Pat Blackwell (Physiotherapist – Burnie)
With the football, netball and hockey seasons well under way it is difficult to go a week without hearing about a hamstring injury causing an athlete a few weeks on the sideline; from Buddy Franklin in the AFL, to the old bloke at your local club that thought he would pull on the boots for one game. In fact, hamstring injuries are the most common injury in the AFL accounting for 15% of all injuries and causing the most missed games per season – 21 missed games per club.
What is the hamstring?
The hamstring consists of 3 muscles: biceps femoris, semitendinosus and semimembranosus.
Hamstring injuries are mostly non-contact and occur during sprinting. During sprinting the hamstrings work eccentrically to slow down the lower leg and control the knee as it is straightening. It is at this point the hamstrings are maximally activating and approaching peak length. It is at this phase of running that most hamstring injuries will occur.
Hamstring injuries fall into 3 categories:
- Grade 1: Strain / minor tearing of muscle fibres
- Grade 2: Involves tearing of a larger number of muscle fibres
- Grade 3: Involves complete tear/rupture of all the muscle fibres.
What should I do if I injure my hamstring?
If you injure your hamstring it is recommended that you see a physiotherapist as early as possible after the injury to form a correct diagnosis and rule out other causes of pain in the hamstring region such as neurological pain. Referral for imaging can also be made if required, although this is rarely needed in hamstring injuries.
Acute management of hamstring strains/tears follows the RICE (Rest/Ice/Compression/Elevation) protocol with gentle stretching and strengthening exercises being incorporated when tolerable. Your physio will then guide you through the rest of your rehab ensuring full length and strength of the muscle is restored.
When can I return to sport after a hamstring injury?
Return to sport following a hamstring injury is highly variable ranging from 1 to 12 weeks depending on the severity of the injury. Return to sport should not be based on set time frames, rather should involve reaching certain milestones in your rehabilitation. These should include:
- Hamstring length equal/ > 90% of the uninjured leg.
- Hamstring strength equal/ > 90% of the uninjured leg.
- Complete a progressive running program with minimal pain / discomfort.
- Complete sport specific drills with minimal pain / discomfort such as: sprinting from a standing start, abrupt changes of pace during sprinting and bending to catch a ball whilst sprinting.
- Complete at least 1 week of full training.
What if I don’t do my rehab?
Frequently athletes return to sport too soon or without completing a proper rehab program, this can lead to injury recurrence, secondary injuries and poor athletic performance. Hamstring injuries have one of the highest recurrence rates of all injuries (recurrence rate of 34% in the AFL). It is therefore important that you follow up with the rehabilitation requirements and ensure, when appropriate, that you are OK to safely return to sport.
If you’ve had a hamstring injury call our Burnie clinic today on 64314586 to make an appointment with one of our physiotherapists to help get you back on the park.
Brukner and Kahn (2006) Clinical Sports Medicine.