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thomas.salvage@physio2you.net

 

                

 

 

 

                                                                                                                                                                         

Hamstring strain

Hamstring strain: Firstly it is important to understand that except for trauma an injury sustained from sport/activity will only affect the biarticular muscle/ muscle groups

For example in a calf strain it will only ever be the gastrocnemius muscle that is affected as opposed to the soleus as this muscle goes over two joints- this is important as the larger biarticular muscles are typically superficial, it is also important in regards to diagnosis and knowing appropriate strength and conditioning programmes for rehabilitation

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Grade 1 Hamstring strain – most common typically up to 33 % of muscle fibres

With a grade 1 hamstring strain the athlete may have tightness in back of the thigh but will be able to walk normally. They will be aware of some discomfort and unable to operate at full speed. There will be little swelling and trying to bend the knee against resistance is unlikely to reproduce much pain.

Grade 2 Hamstring strain

With a grade 2 hamstring strain the athletes gait ( walking) will be affected and they will most likely be limping. Sudden twinges of pain during activity will be present. They may notice some swelling and pain will be reproduced when pressing in on the hamstring muscle as well as trying to bend the knee against resistance.

Grade 3 Hamstring strain

A grade 3 hamstring strain is a severe injury involving a tear to atleast half or all of the muscle. The athlete may need crutches to walk and will feel severe pain and weakness in the muscle. Swelling will be noticeable immediately and bruising will usually appear within 24 hours.

Example: grade 1 hamstring tear

Hamstrings are typically underdeveloped muscles as opposed to the quadriceps which are more highly focused on with athletes- a hamstring tear occurs due to the explosive force of the quadriceps- and therefore commonly seen with explosive sprinting sports such as football and short distance runners as opposed to marathon runners

Signs/ presentation: individual will report a specific onset of pain . i.e pulled up from a run. There will be pain/ discomfort on stretch and contraction of the hamstring fibres

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Treatment protocols

  • Initially PRICE- protection, rest, ice, compression ,elevation- to reduce inflammation into area of injury

  • manual therapy to commence

  • deep soft tissue work increasing intensity/ pressure with treatment sessions

Rehabilitation protocols

  • complete rest 10- 14 days

  • cardiovascular work bike to progress to cross trainer

  • if pain free progress to jogging on alternative days

  • strength and conditioning programmes when pain free

  • regular use of ice/ heat throughout

Healing times:

Elite: 21-28 days

Non elite typically 4-6 weeks

Other information regarding hamstring tears

: 85% will reach cure 15% may require further intervention with injection/operation

5% will not reach cure

There is a possibility of a micro-traumatic injury leading to a hamstring tear, this will be a gradual onset due to poor biomechanics but both injuries will be treated the same bar the fact that the treatment for micro-traumatic injuries should have more focus on biomechanics


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