Muscular tissues are mainly meant for locomotion. There are several kinds of tissues scattered all over the body. Out of them, there are three important muscles placed on the posterior portion of the thigh. They start from medial region and extend laterally. They are biceps femoris, semitendinosus and semimembranosus. These muscles are together referred to as hamstring muscles. Hamstring muscles are found in fibula or in tibia. Hamstring muscles are supplied with sciatic nerve and its branches. The main function of the hamstrings muscles is to facilitate the movement of hip joint and knee. The hamstring muscles are often more prone to injuries.
Function of Hamstring Muscles
Hamstring muscles have the control over two main joints and they are the knee joint and the hip joint. They are also referred to as biarticular muscles because of this reason. Hamstring muscles are necessary for regular activities like trunk movement, walking, jumping and running. The main changes that occur when these muscles work are:
- Extension of hip
- Flexion of knee.
Injury to the Hamstring Muscles
Injuries to these muscles are commonly seen in athletes. The sports like soccer, basketball and sports which needs sprinting are the most common causes of hamstring injury3. Sometimes, hamstrings may have pulling effect or is strained. These problems would be usually range from mild to moderate and can be cured with a few treatments.
As it is discussed earlier, the main reasons or risk factors4 for hamstring muscle injury are the strain or pull. This can happen because of the following reasons:
- Every muscle has its own capacity of stretching. In case, if the muscle is overstretched, it amounts to overloading. This could be the main reason for the above said problem.
- Hamstring injury can also happen when the muscle is stretched when it is loaded or weighted.
- In case of athletes, it occurs when the muscle is eccentrically contracted in the back leg. At this moment the toes would be trying to push the ground and move. Here both stretching and loading occurs simultaneously.
- Hamstring injury can also be caused when the muscle gets the load suddenly which leads to avulsions of hamstring tendons.
Physical Therapy for Hamstring Muscle Injury
For athletes, hamstring muscle injury is a curse as it consumes time to recover. Particularly while playing, it takes up the time and reduces the efficiency. First and foremost thing needed in this condition is rest and proper care. In case the rest or treatment is not given on time, the person may be at risk of recurrence of the symptoms. The disease condition can be sorted out into three levels.
- Mild pull – grade I
- Partial tear of muscle – grade II
- Complete tear- grade III
As a first line of treatment, the patient is advised to undergo RICE. R refers to rest which is utmost important and an immediate step to be followed. The letter I is for ice which gives the cooling effect and reduces the pain and swelling. C is for compression which also supports for healing. E denotes elevation which reduces the bleeding.
Afterwards, the rate of healing can be made fast with the help of physical therapy. The first aim of physical therapy is to reduce the inflammation and pain accompanying the hamstring muscle injury. This facilitates the muscles to become normal and do the functions more efficiently.
A physiotherapist starts teaching some exercises which are specifically designed for hamstring muscles and that too in injury condition. These exercises promote flexibility and also make the muscles strong.
Some of the types of physical therapy are listed below. A physiotherapist can use a single method or combination of methods for the patients depending upon the intensity of the injury.
Massaging with Oil: Many times a simple massage with massage oil would help particularly when the injury is mild.
Ice: Keeping the ice on the muscles helps to feel better by decreasing the pain. Icing also reduces the swelling.
Heat Packs: In some cases, physiotherapist uses wet heat packs. This relaxes the hamstring muscles and improves the stretching efficiently.
Electrotherapeutic Modalities for Hamstring Muscle Injury: In this method, the physical therapist uses e-stim which helps to reduce pain as well as swelling. This is mainly done in rehabilitation program which concentrates mainly on improving the contraction of muscles.
Ultrasound: Ultrasound is given to improve the blood circulation to the injured muscles. Ultrasound technique is used which provides heating effect in depth.
Crutches: In case the injury is of the third grade and is severe, the patient is advised to use crutches for walking during healing process. A physical therapist teaches how to walk, on which muscles the patient has to concentrate while walking, how to relax, etc.
Exercises for Hamstring Muscle Injury: A physical therapist also chooses some exercises required for these patients. Some of the exercises include jumping, hopping, exercises for strengthening lower extremities, exercises involving stretching and strengthening the hip and surrounding muscles, exercises to balance the body and movement of muscles.
Other Treatment for Hamstring Muscle Injury
There are several treatments available other than physical therapy and the physicians choose the particular treatment depending upon the severity. The treatments may be starting with physical therapy for mild injuries to surgical ones to severe cases. The nonsurgical treatments like physical therapies are done which would be enough to get rid of the pain in most of the cases. Surgical treatments are chosen if the tendon is pulled away completely or if tear is seen within the muscle.
How to Diagnose a Hamstring Muscle Injury?
The main symptom which helps a doctor to guess the condition is the sudden pain at the back of the thigh particularly while doing exercises. It can be diagnosed by following ways:
- The first examination would be at clinic. The physical examination discloses the injury or swelling of the back muscle of the thigh.
- Doctor may suggest X-ray to know the tendon avulsion if there is any.
- More clear and specific images are obtained from MRI. From this, the severity of the condition is understood.
What is the Recovery Period for a Hamstring Muscle Injury?
The period required for returning for the normal activities after the injury depends upon the severity. In case of mild injury, the recovery period is very short and can be managed just by massaging several times using appropriate oil1. In conditions like partial and/or complete tear of muscles, the recovery period would be longer and the treatment also needs combination of different techniques3. Usually mild injuries take around 30 to 40 days to cure. In case if the injury is not taken care well and treatment is not given immediately, the symptoms may re-occur. The recurrence of the injury should be avoided as for as possible by taking enough rehabilitation training2.
People, particularly athletes and dancers, are at risk of injuries like this1. So it is very important to an athlete to take care to avoid the injuries. The best way to prevent hamstring muscle injuries is to perform some sort of bending and stretching exercises before commencing the sport. The exercises must be done even after the sport. The duration and intensity of exercises must be increased so that the hamstring muscles become stronger. This could be one of the ways to prevent such injuries4.
- Askling C, Saartok T, Thorstensson A. Type of acute hamstring strain affects flexibility, strength, and time to return to pre-injury level. Br J Sports Med. 2006;40:40–44.
- Askling CM, Tengvar M, Saartok T, Thorstensson A. Acute first-time hamstring strains during slow-speed stretching: clinical, magnetic resonance imaging, and recovery characteristics. Am J Sports Med. 2007;35:1716–1724.
- Bennell KL, Crossley K. Musculoskeletal injuries in track and field: incidence, distribution and risk factors. Aust J Sci Med Sport. 1996;28:69–75.
- Pulled Hamstring Muscles
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