Have you strained your hamstring recently? Must read article!
This blog post is essential for those who have recently strained or "pulled" a hamstring muscle. Here we'll cover the common causes, types of strain, include what's to be expected and what needs to be accomplished in the early, mid and end stages of the rehabilitation process.
Causes/Mechanism of injury:
Hamstring strains are generally caused by an excessive load or stretch to the hamstring muscle. These mechanisms cause a high amount of stress placed through the hamstrings, resulting in damage to the muscular fibres.
Hamstring strains are common in sports involving jumping, quick decelerating and accelerating, kicking and sprinting.
Check out the hamstring anatomy picture below! Did you know there are in fact 3 different hamstring muscles?
Hamstring strains can generally be characterised into 3 grades:
Amount of fibres damaged
Few fibres damaged
Approx 1/2 the fibres have been damages/torn
More than 1/2 the fibres are ruptured/torn
Likely affected acutely
Highly likely affected
Pain may be present at the site of the strain at rest, and worse on palpation
Pain felt at the time of the injury. Likely pain at the site of the strain, worse on palpation and with gait.
Pain felt at the time of injury, pain at the side of the tear, worse on palpation, pain with gait
Hamstring strength when being tested by a therapist
Likely to be weak and potentially causing pain to the site of strain
Moderate amounts of weakness and pain
Large amounts of weakness and pain
Potential (depending on the person)
Likely, but depends on the person
Highly likely + swelling
Phase 1 - Early Management
Promote healing of the damaged tissue
Rest and appropriate loading of structures
Reduce strength loss
Continue use of adjacent muscles
Maintain range of motion
Continue use of adjacent joints
Avoid dysfunctional gait pattern
Avoid excessive lengthening of the hamstrings
Phase 2 - Mid stage rehab
Beginning with non-weight bearing isometric and eccentric exercises, such as: hamstring bridges/sliders, nordic hamstring curls.
Progressing to weight bearing exercises such as: single leg deadlifts, split squats
Regain range of motion
Sciatic nerve tensioning and hamstring mobility exercises.
Hands-on soft tissue massage.
Improve neuromuscular control in preparation for functional strength training
Isometric exercises where the focus is on time under tension.
Hands-on soft tissue massage.
Avoid end range lengthening
Phase 3 - End stage rehab
Restored concentric & eccentric strength through full range of motion
Advanced eccentric & concentric strengthening exercises through full range
Restored high velocity contractions
Strength focus through different levels of speed - deceleration of the knee, aid in hip extension.
Guided and progressively loading sprint & deceleration drills.
Improved neuromuscular control of the pelvis
High level single leg balance and stability training
Functional sport specific exercises
Plyometric training, such as: squat jumps, depth jumps, hops, bounds, leaps, "catch" bridges and hip extensions.
Training symptom-free and bilateral strength capacity
Achieved with adequate and well rounded rehab
Hopefully you've made it this far! :)
As you can see, there are lots of factors contributing to a successful return to sport post-hamstring strain. It will depend on the severity on the injury, nature of the injury, and whether you have successfully completed all stages of the rehab process or not.
Who is the best person to see for this condition:
If you've just recently injured your hamstring playing sport and need an accurate diagnose of your injury, the best person to see is a Sports Physiotherapist. They will be able to kick-start your healing process through manual therapy, and ensure you exercise rehabilitation is appropriate to your injury. Click below to read more!
If however, you have been suffering repeated hamstring strains, with unsuccessful return to sport, the best health professional to see is an Exercise Physiologist, who specialises at exercise rehab and mid-end stage return to sport treatment. Click below to clean more!
Want to read up on more hamstring-related blog posts?
Click here to read about chronic tight hamstrings
Click here to read about Hamstring Tendinopathy vs Hamstring Strains