Hamstring Injuries

The hamstring runs down the back of the thigh and is made up of three muscles:

• Semimembranosis
• Semitendinosis
• Biceps Femoris

They all start in the gluteal region – attaching at the ischial tuberosity AKA the sit bones, they then run down the back of the thigh, cross the knee joint and insert into the lower leg. The hamstring helps you bend your knee and extend your leg back.

Hamstring Injuries

Hamstring injuries typically involve a strain, partial tear or complete tear. Muscle strains are graded based on their severity. Most hamstring injuries occur in the muscle belly of the hamstring or where muscle fibres join tendon fibres.

Hamstring injuries are common in athletes who participate in sports that require sprinting and explosive takeoff just as AFL, NRL, rugby basketball and soccer.

The most common cause of hamstring injuries is muscle overload – when the muscle is stretched beyond its capacity or challenged with too much load or force.

Hamstring injuries most commonly occur when the hamstring is contracting while in a lengthened state. When running, the back leg is straight while pushing off the ground – it is at this exact moment that the hamstring muscle is stretched and contracting at the same time in order to propel the body forward while supporting the weight of the body.

The most common symptoms of a hamstring injury include:

• Sudden sharp pain in the back of the thigh – with limited ability to weight bear on the affected side
• Swelling
• Bruising
• Weakness and loss of power

A summary of the current research:

• Hamstring injury risk is reduced in people who have never injured their hamstring
• Multiple factors should be addressed in the rehabilitation of hamstring injuries including:
  • Workload management which should involve consistent and gradual increases in how much the hamstring is exercising. Spikes or troughs in workload are strongly associated with increased injury risks
  • Rehabilitation should include maximising hamstring strength – especially high load, eccentric exercises
  • High speed running should be included in hamstring injury rehabilitation programmes
  • Optimising recovery
  • Stretching may reduce risk of reinjury however, strength should be the focus in hamstring rehabilitation programmes
• There is limited evidence showing that passive approaches such as massage, ultrasound, foam rolling, and other electrophysical agents help in reducing the risk of hamstring injuries.

Diagnosis

Accurate diagnosis is crucial. Three different muscles make up the hamstring and finding which one is affected will dictate your rehabilitation plan. A physiotherapist can work with you to identify where the tear is using highly specific tests and palpation skills. Sometimes when damage to a central tendon is suspected, an MRI may be worthwhile. Ultrasound investigation has limited reliability as it is strongly associated with the experience of the sonographer.

Treatment

After an accurate diagnosis of which muscle is affected, a structured rehabilitation program is imperative to help the athlete return to sport safely and quickly. If you are already back at sport but have injured your hamstring in the past, a re-injury prevention program is crucial as you have a higher risk of hamstring injuries. Alchemy’s physiotherapists are well versed in the current best practice in preventing hamstring injuries as well as how best to get you on the park as soon as possible.

If you have any concerns about rehabilitation or have had a hamstring injury in the past and want to reduce your risk of re-injury, please don’t hesitate to contact our friendly admin team to book an appointment with one of our physiotherapists.