October 11, 2018 at 10:34 AM
What are they?
The hamstrings are a large group of muscles found at the back of the thigh. The primary role of these muscles is to bend the knee and collectively, these muscles are some of the strongest in the body. Despite their strength, the hamstrings are very prone to injury especially when overworked or undertrained. Hamstring strains and tears are quite common in sports that involve sprinting, jumping and sudden changes in speed. Rugby, touch and soccer players are some of the athletes most commonly affected by hamstring tears.
Hamstring strains are categorised into three grades, these are:
Grade 1 (mild) – A few muscle fibres are either damaged or ruptured; there may be pain a day after the injury but no loss of movement.
Grade 2 (moderate) – Roughly half of the muscle fibres are torn; there may be acute pain and mild loss of function; walking may be affected. You may notice some bruising in the hamstring or back of the knee.
Grade 3 (severe) – More than half of the muscle fibres are ruptured and there is immense pain and swelling; definite muscle weakness and loss of function. There will be bruising in the hamstring, back of the knee and sometimes into your calf muscle.
What are the symptoms?
The symptoms of a hamstring tear depend on the severity of the injury. Common symptoms include pain at the back of the thigh – which could range from mild to severe, swelling, bruising, loss of knee motion, tenderness at the back of the thigh, muscle tightness and weakness of the hamstring. In some cases, tingling, numbness and weakness of the structures below the knee are seen. However, these are rare.
What are the causes?
There are recognised risk factors that increase the possibility of hamstring tears including increased age, fatigue, strength imbalance, previous injury of the hamstrings, poor core stability, poor hamstrings flexibility and tight hip flexors. Of these risk factors, previous hamstring injury is the biggest.
A single cause of hamstring tears can be difficult to determine however, it is thought that a lack of coordination between the hamstrings and quadriceps muscles during sudden changes of speed or when kicking can cause the hamstrings to contract excessively or become overstretched, causing a tear. Apart from having already suffered a previous hamstring injury, one of the biggest causes we see in our clinic are people who have been inactive over the winter months and then they commence playing touch or summer football with minimal training build up. Players may get through one game unscathed but then can increase their playing intensity and “ping”…there goes their “hammy” after bending over to scoop up the ball, sprinting for that gap to the try line or channeling their inner Messi for the winning goal.
How are hamstring tears treated and prevented?
The most common question we hear in our clinic is “When can I get back into sport?” This is a difficult question to answer as each injury presents differently. As a general rule, the lesser the severity the quicker you will be able to get back into your sport. For example, a grade 1 tear may take between 2-4 weeks to recover, whereas a grade 3 tear can range from 8-12 weeks. The best advice for returning to sport following an injury would be to train at an incrementally increasing rate to load the hamstring muscles so that they can handle the pressures of your chosen sport. The biggest risk of re-injury following a hamstring tear is due to poor rehabilitation and insufficient loading of the muscles.
Initial treatment of a hamstring injury is to reduce pain, swelling and bruising, and then improve your flexibility and strength. Common treatments that we use in our physiotherapy clinic to treat hamstring tears include: electrotherapy, acupuncture, ice, heat, massage, stretches of both the muscle and nerves and strengthening exercises of the core, gluteals and hamstrings. Research has shown that patients have improved recovery times with the integration of a gentle stretching program starting two days post injury with no detrimental effects. Strengthening exercises can also be started relatively early to help reduce your pain and maintain the function of your muscle in the early stages post injury. Once you are ready to return to your usual hobby or activity, a maintenance program is usually needed to help reduce your risk of re-injury.
Trying to prevent hamstring tears is really important. Our highly trained physiotherapists will be able to initially treat your hamstring injury and progress you on to appropriate exercises to reduce the risk of you re-injuring your hamstring in the future.
Anlo van Deventer is a Physiotherapist at Cairnhill Physiotherapy and is able to help guide you on your recovery from a hamstring injury. To book an appointment with her click here or call us on 09 631 5991.