The Hamstring Injury

The Hamstring Injury Blog  Hamstring Injury

The hamstring injury is one of the most common injuries suffered by athletes, especially those who must accelerate suddenly and forcefully contract or stretch their legs, like soccer and football players. It is not an uncommon sight for the audience to see an athlete crumple to the field, clutching the back of his or her thigh in obvious pain. The pain is sometimes so severe that he or she will need to be carried off.

What Are Hamstring Muscles?

The hamstring muscles are three muscles in the back of the thigh that are contracted by four tendons. These muscles are the biceps femoris, the semitendinosus and the semimembranosus. They help a person bend their knee and straighten their hip. However, the biceps femoris has a long and short head, and the short head only helps to bend the knee. An injury to a hamstring can range from a minor bruise or strain to a full scale rupture.

also be discolored. The person may have difficulty walking or not be able to walk at all. Another of the symptoms of injury is discomfort when the person exercises or when pressure is applied to the knee. There is also pain when the knee is bent or straightened. If the injury is severe, the person might hear a popping sound at the moment it occurs. If a rupture happens, the hamstring pain will be incapacitating, and the leg will not be able to bear the person’s weight. A doctor can diagnose whether there’s been a hamstring injury through physical examination, MRI or ultrasound.

Treatment

A ruptured hamstring requires that the person seek medical attention right away. If the injury is a bit milder, he should employ the PRICE procedure. This means protect, rest, ice, compress and elevate the area of the injury. For a mild injury, the doctor will prescribe analgesics and refer the patient to a physical therapist. If the injury consists of a rupture, surgery will be needed to suture the damaged tissue together. After that, the patient will need to wear a brace and rest for about six weeks or until the hamstring is healed.

When the patient is healed enough to undertake hamstring exercises, his physical therapist may at first massage the area to relieve symptoms. He may also put strapping over the area to prevent the muscle from being overused and assess the patient’s range of motion. Exercises may begin with bridges, which are exercises where the knee is flexed and held, deep water pool jogging and bicycling. The patient may also be taught to do knee extensions within his pain threshold and exercises that strengthen his core and gluteals.

Later exercises can involve Nordic hamstring lowers and straight leg deadlifts. These exercises should be continued for a while even after the person returns to his sport.

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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)

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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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