Description
Hamstring strains are caused by a rapid contraction or stretching/lengthening of the hamstring muscle group as the heel strikes the ground (2,3,4,5). Hamstring strains are common in sports with sprinting and kicking demands (2,3,4,5).
Anatomy and function of the Hamstring muscle
The hamstring muscle group consists of 3 main muscles: Biceps femoris, Semi-membranous and Semi-tendinous (5).In addition, some authors consider the Adductor Magnus (Hamstring portion) the fourth hamstring muscle. The hamstring muscle crosses the hip and knee joint and plays an important role in bending the knee and straightening the hip.
Characteristics of a hamstring strain
The characteristics of strains will vary based on the severity of the strain. Some common characteristics include sudden, minimal to severe pain, affected gait pattern (limping), tearing feeling in the back of the thigh, bruising, decreased muscle strength, reduced range of movement, increased muscle stiffness and tenderness (1).
Hamstring tears are graded according to severity
Grade 1 = Mild – a few fibres of the muscle are damaged or have torn. Grade 2 = Moderate -more or less than half of the fibres are torn. Grade 3 = Severe – complete tear or rupture of muscle fibres (4)
Assessment
The attending physiotherapist will delve into a detailed, patient-specific subjective and objective assessment comprising of the following: Gait (walking and running) analysis (5), active range of motion, muscle strength testing, muscle length of hamstrings (1), muscle endurance (1&3) and possibly a neurological examination (1) to assist in excluding a nerve injury.
Management
Our goal is to not only get you back to where you were before the injury but also enhance your function beyond that point and prevent re-injury! Physiotherapy sessions will include the following – Education on how to protect the healing tissue and the significance of a gradual return to activities based on healing times, soft tissue massage, specific progressive strengthening, active range of motion exercises and stretches (1,3,4). Return to sport is guided by specific criteria which look at various factors, including your strength, flexibility, power endurance and agility.If you’d like us to help you return to the sport you love, don’t hesitate to contact us on 011 027 2111.
References
1.Chu, S., & Rho, M. (2016). Hamstring Injuries in the Athlete: Diagnosis, Treatment, and Return to Play. Curr Sports Med Rep, 15(3), 184-190.
2.Danielson, A., Horvath, A., Senorski, C., Alentorn-Geli, E., Garrett, W., Cugat, R., . . . Senorski, E. (2020). The mechanism of hamstring injuries. BMC Musculoskeletal Disorders, 21(641), 1-21.
3.Erickson, L., & Sherry, M. (2017). Rehabilitation and return to sport after hamstring strain injury. Journal of Sport and Health Science, 6, 262-270.
4.Heiderscheit, B., Sherry, M., Silder, A., Chumanov, E., & Thelen, D. (2010). Hamstring Strain Injuries: Recommendations for Diagnosis, Rehabilitation and Injury Prevention. Journal of Orthopaedic & Sports Physical Therapy, 40(2), 67-81.
5.Sugimoto, D., Kelly, B., Mandel, D., d'Hemecourt, D., d'Hemecourt, C., & d'Hemecourt, P. (2019). Running Propensities of Athletes with Hamstring Injuries. Sports, 7(210), 1-10.
