For everyone that has had a hamstring injury, you’ll agree that they can be one of the most frustrating and difficult sporting injuries to get on top of. In reality, hamstrings tears are the most common sustained injury in sports that require a high degree of speed, power and agility such as soccer, AFL and rugby.
What are the hamstrings and what do they do?
The hamstrings sit at the back of our legs behind the thigh and is comprised of three muscles:
1. Semitendinosus
2. Semimembranosus
3. Biceps Femoris
a. Short Head
b. Long Head
All three muscles extend from our pelvis to the bones of our lower legs and are extremely important in supporting the body to bend at the knees and move at the hips. Anytime you walk, climb stairs, jump, run your hamstring are working hard.
Additionally, the hamstrings are also important in sports such as football since it helps us control the swing of our legs forward.
Types of injury
There are two different types of hamstring injuries that can be distinguished by different mechanisms of injury and pain location:
The type I occurs during high-speed running – more common type of injury
· Generally, causes a more acute decline in function but requires shorter rehab period
· Usually involves the long head of biceps femoris
The type II occurs during movements leading to extensive lengthening of the hamstrings
· Although it can cause a less acute limitation than type I, the rehab period is longer
· Usually involves the semimembranosus
It is very difficult to determine how long an athlete may be out based on their MRI report. Therefore, other prognostic factors also need to be considered when determining an athlete’s prognosis:
1. Days to walk pain free - >1 day = 4 times more likely to take >3 weeks
2. Involvement of the tendon = longer return to play
3. The more proximal the site of the injury to the pelvis = the longer return to play
4. Larger tenderness area with palpation = longer return to play
5. Less self-confidence = longer return
Rehabilitation & Prevention
As soon as the injury occurs, apply the R.I.C.E principals ( Rest, Ice, Compression, Elevation), and get into see a physiotherapist to begin the rehabilitation process as soon as possible. The physio should be able to identify which predisposing factors contributed to your injury. They will help you put strategies, including a rehabilitation program, in place to correct these factors to significantly reduce your risk of further injury.
Rehabilitation of the injured hamstring happens in 3 stages to achieve the best healing possible:
· Stage 1 – Promote healing of the injured tissue
o Minimize pain
o Minimize muscle atrophy
· Stage 2 – Regain full muscle function and neuromuscular control
o Regain full range of motion
o Regain pain-free hamstring strength
o Pain free running up to maximal speed with changing directions
· Stage 3 – Integrate full sports specific participation
o Symptom-free during all activities
According to numerous recent studies, almost two-thirds of hamstring injuries might be prevented by increasing eccentric strength of the hamstring, one of the most popular exercise is the Nordic hamstring exercise. This exercise in some cases has seen athletes reduce their risk of hamstring strains by 51%.
The graph below demonstrates the protocol for the Nordic hamstring exercise:
So if you have sustained a hamstring tear that needs to be rehabilitated or would like a strengthening regime designed for you to reduce your risk of future Hamstring injury, then why not book a consultation with one of our expert physiotherapists? Book here!