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Hamstring Muscle Injury

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Muscle

Acute Hamstring Muscle Injury Management

  1. Consult your professional/s for treatment and rehabilitation as these are academic principle guidelines only and not prescriptive.
  2. ASSIC does not dispense medical and/or exercise advice.
  3. Consult your professional regarding exercise, treatment and rehabilitation exercise regimes and medical advise.
  4. The contents of the following web page are principle guidelines and must be utilized under the supervision of a relevant medical and/or exercise professional.

Hamstring Muscle Injury

The hamstring muscle complex consists of 3 muscle groups that include the Semimembranosus, Semitendinosus and Biceps femoris muscles.

Acute muscle injury can occur in any of these three muscles.


Injury mechanism:

Hamstring strains are usually sprint-related or stretch-related

Hamstring strains are classified from grade 1-3, with grade 3 being the most severe.

Hamstring Muscle
Diagram showing the 2 common sites of muscle injury:
  • Top arrow: myotendinous junction
  • Bottom arrow: injury at muscle belly.

Signs & Symptoms

Sudden, sharp pain at the back of the thigh occurring during sprinting or while performing a fast stretching movement.

Risk Factors

  • Previous hamstring injury
  • Limited hamstring flexibility
  • Strength imbalance
  • Increased fatigue
  • Poor core stability
  • Previous substantial knee injury

Acute Management

  • Protection
  • Rest
  • Ice
  • Compression
  • Splint or brace, where appropriate
  • Elevation
  • Surgery, where indicated
  • Non surgery management includes conservative treatment, followed by ankle rehabilitation
  • Follow rehabilitation protocol as indicated by your rehabilitation specialist/s

Acute hamstring muscle injury management

Acute Hamstring

Applying ice to injured area

Treatment principles of acute muscle injury

  • Avoid NSAIDs or any medication that may cause muscle bleeding in first 24 hours
  • Protect and rest the injured area
  • Surgery, where appropriately indicated
  • Intermittent ice to reduce swelling
  • Compress and elevate injury to reduce swelling
  • Physiotherapy modality principles:
  • Reduce pain and inflammation
  • Regain ROM
  • Biokineticist:
  • Improve strength and muscle size
  • Sports-specific strengthening
  • Resume functional activity after satisfactory rehabilitation

Rehabilitation and return to play

  • Timeframes for rehabilitation and return to sport vary depending on the nature and severity of the strain.
  • Generally Grade 1 hamstring strains require rest for about three weeks and Grade 2 injuries for between four to eight weeks. In the case of a complete rupture (Grade 3 strain), the muscle may require surgical repair and the rehabilitation to follow will take about three months.
  • Premature return to sport and inadequate rehabilitation will increase the risk of re-injury. Full range of motion and strength should be achieved in addition to the ability to perform full speed training. Assessment of sport-related activities, such as twisting, jumping and changing direction suddenly should also be evaluated.

Hamstring rehabilitation

Hamstring strengthening ranges from initial ROM (range of motion) exercises to resistance training.

Both stretching and strengthening exercises are key.

After the initial acute stage, very gentle static stretching exercises can begin as long as one is pain-free.

As your injury heals, dynamic stretching involving movement is introduced and eventually progressing to sports-specific and plyometric drills.

Hamstring Resistance

Example of Hamstring resistance training using weights. Other resistance modalities include resistance band training.

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