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Hamstring Muscle Strain



Hamstring muscle strains and injuries are very common injuries in sports involving sprinting, change of direction and jumping.

Most experts agree that the majority of hamstring muscle strains happen

  1. while sprinting
  2. and more specifically as the lower limb is in the ‘terminal swing phase’ of running at a time when the hamstring muscle is loaded eccentrically (lengthening fibres under load).

Where/which part of the hamstrings are usually affected?

The most common part of the hamstrings that gets pulled/strained/injured is the biceps femurs (BF), and research shows that this happens in 80% of cases (that is 8 out of 10 hamstring injuries involves the biceps femurs).

Of these 80%:

  • 30% are in the distal musculotendinous junction (MTJ)
  • 20% occur in the proximal MTJ
  • 20% localised to the mid belly

Why does our hamstrings get strained or injures?

The main key risk factors are:

  • age (the older, the higher risk)
  • history / previous injury
  • muscle fatigue
  • imbalance in quadriceps-to-hamstring strength ratio (usually hamstring being too strong)
  • pure accident

Diagnosis

Clinical examination is considered adequately reliable to make a correct diagnosis. The key positive clinical findings are:

  1. sudden onset with a mechanism of force/speed
  2. disability/difficulty walking or running
  3. symptoms well localised on palpation at hamstrings
  4. stretch deficit
  5. strength deficit
  6. negative neural findings

hamstring risk Screening

A reliable clinical test to predict hamstring injury is the ‘single leg hamstring bridge’.

If an individual presents as having weakness with endurance testing compared to the other hamstring/leg/side there is an increased risk of hamstring injury.

hamstring muscle strain physiotherapy Treatment

Treatment is not limited to but can include:

  • immediate RICER
  • early sub-threshold muscle stretching and activation
  • soft tissue massage after early healing phase (gentle)
  • dry needling
  • correcting any abnormal movement patterns
  • decrease any overload in training programs
  • ultrasound therapy to accelerate soft tissue healing
  • ensure balance in quadriceps-to-hamstring strength ratio
  • gradual return to activity over a 3-6 week period dependent on the grade of injury inclusive of well structured running drills that respect acceleration/deceleration


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