Common Injuries 5: Hamstring Strain
What are the hamstrings?
The hamstring muscles are a group of three muscles located at the back of the leg (they are called hamstrings as legs of ham used to be hung by a hook though the space between the femur (thigh bone) and the tendons. The Hamstrings are made up of biceps femoris, semitendinosus and semimembranosus. Biceps femoris is the muscle in the middle of the back of the thigh and the other two are located more towards the inside of the thigh. The primary action of these muscles is to flex the flex (bend the knee) but they can also move the hip when different joint/bones are in a fixed position.Your browser may not support display of this image.
Hamstring injuries can be very complex but I have tried to simplify it as much as possible and this article is just a general guideline
How does it happen?
A hamstring muscle strain typically occurs when the muscle is contracted with excessive force in a stretched position. This commonly occurs during running or sprinting just before or after the foot hits the ground. It can also occur when the muscle is repeatedly forced to contract explosively when it has not been warmed up adequately. Other times it can occur is immediately after strong cramping of the hamstring muscle. Hamstring strains are also very common in other sports such as rugby, football and field hockey.
How does it feel?
When the hamstring muscle is strained, the first sensation you feel is sudden pain in the back of the thigh, due to damage to the muscle fibres. At the same time you may have a â€˜tearingâ€™ sensation. With a minor strain, you may be able to continue participation with minimal restriction. However, as the muscle cools down following activity, pain may gradually increase as bleeding and swelling around the injured muscle continues. This may be associated with progressive tightening and stiffening of the hamstring muscle group. In more severe strains, these sensations may be exaggerated to the point that you are unable to continue participation due to excessive pain in the thigh, muscle tightness, weakness and spasm. In these cases, the pain may be so intense that you may be unable to walk without a limp. There may also be obvious swelling and a visible defect in the muscle.
What should you do?
To limit the severity of this injury, we advise you stop your activity immediately and start treatment. The most important time in the treatment of any injury is the first 24â€“48 hours. Swelling is a necessary step in the healing process; however, too much swelling can delay healing and cause further tissue damage. To control the amount of swelling and limit the degree of damage to the hamstring muscle, the RICE regime should be commenced (Rest, Ice, Compression, and Elevation). This will help to reduce blood flow to the injured area, thereby, reducing the extent of swelling and tissue damage. You should continue the RICE regime until you can visit your osteopath or physiotherapist, preferably within 2 days of the initial injury.
What shouldnâ€™t you do?
Following a hamstring muscle strain, you shouldnâ€™t undertake activities which increase blood flow to the hamstring muscle. These include hot showers, hamstring stretching, heat rubs, massage, consumption of alcohol and excessive activity. These can increase muscle bleeding, resulting in further pain and an extended recovery period. Most importantly you should not continue participating as you risk tearing the muscle and be out of action for many weeks.
Could there be any long-term effects?
Although most hamstring muscle strains heal without complication within a number of weeks, a proportion of injuries can result in longer-term effects, depending on the extent of damage and inappropriate early management. When the hamstring muscle is torn, a number of structures contained within and around the muscle may be injured. Injury to these structures may delay return to kendo/iaido/jodo. This may also result in a tight or weakened hamstring muscle group that is prone to re-injury when returning to activity. Re-injury may also result if the cause of the initial hamstring tear was not accurately diagnosed and addressed.
The assistance of an osteopath/physiotherapist is important in the treatment of a hamstring muscle strain. Initially, they will assist in determining the exact tissue/s damaged and the extent of this damage. From this information, an indication of how long the injury is expected to take to heal can be determined. Osteopaths/physiotherapists can also use a number of other treatment techniques to assist in reducing pain and swelling and enhance the healing of the injured structures. This should also include an appropriate progression of exercises aimed at increasing your range of motion, strength and function. These exercises will facilitate your return to kendo/iaido/jodo participation and, by identifying the reason why you tore your hamstring, help prevent reinjury. This can be performed whilst minimising the risk of a re-bleed and will accelerate your return to kendo/iaido/jodo.
What can you do to avoid it?
To help avoid injury it is fundamental in most sports to stretch and warm-up the hamstring muscle groups. There are several stretches for hamstrings; with each stretch stretching a different part of the muscle. The first exercise below is one we recommend for general use (at home) and the second can be done in a dojo – but please speak to your osteopath/physiotherapist for a more specific stretch for your needs.