Heal Thyself?: Getting Treatment for hamstring Injuries

Heal Thyself?: Getting Treatment for hamstring Injuries Blog  Hamstring Injury

As fitness is central to overall good health, physical activity is key to fitness. That bodily movement can take the form of athletic competition, personal training or even household chores. While such vigorous exercise is a net plus for general wellness, it is not without its risks. One commonly experienced hazard is the pulled hamstring, i.e. a sprain or rupture in the group of three muscles that run along the back of the thigh. Although most exercise causes very small tears that heal and, in fact, toughen the muscle, the hamstring strain may represent a larger tear that calls for immediate attention from a trained physical therapist.

Confirming a Hamstring Injury

Certain telltale signs accompany a hamstring injury. Most frequent are:

  • Swift and intense pain behind the thigh while exercising or laboring
  • Continuous pain in the thigh and in the gluteal muscle when walking, extending the leg or bending over
  • Sensitivity to the touch
  • Visible bruising

If indeed a hamstring strain is suspected, the afflicted individual is advised to take a few immediate initial steps:

  • Protect the affected muscles from further trauma
  • Rest the hamstring and refrain from further exercise
  • Ice the leg to bring down swelling and lessen the pain
  • Compress the leg with elastic bandages to ward off further swelling
  • Elevate the leg whenever seated or reclining

Important to note, however, is that these steps do not constitute treatment for a hamstring injury. The extent and nature of a hamstring strain should be evaluated by a physical therapist or physician, who can then recommend the most effective course of treatment. At their disposal are specialized massage techniques, ultrasound technology and electrical stimulants that prove effective in diminishing pain, swelling, scar tissue and inflammation.

What Will the Physical Therapist Do?

The physical therapist’s goal for a hamstring strain is threefold: first, to restore range of motion and suppleness to the hamstring region; next, to return the tissues to their pre-injury strength; and finally, to train the muscle group to function in a way that prevents further injury. Through manual manipulation and specifically directed exercises—the Romanian Deadlift is one such example—a physical therapist and the patient can achieve all three aims. The only obstacle to realizing restored hamstring capacity is when patients delay or refrain from seeking professional attention, in which case months may pass before healing begins.

Preventing Hamstring Problems

While no prevention action is 100-percent effective, the best protection against hamstring injury is to remain physically fit. Stretching exercises benefit not only the muscles but also tendons and other connective tissue. Isometric exercises and weight training—done safely and moderately—fortify muscle strength and endurance. Advice from coaches and physical trainers is most helpful when keeping the hamstring healthy and intact.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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