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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:

Symptoms

Grade I

Grade II

Grade II

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

Gait

Potentially affected

Likely affected acutely

Highly likely affected

Pain/discomfort

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

Bruising

Potential (depending on the person)

Likely, but depends on the person

Highly likely + swelling


Phase 1 - Early Management

Rehab Goals

Example

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

Advice/education

Avoid excessive lengthening of the hamstrings

Advice/education


Phase 2 - Mid stage rehab

Rehab Goals

Examples

Regain strength

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

Advice/education


Phase 3 - End stage rehab

Rehab Goals

Examples

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

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