What is a hamstring injury?
A pulled muscle or tear that affects the group of muscles and tendons located at the back of the thigh is known as a hamstring injury. It is prevalent among athletes and is considered a troublesome injury.
What is the hamstring? How does it normally work?
Your bone is attached to the largest thigh muscle through the hamstring. Primarily, the hamstring is responsible for the movement of leg flexion and extension. The hamstring is used extensively during activities such as:
- Lunge.
- Run.
- Climb.
- Sprint.
- Jump.
- Stretch too far.
What are the grades of a hamstring injury?
Your hamstring injury’s severity is indicated by the grade.
- Grade 1: A mild muscle pull/strain.
- Grade 2: A partial muscle tear.
- Grade 3: A complete muscle tear.
Who is most likely to injure their hamstring?
Individuals who participate in activities involving jumping, climbing, and lunging are at a higher risk for sustaining a hamstring injury, especially if they have experienced one previously.
Do hamstring injuries hurt?
It is possible for the pain in your thigh to occur abruptly.
SYMPTOMS AND CAUSES
What causes a hamstring injury?
There are several ways in which hamstring injuries can happen, with the most frequent being due to excessive stretching. Additional causes consist of:
- Fatigue from training too hard.
- A direct blow to your thigh.
- Inadequately warming up.
- Inadequate pre-conditioning program.
- Previous hamstring injury.
What are the symptoms of a hamstring injury?
The symptoms you experience can vary based on the extent of your injury.
- Grade 1: Strain. Sudden, radiating pain in the back of your thigh. Your strength won’t be affected, but it’ll be hard to move your leg.
- Grade 2: Partial Tear. More painful than grade 1. You may have some swelling, bruising, and loss of strength in your leg.
- Grade 3: Severe tear. Worse pain, tenderness, swelling and bruising. You might have felt a popping sensation when the injury happened.
Further indications comprise:
- Bump or knot in your thigh area.
- Spasms.
- Muscle stiffness especially after a cool-down period.
What makes a hamstring injury worse?
If you fail to comply with the R.I.C.E. protocol after your hamstring injury, the severity of it might worsen. The acronym R.I.C.E. comprises rest, ice, compression, and elevation.
DIAGNOSIS AND TESTS
How are hamstring injuries evaluated and diagnosed?
Based on the symptoms you describe, your healthcare provider may diagnose your hamstring injury. To assess the tenderness and inspect the swelling and bruising in the region, they may perform a physical examination. Occasionally, they may require an MRI test.
What healthcare providers diagnose hamstring injuries?
If you suffer a hamstring injury, your main healthcare practitioner can identify it, advise on treatment options as well as inform you of when you can resume usual activities. If necessary, they may also recommend consulting a physiotherapist, sports physician or orthopedist for additional support.
What questions might a healthcare provider help to diagnose a hamstring injury?
It can be useful to anticipate the queries your healthcare provider may pose. Some hypothetical inquiries to expect are:
- What symptoms are you experiencing?
- Are you in pain?
- Where is the pain located?
- When did the injury occur?
- What were you doing when you were injured?
- What medications do you take?
MANAGEMENT AND TREATMENT
How are hamstring injuries treated?
Your hamstring injury can be managed from the comfort of your home, although there are instances where individuals may require physical therapy. Follow the guidance of your healthcare provider and consider:
Home remedies
- Remember the acronym R.I.C.E.: rest, ice, compression and elevation.
- Stop your activity, or at least do fewer activities until the soreness is gone.
- Ice the area about 24 to 48 hours after your injury. Keep the ice on for 15 minutes, take it away for 15 minutes and repeat.
- Use a compression wrap or elastic thigh sleeve. It should be worn whenever you’re not icing or showering.
- Do gentle range of motion exercises to maintain flexibility.
- Sit on a table with your injured leg hanging off. Gently raise and lower your leg during icing period. After icing, lie in a prone position on your stomach and continue to gently bend and straighten your leg.
- Take over-the-counter painkillers including pills, creams and/or gels.
- Use crutches if walking is too painful.
Physical therapy
- Strength exercises.
- Flexibility exercises.
Surgery
- Surgery is rare, and only needed if your hamstring is pulled away from your bone.
Hamstring Strain Rehabilitation
Acute Phase Considerations: Did you just injure your hamstring, or is it currently painful?
To begin the process of rehabilitating damaged muscle tissue, it is important to discover methods by which the muscle can be utilized without causing additional harm. Isometric exercise is when a muscle contracts without changing in length, meaning that it is flexed without generating any movement. A demonstration of this type of exercise would be flexing your arm muscles or contracting your abs as powerfully as possible. Isometric exercise has been demonstrated to reduce discomfort and is a beneficial early step in resuming exercise after sustaining an injury. A recommended starting point for performing isometric hamstring exercises is the bridge position.
Isometrics for Analgesia: Direct Load Progressions for a Hamstring Strain
Isometrics are widely used in both strength training and rehabilitation. They serve as an efficient warm-up technique and can effectively reduce sensitivity and pain following an injury. Isometric contractions enable maximal muscle fiber recruitment, facilitating the optimal functioning of the nervous system for efficient muscular contraction. Consequently, athletes regularly engage in muscle “activation” before strenuous weightlifting. Additionally, isometric strength training can develop strength within a narrow range of motion, which is especially beneficial for addressing weak points. For example, pause squats or deadlift holds above or below a person’s sticking point can be employed to overcome training plateaus.
Isometrics can be beneficial not only in providing physiological pain relief and improving neuromuscular recruitment efficiency, but also in aiding in teaching exercise progression and introducing new movements. An example of this can be seen in the bridge progression chart, where one must first complete an isometric hold of each challenging position before attempting repetitions.
In rehab, a session may entail performing dynamic movements from one position and isometric holds from the next more difficult position. This gradual increase in difficulty is crucial to the rehabilitation process. Isometric exercises enable us to explore new motion ranges and are also beneficial for teaching lifting techniques. Moreover, they serve as a reliable means of progression, preventing us from overexerting ourselves and regressing. Isometric exercises help to establish the necessary strength and ease in each newly acquired motion range.
Bridge Progression Chart
- Phase 0: 2 feet on the box and flat ground → begin to experiment with single leg holds
- 1st Phase: single leg bridge marching and holds on the box and flat ground
- 2nd Phase: begin to increase bridging distance. Bridge walk-outs start here. Moving the feet further away makes the bridge more hamstring intensive.
- 3rd Phase: bridging on a swiss ball, sliders, slide board, or sorinex roller, 2 feet
- 4th Phase: able to do all single-leg slider bridges with no pain
Begin every new exercise by holding the isometric position, then advance to repetitions and movement. Increase from 2 sets of 5-8 reps to 3 sets of 10-12 reps before transitioning to the next stage. Use your body’s response and proper technique to determine when to proceed.
Modifying Bridges for Pain
To alleviate discomfort during phase 0 bridge for a hamstring strain, it’s possible to modify the exercise and explore alternative movements that don’t trigger pain. Adjusting the range of motion can minimize the intensity of the muscle contraction. Incorporating isometric resistance from various angles of movement can activate different muscles and noticeably alter the sensation of pain. Furthermore, specific pelvic and core positioning cues can assist in uncovering pain-free movement. Tilting the pelvis backward and flexing the spine can effectively decrease hamstring length and enhance the strength of the contraction. This cue can minimize sensitivity in the initial stage while also training the core to achieve proper positioning when bearing weight later on.
