Safeguarding your hamstrings

If you were to request anyone to demonstrate a body stretch, the odds are overwhelmingly high—about 99%—that they would instinctively lean forward to touch their toes with their hands. This widely practiced flexibility exercise is recognized for its ability to stretch the hamstrings.

However, have you ever wondered about the role of hamstrings and why they're susceptible to strains? In this context, we'll delve into the reasons behind your need to be informed about hamstring strains and explore actionable measures to address them.

Understanding the Hamstrings The hamstrings consist of three muscles located at the back of the thigh. Their primary function involves bending the knee, technically known as flexion. You can easily observe their movement by bringing your feet towards your buttocks. While their primary action is knee flexion, these muscles also act as stabilizers during activities such as walking, running, and absorbing the impact of jumping.

Comprising the biceps femoris (outer hamstring), semitendinosus, and semimembranosus muscles, the hamstrings attach to both the hip and knee, effectively spanning two distinct joints. This dual attachment not only contributes to knee flexion but also supports hip extension, working in harmony with the gluteal muscles.

During walking and running, the hamstrings play a crucial role in the heel phase—when the leading foot initially touches the ground. This phase involves absorbing energy from the ground to safeguard the knees and hips. Furthermore, the hamstrings aid in shifting the body's center of mass forward, propelling the forward motion.

Yet, as your feet come into initial contact with the ground, often through a heel strike, the hamstrings experience their most stretched position under load. This scenario triggers an eccentric contraction, subjecting the hamstrings to load while elongated, which carries the risk of strain if the force is substantial enough.

Unraveling Hamstring Strains Hamstring strains, often referred to as "pulled hamstrings," stand as the most prevalent muscle injury among both athletes and everyday individuals. Particularly common in sports like sprinting, track and field, soccer, and basketball, these strains account for 12-16% of all athletic muscle injuries and exhibit a reinjury rate of 22-34%. They tend to affect males more frequently than females.

The underlying cause of these strains often involves subjecting the hamstring to overload while in an elongated position, followed by a rapid contraction—such as the abrupt contact and shock absorption during the running process.

Severe strains can result in partial or complete tears of the hamstring. These injuries are categorized into three grades:

• Grade 1: Characterized by mild pain, slight swelling, and minimal loss of range and strength. Recovery typically spans 2-3 weeks before a return to full activity.

• Grade 2: Involves moderate pain, inflammation, bruising, and tissue tears leading to notable range and strength reduction. Healing generally requires 4-8 weeks before resuming activity.

• Grade 3: Signifies a complete tear of the muscle or musculotendon junction, marked by severe pain, swelling, and complete loss of function. These cases often necessitate surgical intervention and demand 3-6 months for complete healing and activity restoration.

Risk Factors for Hamstring Strains Individuals most prone to hamstring strains generally exhibit:

• Reduced flexibility and limited range of motion.

• Diminished strength and endurance.

• A history of prior hamstring injuries.

• A history of low back pain.

• Poor stability and control in the lumbopelvic region.

• Utilization of a heel-striking running gait.

• Inadequate or improper warm-up practices.

Numerous factors contribute to the development or recurrence of hamstring strains. Males aged 16 to 25 with functional asymmetry are particularly susceptible. Identifying these opportunities for improvement is critical and should be undertaken in collaboration with physical therapists, chiropractors, or massage therapists.

Recognizing the Sensations of Hamstring Strains Individuals experiencing hamstring strains may encounter:

• Pain and cramping at the rear of the thigh while bending the knee and extending the hip.

• Pain, muscle cramps, and impaired function while walking and sitting.

• Limited knee flexion range of motion.

• Bruising that emerges 24-48 hours post-injury.

• Grade 2-3 strains and tears may exhibit a palpable rupture along with significant muscle spasms.

Expert medical professionals, such as physicians, physical therapists, chiropractors, or massage therapists, can assist in distinguishing hamstring strains, assessing involvement of the sciatic nerve, and initiating the initial steps towards rehabilitation or prevention. In some cases, imaging may be ordered to ascertain the extent of damage.

Managing and Treating Hamstring Strains The good news is that a significant number of strains can be effectively managed non-surgically. Grade 1 and 2 strains typically necessitate rest, ice application for 10-20 minute intervals, modification of activity, and the use of pain medication under medical guidance. Grade 3 strains might require surgical intervention. In the early stages, rehabilitation is primarily focused on safeguarding the tissue and minimising losses in motion and strength.

Early rehabilitation stages will involve a gradual progression of safe exercises, concentrating on strength building and movement re-establishment. While some discomfort is to be expected, the advancement to enhanced mobility and functional strength should ideally be devoid of pain. These exercises will not only emphasise range of motion and strength but also target trunk stability and specialised movement retraining tailored to your specific activities. This is pivotal in reducing external factors that can contribute to hamstring injuries, such as lumbopelvic instability and inadequate strength in the glutes and quadriceps.

Supplementary hands-on techniques, including myofascial methods, acupuncture, and dry needling, can complement therapy by alleviating muscle spasms and pain in overused areas of the body. Once the tissue has healed, ongoing hands-on therapy could potentially enhance hamstring range of motion and provide further input for functional movements.

We hope you enjoyed this blog! If you need advice or have any questions about our treatments, please contact us. You can find us near Essex Rd in Angel Islington. We are always happy to help. If you like this blog, please share!