Hamstring Muscle Injuries

Hamstring injuries are very common in athletes; especially those who participate in sports that require a lot of running or sprinting such as track and field, soccer, or basketball. However, hamstring injuries can happen to anyone who strains the muscle.

Commonly referred to as a pulled hamstring, a hamstring injury involves one or more of the muscles at the back of the thigh. Most respond well to nonsurgical treatments, though it does depend on several factors.

Anatomy
The hamstring is made up of three different muscles:

• Semitendinosus
• Semimembranosus
• Biceps femoris

The muscles start at the base of the pelvis in a spot called the ischial tuberosity. They cross each side of the knee joint and terminate at the lower leg. Hamstring muscles are joined with strong connective tissue near where they are anchored to bone.

Injury Causes
Muscle overload is the primary reason for hamstring muscle injuries, which can happen if the muscle is stretched beyond its range, or shocked with a sudden load.

Hamstring injuries commonly occur when the muscle lengthens as it contracts, which sounds contradictory, but occurs when the muscle is extended while it is under load. This is called an “eccentric contraction.”

Risk Factors
Several factors can make a hamstring strain more likely, including:

• Muscle tightness
• Muscle imbalance – When one muscle group is much stronger than an opposing one, the imbalance can lead to strain in the weaker muscle group
• Poor conditioning – under-trained muscles are less suited to coping with the strains of exercise and are more likely to become injured
• Muscle fatigue

Hamstring strains are common in adolescents as muscle and bone do not grow at the same rate, often leading to the muscles being pulled taught during a growth spurt as the bone outgrows the muscle.

Symptoms
Straining a hamstring during sprinting will cause a sudden, sharp pain in the back of your thigh. Additional symptoms include:

• Swelling in the affected area within hours of the injury
• Bruising or discoloration on the back of the leg within days
• Weakness in the affected leg – sometimes for weeks depending on the severity of the injury

Treatment
Treatments vary depending on the type and severity of the injury, as well as your needs and expectations. The goal of treatment is to allow you to resume the activities you enjoy. Treatments include:

• Nonsurgical Treatment – Most hamstring injuries do not require surgery, and using the RICE protocol is very effective
  • Rest – Cease the activity that caused your injury. Depending on the severity, your doctor may recommend crutches to keep load off of the affected leg
  • Ice – Several times each day, use a cold pack on the affected area for 20 minutes at a time
  • Compression – To help ward off additional swelling or blood loss, use a compression bandage at the affected area
  • Elevation – Keeping your leg higher than your heart when resting will help reduce swelling even further

Immobilization and physical therapy may also be incorporated into a treatment plan if your injury calls for it. Splints are often used to keep the knee in a natural position so that it can heal effectively.

• Surgical Treatment – For severe injuries in which the tendon breaks away from the bone completely, surgery may be required. Tears from the pelvis are the most common form of tendon avulsion, and surgery may be needed if the muscle itself is torn.

Recovery
Most of those who suffer a hamstring injury will fully recover after completing some degree of rehabilitation, and those who utilize the RICE protocol have been shown to recover faster than those who do not.

Do not rush back into physical activity immediately following your injury. Speak with your physician and wait until they give you the go-ahead to resume your normal activities. Re-injuring a hamstring weakens it and makes you more susceptible to permanent damage.

If you are experiencing pain, swelling, or stiffness in your hamstring, request an appointment with the orthopaedic specialists at Orthopaedic Associates of St. Augustine online or by calling 904-825-0540.