What is a Hamstring Strain?

Hamstring strains are very common. Four different hamstring muscles work in unison and if they do not coordinate their functions properly, they can tear. A torn muscle can vary from mild to severe and often results from poor timing when legs switch from recovery to approach and in swing phase, Injury can happen due to a poor ability to absorb shock when contacting with the ground and rebounding too. Once these muscles have been pulled, it is likely to happen again in the future. It is important to understand how it happens and what you can do about it. Preventing a strain is about timing and coordination.

What is a Hamstring Strain? Blog  Hamstring strain

The four muscles are semimembranosus and semitendinosus and short and long biceps femoris. Eighty percent of hamstring injuries occur in the biceps femoris muscle. Intermuscular coordination, stiffness, and eccentric strength in the hamstring also involve the pelvic region and core. There are things you need to be aware of to avoid injury and the need for treatment in the first place.

Start with an analysis of your running mechanics. Are you over-striding? Do you have pelvic control? If not, you are leaving your hamstrings in a vulnerable position when contacting the ground. Consider the hip abductors and adductors are used for balance and adductor magnus is often called the fourth hamstring.

Warm Up. Passive stretching is not enough; it needs to be followed with energetic and vigorous exercise to prepare the body.

Proper Training Load. Fast twitch muscle groups have type II fibers that are quick to fatigue. Your hamstrings are designed for high speed work early in a workout to avoid weakening. You can prepare them for the traumas they will encounter in sprinting and multi-directional movement by keeping ‘hips over the foot’ at contact and tall posture to focus on balance and prevent strain injury.

Level of Fatigue. Don’t begin vigorous exercise if your mind and body are already fatigued.

Lower Back Issues. Problems with the lower spine and pelvic control lead to nerve dysfunction (numbness, tingling, or pain), weakening muscles and making you prone to strain injury.

Ground Surface. Slippery and uneven surfaces will strain muscles as they correct themselves for balance.

What Causes a Hamstring Strain?

Primary causes involve poor intermuscular coordination due to timing and localized strength in the hamstring muscles ‘during the switch between late leg recovery and initial leg approach in the swing phase of sprinting’.

Also, lack of localized muscle strength in the hamstrings, during the ground contact phase of running, affecting the ability to absorb shock and rebound.

Prior strain injury.

What are the Symptoms of a Hamstring Strain?

Mild strains may feel more like a stiffness or dull ache in the hamstring. A higher grade strain is excruciating and walking or standing may be impossible. An accurate diagnosis will require further analysis.

Other possible symptoms of hamstring strain injury are:

  • A snap or pop in the hamstring followed by sudden and agonizing pain during exercises
  • Rear thigh and gluteal pain when walking, extending the leg, or leaning over
  • Soreness
  • Bruising

How is a Hamstring Strain Diagnosed? What is the Recovery Time?

Physiotherapists (sports doctors) look for signs of pain when contracting the muscle, reduced flexibility, soreness or a substantial lump or gap within the muscle tissue. The strain is graded 1, 2, or 3 and will vary and due the demands of activities. General recovery times listed will need further analysis by a physiotherapist.

Grade 1

May feel tension in the back of the thigh but able to walk normally. A sense of discomfort and inability to run at full speed, mild swelling, and spasm of the muscle. Bending your knee against resistance is not likely to cause much pain. Recovery expected is 1 to 3 weeks

Grade 2

Walking pattern will be affected and cause limping. Sudden spasms during exercises and activity, some muscle swelling, and tenderness to the touch. It will also be painful to bend your knee against resistance. Recovery expected is 4 to 8 weeks.

Grade 3

This is a severe strain injury involving a tear to half or more of the muscle. Crutches may be needed due to terrible pain and weakness in the muscle. Swelling will be evident right away and bruising will appear within 24 hours. Recovery expected is 3 to 6 months and may require surgery.

Note: The grade of injury and its exact location can be found by your physician using diagnostic MRI. Also, due to your sciatic nerve passing through the hamstring muscle group, a back injury , among others, pinching the sciatic nerve, can replicate the symptoms. It is important to get a professional diagnosis from a physiotherapist skilled in treatment of these particular strain injuries.

Hamstring Strain Treatment

Many patients start to feel better within a few days of the injury. Re-injury rate is high due to a poor rehabilitation process. A specific exercise program and treatment by a sports physician is recommended.

Hamstring strains are one injury where expert analysis is recommended for an accurate diagnosis to provide you with the best chance of avoiding reoccurring injury and issues in the lower back and hips created by building scar tissue.

  • Hamstring Physiotherapy Treatment
  • Physician Focus
  • Reducing pain and swelling
  • Regulating range of flexibility and extension with stretching
  • Strengthening the knees and thighs with exercises that train muscular stiffness and reactivity
  • Reinforcing lower limb muscles like the calves and pelvis
  • Normalizing core stabilization – a mitigating factor in many strains
  • Stabilizing communication in the nervous system enabling your sciatic nerve to pass freely without intrusion of scar tissue
  • Improving the body’s overall ability to determine and react to position, motion, and equilibrium
  • Develop your method and purpose during running, sprinting, jumping, hopping, and landing
  • Diminish risk of re-injury and further treatment with the proper exercises
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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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