The hamstring muscle consists of three individual muscles which are Biceps Femoris, Semitendinosus and Semimembranosus. These three muscles originate from the pelvis, travels down the rear of the thigh and they attach on a lower leg bone called the Tibia. The Hamstring muscles as a group are required for the flexing/ bending of the knee but also help in the straightening of the hip.
What is a hamstring strain?
A hamstring strain usually involves one or more of the hamstring muscles tearing or partially tearing, producing pain in the back of the thigh. This type of injury is extremely common at all levels of competition. It is reported that strains account for up to 29% of all lower limb injuries across all sports.
Injury to the hamstrings can have a negative impact on training, competing and day to day living. The average number of days lost can be between 8 and 25 depending on the injury location and severity. Due to the frequent use of the hamstrings, there is a high rate of re-injury, particularly within the first two weeks returning to activity. Therefore, the therapist and client should work together when diagnosing the injury and create a treatment plan in order to reduce the risk of injury re-occurrence and any strength deficits that may occur.
Treatment of a Hamstring Strain
There are three phases which usually take place during the healing of a hamstring injury, during these healing stages different methods of treatment should be used. The first phases is referred to as the Inflammatory phase, which occurs during the first 3 to 7 days post injury. At this stage pain control, decreasing inflammation and protecting the tendon for scar tissue to develop is critical. Most of this stage will be non-weight bearing to help pain free healing. Progression to phase two is when the client can walk with a normal gait, can contract hamstrings 50-70% and a low speed jog without pain.
Phase two is known as the Reparative phase, during this stage the therapist should help the client try to regain full range of movement, whilst being cautious not to overstretch. Once full range has been restored more challenging exercises should be introduced, remembering that all activities should be kept free from pain. This phase normally lasts between 6 to 8 weeks with patient comfort and severity of the injury taken into account. Progression into the third and final stage should be made once the client regains full strength and range of movement, whilst also tolerating a backwards jog at a midway/ 50% intensity.
Phase three is known as the Remodelling phase, during this stage the clinician should customize the rehabilitation plan to specifically suit the client. Competition specific as well as agility drills are highly recommended to help promote tissue remodelling, which in turn will help the client return to their previous level of activity. Plyometric exercises as well as SAQ exercises are ideal and greatly help when the client returns to sport or activity.
Although this is a general overview of a treatment plan for a Hamstring strain, it is always recommended to consult a qualified therapist in order to receive the best treatment plan, which can target your specific needs and help get you back to your top level.
By Richard Morris
Sports Massage Therapist at BodyWorks