The Pulled Hamstring
The hamstring is one of the major muscles behind the thigh. It attaches to the hip and knee. This allows movements such as knee flexion (bending the knee) and hip extension (straightening the hip). One of the most common sports injuries I assess and treat are hamstring strains/tears. They occur in sports involving sprinting and kicking such as: soccer, rugby league and AFL.
The hamstring consists of a group of 3 separate muscles:
There are 3 types of hamstring strains:
Grade 1: able to walk, no loss in strength and minimal swelling (2-4 week recovery).
Grade 2: partial tear of muscle fibres - mild swelling/bruising, difficulty to walk, reduced strength (4-6 week recovery).
Grade 3: complete tear of muscle fibres – severe swelling and bruising, unable to walk, major loss in strength (3-6 months).
What causes a hamstring tear?
Many people assume that they’re at risk of a hamstring tear because of “tightness”. This is false. It’s still adequate to stretch and foam roll your hamstring. However, research shows it’s more effective to follow a strength based exercise program.
Hamstrings commonly tear due to:
reduced muscular endurance
fatigue during activity
inadequate preparation for running/sports
previous hamstring strain
How do I treat a hamstring tear?
Physiotherapists use a variety of treatments depending on the grade of the hamstring strain. These include:
Education: understanding your injury and what to do. Eg. Ice, compression and elevation are important methods to help with recovery rate.
Massage to reduce scar tissue and swelling: In the first session I give a lighter massage so I don’t aggravate or bruise the muscle.
Exercise program focusing on strength and mobility: starting off with isometrics (holding muscle contraction against resistance) and progressing to eccentric (muscle contraction in lengthened position).
Assigning a running program when close to returning to activity and built up adequate strength. Progressions can also include plyometric exercises (explosive exercises such as box jumps).
How can I prevent a hamstring tear?
The most effective way to prevent a tear is to improve strength and endurance in the muscle. When playing sports, it’s critical to complete an extensive pre-season. Exercises such as bridges, single leg deadlifts, box jumps and explosive lunges are all essential for targeting the hamstring.
I tend to give higher repetitions and sets for the non-explosive exercises (12 reps, 4 sets) to target endurance.
Jeremy Abood (Physiotherapist at Fine Form Physio)