Hamstring strains are one of the most common sports injuries.
The hamstring muscles are found at the back of your thigh. The hamstrings are composed of three main muscles; the biceps femoris muscle, the semimembranosus muscle and the semitendinosus muscle. The biceps femoris muscle is the most commonly injured. Hamstring strains occur when excessive or sudden tension is put through the hamstring muscle fibers. Hamstring strains vary from simple strains to complete tears.
The hamstrings are responsible for bending the knee and they help to extend the hip. The hamstrings are extremely important in deceleration of your leg as you run. They are most prone to injury just before your foot hits the ground, as this is when they exert their maximum force. Hamstring muscle strains are extremely common in sports involving sudden acceleration and deceleration, such as hurling and camogie or sports that involve kicking. They are very common in sports like hockey that require a low body position.
Hamstring injuries have the highest recurrence rate of all injuries with a recurrence rate of 34% in Australian football and 12% in soccer. This is often due to hamstrings not being fully rehabilitated and the risk factors (see below) not being addressed.
Risk factors for hamstring strains:
- Previous injury
- Poor hamstring flexibility
- Poor hamstring strength, especially when the hamstring is in a lengthened position
- Tightness of your sciatic nerve
- Poor muscular control of your pelvis
- Lower back issues, including lower back stiffness and weakness
- Poor running biomechanics; over-striding and poor hip strength can put your hamstrings in a vulnerable position
- Increasing age
- Poor warm up; we would recommend an active and dynamic warm up.
- Fatigue; tired muscles are able to absorb less energy. It is important to schedule recovery between sessions. Speed work should be done early in the workout, to avoid hamstring fatigue
- Slippery playing surfaces
How to treat hamstring injuries:
Initially you will be advised to follow the RICE protocol (Rest, Ice, Compression, Elevation). The extent of the tear needs to be diagnosed. This will determine how quickly you can progress through the stages of rehabilitation. Gentle pain-free stretching can be useful, but stretching should be avoided if it increases your pain. The hamstrings will need to be strengthened, and strengthening exercises will progress from gentle to more intensive as the hamstring heals. Any lower back, pelvic or hip weakness or lack of flexibility, and any faults in your training program also need to be addressed. Your rehab should be focused on you as an individual, with a gradual return to your previous sport/activity.
It is important to remember that there are multiple causes of thigh pain. It is advisable to seek professional assessment, diagnosis and guidance for all injuries.
References: Brukner and Khan, Clinical Sports Medicine