WHAT IS IT? HAMSTRING STRAIN

  • A hamstring strain is a tear in one or more of the hamstring muscles. The hamstring group is made up of three muscles, the semimebranosus, semitendinosus and biceps femoris. Their main function is to bend your knee and extend your hip, and contribute to the position of your pelvis.

  • The most commonly strained hamstring muscle tends to be the biceps femoris.

  • Like most muscle strains, a tear is likely to occur at the musculotendinous junction.


Signs and symptoms

  • A sudden sharp pain or pull at the back of the thigh during exercise – most probably during sprinting or high velocity movement

  • Pain on stretching your hamstring

  • Pain on contracting your hamstring (knee flexion or hip extension)

  • Possible swelling and/or bruising

​WHAT CAUSES IT?

Hamstring strains are extremely common in sports involving sprinting, sudden acceleration/deceleration, hurdling, and kicking.

 

When you are sprinting and stride out, the hamstring muscle is in a lengthened position, but also at the point where it generating most of its power.  This position is therefore the point at which strains often occur.  Other contributing factors include:

  • Decreased flexibility of the hamstring group

  • Poor hamstring strength

  • Poor core stability leading to increased reliance on the hamstring group as a pelvis stabilizer

  • Weak glute strength, resulting on an increased reliance on the hamstrings to generate power

  • The presence of trigger points in the glutes and hamstrings which refer pain and affect length and function of the hamstring muscles.

  • Lumbar degeneration, affecting nerve supply to the hamstring muscles

HOW TO SELF MANAGE
  • Cease activity immediately to prevent damage

  • Apply the R.I.C.E.R. principles

  • During this phase, do not run or exercise, do not stretch the injured area, do not consume alcohol, do not apply heat and do not massage the area.

  • It is advisable that you seek treatment for this injury, because if scar tissue forms then this will form a point of weakness in the muscle and could increase the likelihood of reinjury. 

 

PROGNOSIS

Hamstring injuries will be graded by your physio from grades 1-3 depending on the severity of the injury. The recovery time also depends on the degree of the tear.

A strain to the hamstring typically occurs from overload or excessive stretch to the muscle.  Muscle strains can be categorized in to three grades

 

Grade I – damage to a few muscle fibers (<30%), localized pain, normal strength 

 

Grade II – damage to more muscle fibers (30-80%), localized pain, swelling, and pain reproduction on power testing of the muscle                                                        

 

Grade III – damage to >80% of fibers or complete rupture.  Most commonly occurs at the musculotendinous junction.

HOW PHYSIO HELPS?

Your physiotherapist will:

  • Assess the length and strength of your hamstring to determine the degree of strain (see soft tissue healing and management for details).

  •  Assess the length and strength of your core and lower limb muscles to check for any imbalances

  • Assess your thoracic and lumbar spine for any restrictions

  • Provide manual treatment to promote healing and reduce scar by using massage, deep transverse frictions, joint mobilization, stretching of the muscles  and nerves, ultrasound, and acupuncture.

  • Prescribe a relevant rehabilitation program including progressive strengthening, as well as agility and sports specific exercises where needed.

 

 

 

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Sammy Margo Physiotherapy

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London

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Disclaimer: Information made available by AskPhysio (Sammy Margo Physiotherapy) is provided for guidance only and should not be considered as medical recommendations or advice.  AskPhysio is not responsible for errors or omissions in the information. Please consider what the best options for your healthcare are, based on the urgency of your condition and nature of your condition. Please consult a GP or Healthcare Specialist to discuss any specific concerns that exist prior to using the information provided.