Hamstring Strains Hamstring Strains

By Dr. Aaron Dutruch D.C.

Hamstring strains are probably one of the most common injuries seen in athletes. These injuries generally present as pain or tenderness in the back of the leg while in use. The pain is often accompanied by swelling and bruising, and can even cause ongoing weakness in the leg long after the initial injury. Muscle strains usually happen when the muscle is being overloaded and the fibers can’t bear the forces and tear. For the hamstrings, this typically occurs while running. When the leg is fully extended in front of the athlete, the hamstring is stretched to its maximal length. As the foot contacts the ground and the muscle contracts to pull the athlete forward, the force applied through the muscle is sometimes too much and the muscle becomes injured.

Hamstring Anatomy

The ham“string” is actually comprised of three separate muscles: the Semitendinosus, Semimembranosus, and the Biceps Femoris. All of these muscles attach from the bottom of the pelvis, at the ischial tuberosity (the “sit bones”) and extend to right below the back of your knee at the top of the tibia and fibula. The most commonly injured of these three muscles is the Biceps Femoris, which is located more toward the outside of the leg.

Treatment and Prevention

Preventing a hamstring injury doesn’t require many instructions. Emphasis should be placed on stretching and warming up. If you can increase the overall flexibility of the muscles, they are less likely to tear when the force is applied through them. “Warming up” can be different for everyone, but generally, mild activity that is similar to the activity you are going to try to maximally perform is ideal. Examples of this include walking, jogging, or high kicks and even more dynamic motions to engage the muscles. The goal of warming up is to increase the blood flow and to “wake up” your muscles for whatever they are about to do.

Treatment guidelines have shifted around in the recent past and no longer support the exclusive use of the “RICE’’ method, (rest, ice, compression, elevation). Some of the newer information has given some credence to the old phrase “walk it off’. While the “RICE’’ method emphasized the near elimination of inflammation, the current method is focused on the control of the inflammatory process. Inflammation after an injury isn’t necessarily a bad thing. It’s your bodies way of protecting an injured area and providing the nutrients to the area it needs to heal. It only becomes a problem if the inflammation or swelling stays in the area too long and makes it difficult to get new blood to the area to continue the healing process. Please note that every injury is different and should be properly evaluated for the correct treatment method. Generally, however, after a hamstring injury it’s important to try keep moving in a comfortable range of motion. The continued use of the muscles will help to “pump out” the swelling and keep the nutrients going where they need to. Gentle stretching is also recommended, this will help to prevent the muscle from healing in a shortened position and decrease the risk for future injuries and help decrease recovery time.