Hamstring Injuries

 

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“That grumbling old hamstring is back!” A problem encountered by elite athletes and weekend warriors alike.

Pain in the back of the thigh can arise due to a multitude of factors and depends on the mechanism /timing of injury and the presence of spinal or pelvic dysfunction. We can categorise these injuries in terms of how they occur; acute hamstring injury compared to a more gradual onset, vague pain referral from central structures (ie Lumbar spine).

Hamstring tears

Hamstring tears are the single most common cause for games missed in elite level football. The familiar scenario of a player sprinting after a ball and pulling up short with a stiff leg, clutching the posterior thigh, is characteristic of acute hamstring muscle disruption. These injuries tend to occur at full pace sprinting when the hamstring is working overtime to decelerate a fast forward moving leg (eccentric contraction).

Risk Factors

Pain onset is acute and will prevent the individual from continuing activity due to disruption of muscle fibres, inflammation and muscle spasm. It is thought that a lack of eccentric hamstring strength in outer range (Leg striding forward) can increase the risk of hamstring tear. Although these injuries are very obvious, there is a group of hamstring injuries that are a little more obscure.

Pain in the back of the thigh can also arise from a variety of central structures. Lumbar spine, pelvic joints, gluteal trigger points, sciatic nerve or tight bands within hamstring can present as pain in the back of the thigh. These ‘pseudo’ hamstring strains generally come on more gradually and are more diffuse in their pain location. Effective management of this type of hamstring involves correct identification and appropriate intervention for the dysfunctional tissues. Broadly speaking this may involve increasing neural mobility, lumbar/pelvic core strengthening etc.

Management of hamstring Injuries

So now you should be able to correctly categorise your thigh pain. Acute hamstring tears generally take 3 to 6 weeks to heal with the correct management. This involves a RICE regimen, short period of rest, followed by early restoration of normal movement patterns and a graduated strengthening program. Failure to do this may result in excessive build up of scar tissue and potential recurrence of tears. Management of the more complicated ‘back related’ hamstring involves correct identification and management of the contributing factors and will be guided by your sports physiotherapist.


Shane O’Sullivan
Sports Physiotherapist
Prahran Sports Medicine Centre
 

 

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