Hamstring Strains

By Simon Yoon

A hamstring strain is a common sporting injury but it can happen in varying situations. It typically occurs when the hamstring is suddenly overloaded such as kicking, sprinting or even slipping.

Risk factors

  • Previous hamstring strains
  • Participating in sports that require kicking or sprinting
  • Tight hamstrings that restrict full range of motion
  • Localised discomfort when palpating along the hamstring
  • Reduced hamstring strength

Symptoms

  • Sudden “pull” or sharp pain at the time of injury.
  • Swelling
  • Bruising within the first few days of the injury
  • Reduced strength and range of motion
  • Pain when walking or going up stairs

Many people are able to return to activity with a regimented rehabilitation protocol. However, many individuals return to sport too quickly once it starts to feel better. This situation tends to increase the risk of re-injuring the hamstring and delay the healing process. In fact, re-occurrence rates have been found to be between 13.9 – 63.3% within the first two years of the hamstring strain according to a systematic review [1].  Many hamstring strains also occur again within the first month after returning to sport. It is important to complete the rehabilitation process to maximise the chances of a complete recovery.

The rehabilitation process will involve focusing on different aspects depending on the stage of healing and the severity of the injury.

  1. Reduce pain and swelling
  2. Regain range of motion
  3. Return to daily tasks and function
  4. Strengthening
  5. Agility and stabilisation exercises
  6. Return to sport
  7. Prevention

In the early stages, a reduction in pain is usually a good indicator of healing as well as being able to perform daily tasks more easily. However, the absence of pain does not always mean the injury has fully recovered and it is still susceptible to re-injury if one returns to activity too quickly. In order to bridge this gap, particular attention to stabilisation and eccentric loading exercises would be recommended in the later stages as they seem to reduce the chances of re-injuring the hamstring. Once healing has completed, injury prevention exercises should be incorporated; particularly for athletes. Also, appropriate loading, sufficient leg control, and adequate dynamic warm-ups are all be beneficial for those continuing with their activities and wishing to reduce their risk of re-injury. As physios we not only help with the pain reduction and regaining range of motion, but specialise in the rehabilitation that is needed for each individual to return to their specific sport, or exercise. We provide the guidance and rehabilitation program to bridge that gap.

[1] De Visser, H. M., Reijman, M., Heijboer, M. P., & Bos, P. K. (2012). Risk factors of recurrent hamstring injuries: a systematic review. Br J Sports Med46(2), 124-130.