hamstring injury

Hamstring injuries and strains frequently happen in various sports, particularly ones that require running, kicking, or other high-speed movements. They are still one of the leading causes of AFL lower-body injuries.

Hamstring injuries are observed to result at a rate of 6.1 per club annually, with a recurring rate of nearly 1 in 4. Hamstring muscle weakness and thigh muscular imbalance, former hamstring injury, other previous injuries, and age are significant risk factors for hamstring strains.

Before we move forward, let’s first discuss what the hamstrings are.

What are the Hamstrings?

The hamstrings are muscles that connect the major thigh muscle to the bone at the back of the thighs. The term “hamstring” also refers to a group of three muscles that go from the hip to just under your knee around the back of your leg. While the hamstring muscles aren’t being utilized as much while you’re just standing or walking, they are pretty engaged during tasks that require knee bending, like sprinting, leaping, and climbing.

What Causes Hamstring Injuries?

Any of the tendons or muscles of the hamstring can be strained above their breaking point, resulting in a hamstring injury. They frequently happen during quick, abrupt actions like running, lunging, or leaping. They can also occur over time or as a result of gentler movements that hyperextend your hamstring. Athletes and sportsmen are more likely to re-injure their hamstrings if they’ve already been hurt.

The three grades of hamstring injury are:

Grade 1 – a mild muscle pull or strain

Grade 2 – a partial muscle tear

Grade 3 – a complete muscle tear

How long it takes to heal?

From a hamstring strain or tear is determined by the extent of the damage. A moderate muscular pull or strain (grade 1) can heal in just a few days, while a muscle tear may take as long as several weeks or even months to mend (grade 2 or 3).

There are a few things that can raise the likelihood of getting a hamstring injury. These can include the following:

  • Reduced flexibility
  • Subpar fitness and lifestyle habits 
  • An imbalance in the strength and flexibility of the leg muscles
  • An injury to the back might irritate the nerves that run into the hamstrings.

How Do You Know if You’ve Injured Your Hamstring?

Mild hamstring strains (grade 1) are characterized by abrupt discomfort and sensitivity in the back of the leg. Although moving your leg may be uncomfortable, the muscle’s strength should not be compromised.

Grade 2 partial hamstring injuries are typically more acute and tender. You may also have some pain and swelling at the back of your thigh, as well as a loss of muscular endurance.

Discomfort, tenderness, swelling, and bruises are typically associated with severe hamstring tears (grade 3). You wouldn’t be able to utilize the injured area if there was a “popping” feeling at the moment of the accident.

Diagnosis

It’s critical to have an appropriate diagnosis, mainly if the condition is reoccurring. A physiotherapist or a doctor’s evaluation will aid in identifying the proper cause of any underlying ailment. This can be clarified using a scan and diagnostic ultrasonography. The discomfort in the hamstring may simulate a tear if there is a condition in the lumbar spine that is producing irritation in the sciatic nerve.

Rather than a quick sharp pain, this back-related hamstring strain frequently feels like a steady tightening of the muscles. 

It causes a persistent aching even when you’re not moving, but it can also cause pain solely when you’re sprinting or kicking. A physiotherapist can evaluate the condition and focus treatment on mobilizing the joints in the lower back to relieve the pressure on the nerves. This type of injury may be quite disabling, and if not treated promptly, it can keep you out of the game for several weeks. In severe circumstances, surgery and early retirement from the game may be required.

Treatment

The RICER technique is the first line of treatment for all initial injuries:

1) Rest 

To minimize further damage, stop running and avert as much motion as possible.

2) Ice the injured area 

This helps to reduce additional bleeding and swelling by cooling the tissue. According to the procedure, ice should be applied for 20 minutes every couple of hours for at least 48 hours. In the initial stages of an injury, icing has been demonstrated to be one of the most efficient techniques of lowering pain and swelling.

3) Compression

Apply compression with a bandage, covering the area above and below the injury.

4) Elevation

Elevate the leg, which will assist in minimizing bleeding and, as a result, edema.

5) Referral 

Schedule an appointment with a sports doctor or a psychotherapist at the soonest possible time.

When the source of the pain is discovered to be the hamstring muscle itself, the doctor may prescribe anti-inflammatory medicine. The physiotherapist may employ ultrasound and electrotherapy to reduce inflammation and ease the muscle.

Once the bleeding has ceased, soft tissue massage will help to prevent the creation of scar tissue. Stretching will aid in the restoration of a complete range of motion. Stretches should be painless and held for 20 to 30 seconds at first.

Rehabilitation 

The injured hamstring’s rehabilitation training goes a step further. Once the discomfort has subsided, it is critical to restoring complete strength in all leg muscles. This is necessary to reclaim proper lower-limb mobility. It’s crucial to maintain a balance of muscle strength between the quadriceps (front thigh muscles) and the hamstrings. To prevent a decrease in strength and conditioning, functional workouts are employed as soon as possible. After the acute period of injury, it is now typical to see players practicing gentle jogging for moderate hamstring strains (48 hours).

This is only performed when there is no pain and no striding out. As the inflammation subsides, more demanding agility activities are slowly introduced. Backward, sideways, and zigzag running are examples. Straight-line jogging is gradually increased from 12 to 34, then to full speed. Quick accelerations and decelerations, as well as changing directions at high speeds and jumping, will add to the training’s specificity.

Hamstring eccentric exercises are also used to build up hamstring eccentric strength. These exercises include prone hamstring curls, seated theraband hamstring curls, Swiss ball bridge with curl, hamstring leans, and Romanian deadlift.

Meanwhile, hamstring proximal exercises are conducted in different phases. 

Phase 1 is isometric contractions which uses exercises such as long lever holds, standing hip extensions, and glute bridges. 

Conditioning: Straight line jog (minimal fatigue) running drills 

Skills: walking handball games 

(Avoid kicking, ground balls) 

Phase 2 is concentric-eccentric contractions which utilizes drills like 

  • Long lever bridges
  • Banded Nordics eccentrics 
  • Single leg hamstring curls 
  • Single leg Romanian deadlifts 

Conditioning: Repeat Speed 70-80% of max speed change of direction drills ie Y, T, and ladder footwork. 

Skills: introduce kicking, craft like drills 

Phase 3 is plyometric contractions and strength exercises involved are:

  • Drop catches 
  • Single leg Swissball curls 
  • Nordics 
  • Bring back compound lifting ie box squat, hip thrust, and trap bar deadlift 

Conditioning: Sprinting 90%+ of max speed shuttles, and longer threshold efforts with combat/wrestling (high fatigue) 

Skills: Full skills encourage to compete and bring match intensity 

Throughout the phases, you need to continually communicate with the athlete and adjust the above plan as you go to suit the athlete on the day.

Working closely with a Physio, Sports psychologist, and Sports dietitian can be helpful to get a well-rounded informative approach.

Ultimately if the athlete doesn’t feel comfortable professing, I would recommend holding the current phase until s/he feels ready. 

Getting the athletes physically as close to where they were prior to the hamstring injury is the aim; however, the majority of the time in sport you need to accept close enough is good enough. 

What I mean by this is that you may not hit all the objective measures such as GPS, nord board, and strength profiling but if you feel ready and you have got close to your best, then accepting this is important.

Please note that with the above gym exercises, you do not have to follow these exercises entirely. As a coach, you need to have an understanding of what the athlete was used to in the gym before the injury.

If they had no history of gym work then this plan would look very different. 

For more information or any questions feel free to contact me.

Cheers!

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