Ouch, Hamstring Strains

Wednesday is track day for me. Intervals, anaerobic intensity and intense pain are the order of the day. This particular day however, I was running late and didn’t get to the track early enough. A 500 meter warm up jog for the 6 x 400 meter repeats at 75 seconds didn’t quite work. Leading on interval number 5, I felt a twinge in my left hamstring 180 meters out. I thought I could run through it, but the sharp pain had me limping off to the side of the track 10 meters later. Voila…instant hamstring strain and it was totally my own fault! The lesson here: do as I say, not as I do!

What is a hamstring strain?

The hamstrings consist of 3 muscles at the back of your thigh (semimembranosus, semitendinosis, and biceps femoris). In a very simplified explanation, these muscles function to extend the hip and flex the knee joint. Overstretching or tearing any of these muscles is considered a hamstring strain.

Muscle tears are graded from 1 to 3. A grade 1 tear is considered a mild injury with microscopic tears, a grade 2 is a partial tear, and a grade 3 injury is a complete tear.

What are the causes and predisposing factors of injury?

Here are a number of factors that can lead to a hamstring tear.

• Previous hamstring injury
• Lack of hamstring flexibility
• Lack of hamstring strength
• Imbalance between hamstrings and quadriceps
• Imbalance between the left and right hamstrings
• Anterior pelvic tilt
• Hypomobile lumbar spine
• Muscle fatigue
• Dehydration
• Electrolyte depletion

What are the symptoms of a hamstring strain?

Sharp pain in the back of the leg caused by sprinting or high velocity movements is a common presentation. There will usually be spasm in the hamstring and, in more severe cases, there will be swelling and bruising. Larger tears may also have palpable gaps in the muscle at the injury site.

What can be done to prevent and treat hamstring strains?

First, any of the causative factors listed above must be addressed. Obviously a good warm up prior to activity is essential. This should consist of light aerobic activity for at least 10-15 minutes, followed by stretching. Make sure you are properly hydrated and if you are particularly tired, you may want to make your workout less intense.

Treatment of hamstring strains can be a lengthy process. The hamstrings tend to heal with a lot of scar tissue, so minimizing excessive scarring is a priority.

Initial care consists of the RICE protocol (rest, ice, compression, elevation) to reduce inflammation. The use of anti inflammatory drugs is somewhat controversial, since it may interfere with the normal healing process and create tissue that is weaker than normal. Ice or cold packs are a safer option.

Later care (after 1-2 days) includes pain free stretching, physical therapy modalities, light cross friction massage, and any mobilization and manipulation techniques that address pertinent biomechanical problems.

Rehabilitation should focus on isometric exercises initially, and then progress to exercises that will help to strengthen and balance the hamstring muscle from side to side and with the other muscle groups in the lower extremity.

Running through the recovery phase is done in a graduated fashion, and should only start when you are able to run pain free. It may take several weeks to be able to run at a high intensity again, depending upon the severity of the injury.

Remember, taking the time to properly prepare for your faster paced workouts can prevent many hamstring injuries from occurring in the first place.

Photo credit: HKmPUA