Your Guide to Hamstring Strains
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 & follow the steps to your full recovery. Understanding the goals of your treatment & 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 & biceps femoris, & are located in the back of the thigh & attach at the hip & at the knee. The role of the hamstring muscle group is to bend the knee & 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 & the muscle tears. Hamstring injuries are common in sprinters & hurdle jumpers & are common in other sports such as football & rugby.
Hamstring strains are graded as 1, 2 or 3 depending on the severity. Grade 1 tears are minor & may result in little pain with stretching & you may also feel tightness & discomfort. Grade 2 tears are partial tears where you may see some swelling & bruising. Stretching is painful & you will usually be limping & be unable to fully straighten the knee.
Grade 3 tears are a complete rupture of the muscle with severe pain, swelling & you may be able to feel a gap in the muscle fibres. Walking will be difficult & 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 & in more severe cases, there may be a gap able to be felt along the muscle which indicates a significant tear of the muscle.
What Happens If I Don`t Fix My Hamstring?
Early advice & treatment is crucial to prevent any long term complications. If left untreated your pain may become constant & the hamstring will scar at the tear site causing tightness & recurrent strains. This makes a return to sports & normal activities such as walking difficult. The more times a hamstring is torn, the more significant the scarring & the higher risk of more serious problems, so getting fully recovered from your initial tear is vitally important.
How Long Does It Take To Get Fully Better?
Your This will depend on the severity of your strain & 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 journey to peak performance with Central Physio
Your physio has been extensively trained to thoroughly assess & 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 & timing of the phases are tailored individually for you & so may vary form this list. Please feel free to ask your physio if you have any questions about your recovery plan.
Phase 1: Optimise & Control Inflammation
Inflammation is the redness & 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 & pain in your hamstring.
The techniques your physio may use to manage your inflammation include specific local massage, ice & ultrasound . Importantly, they will also guide you on modifying your current activity & exercise to ensure that you are not continually reaggravating your inflammation as this will significantly slow your recovery.
Phase 2: Restore Muscle Length
If part of your hamstring stays tight then it takes more tension that the surrounding muscle & 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 & cause too much load on joints. Tight muscles also change the way you move & 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 & 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.
Phase 3: Specific Muscle Strengthening
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 & 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 & lasting recovery. You will start with slow & lowresistance exercises, & gradually progress to higher paced movements with increased resistance.
Phase 4: Restabilise
Often hamstring injuries are associated with imbalances in our hips, pelvis & 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 & other muscles around the hip, then our hamstrings are pulling hard on an unstable attachment point, & this greatly inreases the risk of hamstring & other injuries. As part of our hamstring rehabilitation your physio will check on the strength & co -ordination of your core & hip muscles, & guide you through a program to restore correct strength & stability to those muscles as needed.
Phase 5: Proprioception Retraining & Functional Strengthening
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 & resistance before being back in the game. In this phase we tailor exercises specifically to your activity with varying speeds, forces & frequencies. This is vital in reducing the risk of re-injury & future problems.
Phase 6: Sports/Ballistics & Advanced Strengthening
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 & resistance before being back in the game. You need to be able to apply your speed & 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 & high speed movements combined with rapidly changing directions. This phase is essential both for getting your back to your full level of performance, & 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 & Conditioning coaches or Personal Trainers is a great way to build strength, ability & 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 & strength. As well as being an important part of your rehab program these services can help you lift your sports performance whilst staying safer & reducing your risk of future injury.
For more information or to speak with one of our physio’s to discuss your symptoms please call us on 9280 2322 or contact the clinic.