What is it?
Hamstring strains are one of the most common sporting injuries, particularly in sports requiring a high degree of speed, power and agility. A sudden onset of sharp pain or pulling through the back of the thigh is the most common symptom. This usually occurs during speed/power activities causing an abrupt stop in motion. Tears to the hamstring muscle can range from a small partial tear whereby there is minimal pain and minimal loss of function, to a complete rupture which may require surgical reconstruction. Hamstring strains range from a grade 1 to a grade 3 tear and are classified as follows:
- Grade 1: A small number of muscle fibres are torn resulting in some pain. Usually function is normal however running at full speed may be limited. Pain may develop after activity or the next day.
- Grade 2: Up to 50% of muscle fibres are torn, there is loss of muscle flexibility and strength, pain with walking, inability to run and bruising are common.
- Grade 3: Complete tear of the muscle, major loss of function, potential surgical intervention may be required.
Why did I get it?
Hamstring strains commonly occur due to a sudden contraction of the hamstring muscles often when they are in a position of stretch. This sometimes occurs with rapid acceleration whilst running or when a footballer performs a long kick. They generally occur in the older athlete and after improper warm-up. There are several factors which can predispose patients to developing a strained hamstring. These need to be assessed and corrected with direction from a physiotherapist:
- Poor muscle flexibility (particularly hamstrings, quadricep, hip flexor, low back)
- Reduced muscle strength
- Muscle imbalances (between quad and hamstring and between medial and lateral hamstring)
- Poor running technique
- No warm-up/cool-down
- Poor core stability
- Reduced fitness
- Previous hamstring injury
- Low back stiffness
- Neural tightness (particularly sciatic nerve)
- Inadequate recovery from sport/activity
- Inappropriate training
Treatment for an acute strain generally follows the R.I.C.E regime whereby there is a period of relative rest combined with ice, compression, elevation plus gentle stretching and strengthening exercises depending on comfort levels. It is important to get a thorough examination from a Physiotherapist to determine the grade of injury. Treatment usually consists of: exercise, stretching, massage, trigger pointing, dry needling. Addressing any factors listed above is also fundamental during the rehab period.
While every hamstring injury and person is different, here are some general recovery times:
- Grade 1: 2-4 weeks
- Grade 2: 6-8 weeks
- Grade 3: 12+ weeks