Hamstring injuries are common to athletes in many sports.
With early management and treatment these injuries should respond well and return to sport between two to four weeks is expected. However, without proper treatment and return of adequate strength and function, some authors report a rate of re-occurrence as high as 77%.
The hamstring muscle group consists of three muscles, semimembranosus, semitendinosus and biceps femoris.
Function of the hamstring muscle group is complex and involves flexion and rotation control of the knee, extension and rotation control of the hip. The muscles may also have a role in load transfer between the lower limbs, trunk and upper limbs via pelvic ligament attachments.
Initial treatment of hamstring injury should involve rest, ice, compression and elevation.
The athlete may require crutches to walk in cases of moderate to severe strain / tear.
Physiotherapy assessment is required to diagnose the injury and any contributing factors which may be causative of the hamstring injury, such as:-
- lower spine pathology eg: hypomobility / spondylosis / spondylolisthesis
- neural tension signs
- weak abdominals / back / gluteal muscles
- sacroiliac joint dysfunction
Rehabilitation programs are progressed by:
- gentle stretching to P1 (first onset of pain)
- progressive soft tissue massage
- concentric and eccentric hamstring strengthening exercises
- proprioceptive hamstring control exercises
- gradual return to functional movements as required by the sport e.g. jog / change direction / accelerate and deccelerate / jump and land / hop and land.
Due to the multi-factorial nature of hamstring injuries, a thorough approach to rehabilitation is encouraged. This should ensure a complete recovery and hopefully reduce the rate of re-occurrence which may be seen with this injury.