Recovery Times
While every hamstring injury and the demands of your sport differ, here are some general hamstring strain recovery times when you follow an optimal physiotherapist-guided rehabilitation program.
Grade 1 - 1 to 3 weeks
Grade 2 - 4 to 8 weeks
Grade 3 - 3 to 6 months. These may also require surgery.
For more information, please ask the advice of your physiotherapist.
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