Sportsguide Multisport Magazine

HAMSTRING INJURIES WITH MEDICAL SPORTS CHIROPRACTOR DR. BRIAN KRUGER

 By bianca on November 9th, 2009

FUNCTION: The hamstring muscles bend the leg at the knee, bend the hip backwards (extend the hip) and slow the athlete down when the foot strikes the ground after the swing through phase.

CAUSES: A muscle tear usually occurs in sports where there is a sudden acceleration, such as in sprinting, or a sudden change in direction such as in soccer, rugby or when there is inadequate warm up.
Adding substantial mileage to a running or cycling programme will also put the athlete at risk of a hamstring injury. The muscles get extremely fatigued and are then incorrectly utilised by the body, resulting in injury to the muscle.

Recurrent hamstring injuries are usually caused by a lack of flexibility, a poorly treated initial hamstring injury, resulting in scarring and shortening of the muscle, or an injury in the lower back or pelvis, restricting overall movement of the hip and leg.

SYMPTOMS: The severity of hamstring injuries/strains vary considerably, but most start out as a dull ache within the hamstring muscle and progress to the point where training is hampered, or has to cease completely.

Alternatively, the hamstring injury can present as a sudden sharp pain within the muscle, if there is an acute muscle tear.

TREATMENT: The initial treatment of an acute hamstring injury should always include icing, preferably for 10 minutes, every 2 hours. Within a day or so the muscle should be taken to the normal full length position at regular intervals, in other words the leg should preferably be held in a straightened position rather than a bent position, the leg should also gently be bent and straightened, with no weight on it. This is best done by hanging the leg from a bed or chair and slowly straightening and bending it. This will encourage the healing fibers to heal in a lengthened position, and maintain overall flexibility of the tissues, which is most desirable and will reduce the long term complications associated with hamstring injuries.

Ultrasound therapy is also useful, as it reduces the amount of blood and debris that gathers in the muscle following the injury and encourages the body to absorb it.
After a few days, some massage can be performed over the area, starting very gently and progressing in intensity to the level of fairly hard cross-friction massage – aimed at maintaining flexibility of the injury site. This should be performed by a professional, as too deep a massage early on can aggravate the injury by encouraging further bleeding within the tissues.

Severe hamstring injuries should be assessed by a professional, and a diagnostic ultrasound should be performed to assess the extent of the tear. Significant bruising behind the knee and over the hamstring muscle, with weakness while bending the knee, usually indicates a severe hamstring tear, although this is not always reliable.

An interesting variant of the classic hamstring injury is when the hamstring is “strained” as a result of a lack of movement within the sacro-iliac joint. I have noticed that this is also often the cause of persistent hamstring injuries, which don’t heal despite intensive therapy to the hamstring. Often it is difficult to isolate a tender site within the hamstring itself. (SEE PREVIOUS ARTICLE – edition 12 on the sacro-iliac joint)

PREVENTION: The best way to prevent hamstring injuries is to warm up adequately and maintain flexibility of the hamstrings. Ironically the fastest way to shorten the hamstring is through running and cycling.

Ideally the athlete should perform a mild warm up, just breaking a sweat. Then stretching should be performed, prior to training. I recommend that the hamstring is stretched while the athlete is lying down, using a towel in the arch of the foot to lift the leg and stretch the hamstring. It is important that the knee is locked straight in order for the hamstring to be stretched.

Mild hamstring injuries or strains are fairly common. They are usually associated with a change in training structure, often an increase in speed, hill work or mileage. The worst hamstring tear I ever came across was when an elite athlete decided to join some friends for a social “soccer” game! The tear cost him three months of competition and extensive rehabilitation and treatment.

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