Hamstring Injuries: Hamstring Injury Symptoms and Treatment
What is a hamstring injury?
A strain injury to a hamstring muscle or tendon or their bony attachments. The hamstring muscles run from the pelvis and femur to the back and side of the knee. The hamstring tendons can be felt behind the knee on either side. They feel like tough rope. The hamstring tendons, muscles and their attached bones comprise contractile units that stabilize the knee and hip and allow their motion. The injury, usually a strain, occurs at the weakest part of the unit.
How do you prevent hamstring injuries?
Hamstring injuries can be prevented or greatly reduced by properly stretching and warming up the hamstring and quadricep muscles prior to any physical activity, practice or competition. The athlete should participate in a strength and conditioning program appropriate for their sport. Conditioning of the connective tissue (ligaments and tendons) can greatly reduce the incidence of injury. It must also be understood that the rate of strengthening of connective tissue lags behind the rate of strengthening of muscle. Therefore the training program should consist of work involving low weight and high repetitions for 3 to 4 weeks at the beginning of a strength and conditioning program to begin the strengthening process of connecting tissue before muscle strength is increased.
What types of hamstring injuries are there?
Hamstring strains are of three types;
- A mild or (grade I) strain, which is a slightly pulled muscle without tearing of muscle or tendon fibers. There is no loss of strength.
- A moderate or (grade II) strain, which is a tearing of fibers in a muscle or tendon or at the attachment to the bone. Strength is diminished.
- A severe or (grade III strain), which is a rupture of the muscle tendon-bone attachment, with separation of fibers. A severe strain may require surgical repair. Chronic strains are caused by overuse. Acute strains are caused by direct injury or over-stress.
What muscles are involved in a hamstring injury?
The specific body parts involved are the tendons and muscles of the hamstring area, including bones in the pelvis and knee joints. There are also soft tissues surrounding the strain, including nerves, periosteum (covering of bone), blood vessels and lymph vessels.
How do I know if I’ve injured my hamstring?
The signs and symptoms of a hamstring strain are: (1) pain when moving or stretching of the leg, (2) muscle spasms of the injured muscles, (3) swelling over the injury, (4) Weakened leg (moderate or severe strain), and (5) Crepitation (“crackling” feeling and sound when the injured area is pressed with fingers). Calcification of the hamstring muscle or tendon (visible with x-ray) and (6) Inflammation of the sheath covering the hamstring tendon. These injuries are generally caused by prolonged overuse of muscle tendon units in the leg or a single violent injury or force applied to the muscle-tendon units in the leg.
Am I at risk for hamstring injuries?
The risk of sustaining a hamstring injury increases with contact sports, sports that require quick starts, such as the start of a race. Obesity, poor nutrition, previous pelvic or knee injury or poor muscle conditioning also increase the risk. The likelihood of sustaining a hamstring injury can be decreased by participating in a strengthening, flexibility and conditioning program appropriate for your sport or athletic activity, by adequately warming up before practice or competition and by using proper protective equipment, such as knee pads and thigh pads, during participation in contact sports.
What is the proper care for a hamstring injury?
The appropriate health care for a hamstring strain is a doctor’s care, application of tape or an elastic sleeve if a muscle ruptures or the muscle-tendon-bone attachment loosens. Your own self-care during rehabilitation, proper physical therapy (for moderate or severe strain), or surgery for a severe strain. The condition is most commonly diagnosed through your own observation of symptoms, your medical history and exam by a doctor and x-rays of the pelvis, femur and knee to rule out fractures.
Are there any complications with hamstring injuries?
Some possible complications can be (1) prolonged healing time if activity is resumed too soon, (2) proneness to repeated injury, (3) Loss of the ability to quickly accelerate and decelerate, (4) inflammation at the attachment to bone (periostitis); or sometimes, prolonged disability. With a first-time injury, proper care and sufficient healing time before resuming activity should prevent permanent disability.
How long does a hamstring injury take to heal?
The average healing times are: (1) mild strain – 2 to 10 days, (2) moderate strain – 10 days to 6 weeks, (3) severe strain – 6 to 10 weeks. The complications listed above are more likely to occur in the case of repeated injuries.
What treatment should I use for a hamstring injury?
Treatment should consist of following your doctor’s instructions. Some supplemental first aids are the “R.I.C.E.” instructions: Rest, Ice, Compression, and Elevation (if possible). It is helpful, as continuing care, to use an ice pack 3 or 4 times a day for 20 minutes at a time. Place ice chips or cubes in a plastic bag. Wrap the bag in a moist towel, and place it over the injured area. After the first 72 hours, apply heat instead of ice if it feels better. Use heat lamps, hot soaks, showers, heating pads or heat liniments and ointments. Take whirlpool treatments, if available. Wrap the injured leg with an elasticized bandage between ice or heat treatments. Massage gently and often to provide comfort and decrease swelling.
What medications, if any, are recommended?
Medication for minor discomfort can be nonprescription medicines such as aspirin, acetaminophen or ibuprofen. Topical liniments and ointments can be used. Your doctor may prescribe stronger pain relievers or even an injection of a long-acting local anesthetic to reduce pain. The doctor may prescribe injections of a corticosteriod, such as triamcinolone, to reduce inflammation.
What activity is proper during rehabilitation and recovery?
Walk with crutches for at least 72 hours in the case of a moderate or severe strain. Resume your normal activities gradually. During recovery, you should balance the amount of food you eat with any change in your level of physical activity. Eat a variety of foods to get the energy, protein, vitamins, minerals and fiber you need for good health and healing. You can begin daily rehabilitation exercises when supportive wrapping is no longer needed and with the blessing of your doctor. Use ice massage for 10 minutes before and after exercise. Fill a large styrofoam cup with water and freeze. Tear a small amount of the foam from the top so the ice protrudes. Massage firmly over the injured area in a circle about the size of a softball.
Call your Doctor if:
Be certain to call your doctor if you have symptoms of a moderate or severe hamstring injury or a mild injury persist longer than 10 days. Call your doctor if pain or swelling worsens despite treatment or if either of the following occurs with splints, tight bracing or taping: Pain, numbness or coldness below the injury. Dusky, blue or grey toenails.
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