This information has been prepared to help you fully understand your condition so you will be in the best position possible to work with your physio and follow the steps to your full recovery. Understanding the goals of your treatment and having complete confidence in your physio are vital elements of your recovery plan, so if you have any questions then please feel free to ask your physio.
There are 3 hamstring muscles on each of our legs. They are called the semitendinosis, semimembranosis and biceps femoris, and are located in the back of the thigh and attach at the hip and at the knee. The role of the hamstring muscle group is to bend the knee and to move the thigh backwards at the hip. A hamstring injury is sometimes known as a ‘pulled hamstring’. The term ‘pulled muscle’ comes from the description of how the muscle is damaged, ie. It is forcibly stretched beyond its limits and the muscle tears. Hamstring injuries are common in sprinters and hurdle jumpers and are common in other sports such as football and rugby.
Hamstring strains are graded as 1, 2 or 3 depending on the severity. Grade 1 tears are minor and may result in little pain with stretching and you may also feel tightness and discomfort. Grade 2 tears are partial tears where you may see some swelling and bruising. Stretching is painful and you will usually be limping and be unable to fully straighten the knee.
Grade 3 tears are a complete rupture of the muscle with severe pain, swelling and you may be able to feel a gap in the muscle fibres. Walking will be difficult and you may require crutches due to pain.
Most clients feel a sharp pain at the back of the leg during leg movements, especially during fast movements. Pain will also be felt during stretching or muscle contraction against resistance. There may be swelling, bruising and in more severe cases, there may be a gap able to be felt along the muscle which indicates a significant tear of the muscle.
Early advice and treatment is crucial to prevent any long term complications. If left untreated your pain may become constant and the hamstring will scar at the tear site causing tightness and recurrent strains. This makes a return to sports and normal activities such as walking difficult. The more times a hamstring is torn, the more significant the scarring and the higher risk of more serious problems, so getting fully recovered from your initial tear is vitally important.
Your This will depend on the severity of your strain and if your have any history of previous injury. With early treatment a full recovery is possible in 6-8 weeks, however more severe tears or recurrent problems may take around 12 weeks. Getting your muscle back to full strength once your pain is settling is vital for a long-term fix. Physio management usually produces great results without any other treatment or investigations being required.
Your physio has been extensively trained to thoroughly assess and diagnose your injury. They will give you a step-by-step recovery plan to make your treatment easier for you to understand. The most common phases, or steps, that you will go through during your recovery plan are outlined below. The order and timing of the phases are tailored individually for you and so may vary form this list. Please feel free to ask your physio if you have any questions about your recovery plan.
Inflammation is the redness and swelling that occurs whenever you injure yourself. Our bodies need inflammation to start the normal healing process but we also need to control it. Therefore, the first goal is to reduce the inflammation and pain in your hamstring.
The techniques your physio may use to manage your inflammation include specific local massage, ice and ultrasound . Importantly, they will also guide you on modifying your current activity and exercise to ensure that you are not continually reaggravating your inflammation as this will significantly slow your recovery.
If part of your hamstring stays tight then it takes more tension that the surrounding muscle and is therefore prone to re-tearing. Also, if your muscle is tight it puts more stress on tendons (the ends of muscles) at the point where they attach to the bones. Tight muscles can make the job of other muscles harder and cause too much load on joints. Tight muscles also change the way you move and can stress other parts of your body. Therefore it is important to get your full muscle length back to stop all this from happening.
Your physio will use techniques including heat, stretches and specific muscle releases for your hamstrings to regain your flexibility. If your normal exercise has been a significant cause of your hamstring tightness then often a quick but effective stretch routine will need to be included with your regular exercise on an ongoing basis.
Weak muscles are a major problem when recovering from an injury. Often muscles are weak because they are not being used properly, they have been damaged, or they have been resting after an injury. When strengthening muscles you must strengthen the correct muscle and in the way the muscle would normally be used.
Your physio will guide you through a specific strength program for your hamstrings to ensure you achieve a safe and lasting recovery. You will start with slow and lowresistance exercises, and gradually progress to higher paced movements with increased resistance.
Often hamstring injuries are associated with imbalances in our hips, pelvis and low back. Basically, because the hamstrings are large strong muscles they often pull very hard on their attachment points, especially to the pelvis. This means that if the pelvis is not being stabilized well by our core stabilisers and other muscles around the hip, then our hamstrings are pulling hard on an unstable attachment point, and this greatly inreases the risk of hamstring and other injuries. As part of our hamstring rehabilitation your physio will check on the strength and co -ordination of your core and hip muscles, and guide you through a program to restore correct strength and stability to those muscles as needed.
This is the last phase of your journey to full recovery. When you are returning to your activity you must be able to do it at full speed and resistance before being back in the game. In this phase we tailor exercises specifically to your activity with varying speeds, forces and frequencies. This is vital in reducing the risk of re-injury and future problems.
This is the last phase of your journey to full recovery. When you are returning to your activity you must be able to do it at full speed and resistance before being back in the game. You need to be able to apply your speed and force with the correct technique in training first to prevent another injury. In this phase we tailor exercises specifically to your activity by doing advanced sports-specific strengthening and high speed movements combined with rapidly changing directions. This phase is essential both for getting your back to your full level of performance, and also for preventing re-injury due to persisting background weakness or reduced co-ordination of muscle contractions.
Many clients find that seeing one of our Exercise Physiologists, Strength and Conditioning coaches or Personal Trainers is a great way to build strength, ability and confidence for a smooth return to full sporting activity. If Pilates is more your style then our great Sports Pilates program is an ideal way for you to continue to build your stability and strength. As well as being an important part of your rehab program these services can help you lift your sports performance whilst staying safer and reducing your risk of future injury.