Hamstring Strains

Hamstring strains are an indirect hamstring injury very common in sports involving jumping and sprinting. They are a very common injury and have an  extremely high recurrence rate of 12-31%.
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Anatomy
The hamstring consists of 3 large muscles making up the posterior thigh. They attach to both your hip and knee therefore working to bend your knee and also extending the hip.
They have a very important role in walking and running as well muscle actions in sport such as jumping and kicking. They are therefore injured performing these movements, either being damaged when sprinting during the late swing phase or over stretched when kicking or jumping.
Risk factors
There are many different factors that can cause the hamstring being increasingly prone to injury:

• Age – older athletes have been shown to have an increased risk
• Muscle fatigue
• Hamstring tightness
• Muscle imbalance
• Previous hamstring injury with poor rehab
• Insufficient warm up    ​

Physiotherapists are trained at identifying any biomechanical faults that would lead to an increased load placed through the hamstring muscles. If you have had a previous hamstring injury and did not undergo a rehabilitation plan then you are likely to be more susceptible to re injury.
Signs and symptoms
Hamstring strains are broken into grades, ranging from a small amount of fibres torn to a complete tear of the muscle. The higher the grade the more pain and weakness.
Pain usually occurs suddenly during exercise and can lead to:

• Bruising
• Pain when walking, bending knee or straightening leg
• Swelling and deformity
• Discomfort when sitting

Treatment
Immediate management
First 48- 72 hours
RICER (rest, ice, compression, elevation and referral) and no HARM (no heat, alcohol, heat and massage) protocol for the first 48-72 hours. This will allow reduction of pain, bruising and swelling and encourage healing to the injured tissue. Gentle movements can begin once pain free walking is achieved
Rehabilitation
To ensure a quicker return to sport and reduce the likelihood of re-injury then an individualised program should be commenced shortly after the injury has been sustained.
A program should consist of a graduated strengthening program which is targeting the goals and needs of the patient. Manual therapy can also be used effectively to alleviate pain and promote movement.
Return to sport is possible once full strength and flexibility hais returned as well as ability to complete the functional movements of the sport e.g. sprinting or jumping
 
 
References

• Brukner P, Khan K, et al.  Clinical Sports Medicine.  Volume 1, Injuries.  5th Edition. 2017

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