What is a Hamstring Strain?

A hamstring strain is a tear of the muscles of the back of the thigh. The hamstrings are composed of three muscles  which run from the bottom of the glute muscle & run down the leg to insert just below the back of the knee. Most hamstring strains occur in the lateral fibres of the hamstring (the biceps femoris muscle). On occasion, a complete hamstring tear (avulsion) may occur at the insertion point at the pelvis bone at the top of the thigh.

Hamstring strain injuries have been shown to account for between 12 & 16% of professional football injuries, resulting in 15-21 missed games for each club per season (1, 2).

A hamstring tear can vary in intensity from mild (Grade I) and requiring a few weeks of recovery to a more severe (Grade III) hamstring tear which requires several weeks & up to two months of rehabilitation.

A hamstring tear is something I experienced on a few occasions while playing football. I recall the frustration of undergoing repeated hamstring tears for which I attended a number of therapists prior to getting back on the road to recovery. Oftentimes, inherent muscle weaknesses, flawed running technique, inadequate fitness & poor muscle activation patterns & running technique may be predisposing factors in hamstring tears. Only a comprehensive hamstring rehabilitation programme can address these underlying issues & minimise the risk of re-occurrence.

Treatment for hamstring at Naas Physio Clinic

What causes a Hamstring Strain?

The hamstring is particularly predisposed to injury because the muscle is biarticular i.e. it crosses two joints (the hip & knee). This complexity in terms of function means that any biomechanical dysfunction can quickly give rise to hamstring tears.

Hamstring strain / tears most commonly occur from sprinting where a heavy force is placed on the hamstring while it is simultaneously being stretched during the late leg swing phase of the running cycle. The hamstring may also be injured from rapid changes of direction or long range kicking.  

The athlete will often experience a sudden, sharp pain in the back of the leg. This sudden pain is a very strong indicator of a tear. Often, the athlete will attempt to continue in the hope that the pain may go but this is rarely possible & generally this results in a longer period of rehabilitation.

Research has suggested that a combination of factors (strength, flexibility, fatigue, warm-up) may all increase the risk of hamstring tears (1).

Treatment of a Torn Hamstring

As with any muscle injury, a short period of rest is vital, but we like to get the athlete back on their feet & exercising as soon as possible. The timescale will depend on the grade of the tear. Oftentimes, athletes make the mistake of resting the hamstring injury for a number of weeks and then because they no longer feel any hamstring pain they believe they are ready to go  straight back onto the pitch. This can be a costly error as a graded rehabilitation process is required to build up the strength in the muscle and prepare the hamstring for the stresses it will endure when playing sport. Failure to do this will significantly increase risk of re-injury and a significant time out of your sport as a consequence.

The benefits of a specific rehabilitation approach is made abundantly clear by research performed by Sherry & Best (2004). This study demonstrated that specific agility & stabilisation exercises prescribed by your physiotherapist can significantly decrease hamstring injury re-occurrence when compared with performing standard hamstring stretches.

Two weeks after return to sport, 6 of 11 athletes performing the stretching exercises suffered a re-occurrence of hamstring tears compared with none of the athletes in the agility & stabilization group. This suggests that hamstring stretching is a less than optimal means of managing a hamstring tear.

This is backed up by a randomized controlled trial by Mechelen et al. (1993) that found no benefit for hamstring stretching in the reduction of hamstring injuries.

 

Study: The effect of a sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: a randomized controlled trial.

In this study the researchers investigated whether manipulation from a sports chiropractor could prevent the occurrence of hamstring and other lower-limb injuries. Both groups received the current best practice medical management. Additionally, the intervention group received mainpulation from a chiropractor. Minimum scheduling was: 1 treatment per week for 6 weeks, 1 treatment per fortnight for 3 months, 1 treatment per month for the remainder of the season (3 months).

Conclusions:

‘This study demonstrated a trend towards lower limb injury prevention with a significant reduction in primary lower limb muscle strains and weeks missed due to non-contact knee injuries through the addition of a sports chiropractic intervention to the current best practice management.’

 

To book an appointment at Naas Physio Clinic call:
(045) 874 682

or email us at info@physioclinic.ie

References

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For further information on conditions treated go to:
www.physioclinic.ie/conditions