Introduction:
Did you feel a sudden, sharp pain at the back of your thigh when running or playing sport? Was there a popping or tearing sensation? If you have answered yes, you may have a strained hamstring muscle. This article will help get you back in the game.
Essential anatomy:
The muscles in the back of your thigh are collectively known as the hamstrings. They consist of the biceps femoris, semitendinosus and semimembranosus. The three hamstring muscles originate from the ischial tuberosities, also known as your “sit bones”, and attach onto the side of your knees. These attachment points enable the hamstrings to extend your hip and flex your knee.
What causes hamstring strains:
There are two types of hamstring strains. Type I occur mostly in kicking sports, in sprinters, jumpers and hurdlers. The muscle commonly affected is the biceps femoris muscle. They tend to happen when hamstrings are at their most vulnerable- just before your foot strikes the ground, as they work to decelerate the swinging leg. Type II commonly occur in dancers and gymnasts and affect the semimembranosus muscle and occur when it is excessively stretched.
There are various risk factors for hamstring strains, including hamstring weakness, decreased flexibility, muscle imbalances and a history of hamstring strains or other lower limb injuries.
Physiotherapy treatment of hamstring strains:
Like any acute sporting injury, there are three phases of healing: the inflammatory phase, the reparative phase and the remodelling phase.
During the inflammatory phase, you should follow the RICE principle: Rest, ice, compression, and elevation. For example, you are applying ice for 10-15 minutes using a cold pack every 3-4 hours for the first few days until pain settles. This phase's length depends on the severity of the injury but typically lasts 3 to 7 days. During the reparative phase, it is important to begin working on mobility, control, and strength. Some examples are provided below.
Mobility –
When you first strain your hamstring, it is likely to be painful if you stretch it. It is important to avoid any excessive or aggressive hamstring stretching in the early days. A better way to mobilise it is to perform a dynamic exercise. You can do this by laying on your back, holding the back of your thigh with your hip bent to 90 degrees, and then straightening your knee to the point just before pain is felt.
Control –
It is important to have good control around your pelvis for optimal functioning of the hamstrings. A great beginner exercise is just to practice tilting your pelvis forwards and backwards while laying on your back. A more advanced exercise that requires exceptional lumbopelvic control is the Nordic curl. This exercise is recognised as one of the best exercises to strengthen the hamstrings and prevent injury.
Strength –
Strengthening is an essential component of the rehabilitation and prevention of hamstring strains. As most hamstring strains occur when the hamstring muscle is lengthened, it is, therefore, useful to strengthen the hamstrings in the same way. Eccentric hamstring bridges and the “Glider” exercise are great examples of this.
In the remodelling phase, sport-specific drills are introduced to ensure a safe return to activities.
**Please note that all hamstring strains are unique in their type and severity, and it is advised that a Physiotherapist guides you on the best place to start. **
Summary:
In summary, remember these three things about hamstring strains:
Hamstring strains are usually felt as a sharp pain at the back of the leg when doing things such as sprinting or kicking.
Initial management should follow the RICE protocol of rest, ice, compression and elevation.
Eccentric hamstring strengthening exercises are crucial to prevent re-injury.
If you are suffering from hamstring pain, Book in with your Physio for a thorough assessment by clicking here. Once the cause has been identified, a plan can be designed specifically for you and get you back to doing what it is you love.
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