A hamstring strain can occur during an isolated athletic activity (acute) or result from persistent repetitive stress (chronic). Often an acute strain occurs as a result of a chronic condition which has rendered the muscle weak and vulnerable .

As in the case of the football player, hamstring strains often occur while sprinting. They also can occur during jumping and other activities where quick starts and stops are required. High risk sports for hamstring strains are: triathlon, rugby, tennis, basketball, and many track and field events. Runners are especially susceptible to chronic hamstring strains due to the repetitive nature of the sport.

Three muscles in the back of the thigh are collectively called the hamstrings:

biceps femoris

semitendinosus

semimembranosus

The two general attachment sites for the hamstrings are the bony prominence felt under each "cheek" when sitting (ischeal tuberosity) and the back of the knee.

Contraction of the hamstring causes the knee to bend and the thigh to move backwards relative the trunk, although these actions usually do not occur simultaneously.

The hamstrings play a vital role in walking, running, jumping, and controlling movements of the trunk.

Most hamstring injuries occur in the musculotendinous complex. This is the area where the muscles and tendons join. (Tendons are bands of tissue that connect muscles to bones.) The hamstring has a largemusculotendinous complex, which partly explains why hamstring injuries are so common.

Hamstring injuries happen when the muscles are stretched too far. Sprinting and other fast or twisting motions with the legs are the major cause of hamstring injuries. Hamstring injuries most often occur in running, jumping, and kicking sports. Water skiing, dancing, weight lifting, and ice skating also cause frequent hamstring injuries. These sports are also more likely to cause avulsions.

The major factors in hamstring injuries are low levels of fitness and poor flexibility. Children very seldom suffer hamstring injuries, probably because they are so flexible. Muscle fatigue and not warming up properly can contribute to hamstring injuries.

Imbalances in the strength of different leg muscles can lead to hamstring injuries. The hamstring muscles of one leg may be much stronger than the other leg, or the quadriceps muscles on the front of the thigh may overpower the hamstrings

Hamstring injuries usually occur during heavy exercise. In especially bad cases, an athlete may suddenly hear a pop and fall to the ground. The athlete may be able to walk with only mild pain even in a severe injury. But taking part in strenuous exercise will be impossible, and the pain will continue.

In less severe cases, athletes notice a tight feeling or a pulling in their hamstring that slows them down. This type of hamstring injury often turns into a long-lasting problem.

The hamstring may be pulled, partially torn, or completely torn. The injury can happen at the musculotendinous junction (mentioned earlier), within the muscle, or where the tendon connects on the ischial tuberosity (avulsion). In the rare case of a complete tear, the pain is excruciating. The torn tissues may form a hard bunch in the back of the thigh when the leg is bent. The skin may also bruise, turning purple from bleeding under the skin. This is not necessarily dangerous but can look somewhat alarming.

Hamstring starins are classified as either 1st, 2nd, or 3rd degree depending on the severity.

First Degree:

Second Degree:

Third Degree:

When the hamstring is injured, the fibres of the muscles or tendon are actually torn. The body responds to the damage by producing enzymes and other body chemicals at the site of the injury. These chemicals produce the symptoms of swelling and pain.

P - R - I - C - E

Protection - Your ankle may be splinted, taped or braced to prevent further injury.
Rest - You should rest from all activities that cause pain or limping. Use crutches/cane until you can walk without pain or limping.
	Ice - Place a plastic bag with ice on the affected areafor 15-20 minutes, 3-5 times a day for the first 24-72 hours. Leave the ice off at least 1 1/2 hours between applications.
	Compression - Wrap an elastic bandage from the knee to the buttocks, using even pressure. Wear this until swelling decreases. Loosen the wrap if your toes start to turn blue or feel cold.
Elevate - Make sure to elevate the leg above heart level (hip level is acceptable).

The chemicals that are produced and the blood clotting are your body's way of healing itself. Your body heals the muscle by rebuilding the muscle tissue and by forming scar tissue. Carefully stretching and exercising your injured muscle helps maximize the building of muscle tissue as you heal.

Firmly attach one end of an elastic tubing to a door knob or an other stable structure and attach the other end around your ankle. While sitting in a chair, bend your knee and then allow it to slowly straighten against the resistance of the elastic. To increase the resistance, move the chair away from the door knob.

 

TO HELP PREVENT RE-INJURY

 

Remember that many hamstring problems  occur at contact phase of gait (when the foot hits the ground) due to increased biomechanical stress at this point. No amount of exercising will influence what happens at the point of heel strike, mid-stance and toe off phases of gait. It is therefore vital to improve your biomechanics with orthotics designed for your chosen sport.

Golden rule- Don't ignore the problem, it won't go away!

The way we function biomechanically is predominantly controlled by genetics, its hereditary (runs in the family). The way you function is set and cannot be cured. What you can do however is control lower limb biomechanics by altering foot position during the contact phase of gait. This can only be done by wearing a good shoe (see our shoe guide) and with orthotics  (foot beds). This is the cheapest and most cost effective way for any athlete to reduce the risks of injury from occurring and from helping to prevent re-injury. Overall costs for the average athlete will run into pennies per mile/hour of sport. Orthotics are designed to alter the biomechanics during the time the foot is on the ground. They are also used to provide increased shock absorbency working in harmony with the sport shoe worn.

*please see terms & conditions
 

RETURNING TO SPORTING ACTIVITY

The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity is determined by how soon your achilles recovers, not by how many days or weeks it has been since your injury occurred.

You may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:

You have full range of motion in the injured leg compared to the uninjured leg.

You have full strength of the injured leg compared to the uninjured leg.

You can jog straight ahead without pain or limping.

You can sprint straight ahead without pain or limping.

You can do 45-degree cuts, first at half-speed, then at full-speed.

You can do 20-yard figures-of-eight, first at half-speed, then at full-speed.

You can do 90-degree cuts, first at half-speed, then at full-speed.

You can do 10-yard figures-of-eight, first at half-speed, then at full-speed.

You can jump on both legs without pain and you can jump on the injured leg without pain.

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