Now as with any injury, you should always consult your GP and or physiotherapist before commencing any new exercise…

So a big mistake when rehabilitating the hamstring  is the lack of eccentric work… people tend to stretch and concentrically strengthen muscles which does not protect the hamstring when it is under the most strain. Eccentric contraction involves contracting a muscle in a lengthened position- in the case of the hamstring this would be from knee flexion through to knee extension. This differs to concentric muscle activity where muscles are both contracted and shortened at the same time, this would be the equivalent of performing a hamstring curl

Nordic hamstring exercises are found to be quite useful in strengthening the hamstring muscle

Look out on MCR for a detailed hamstring rehabilitation programme in the coming weeks

Recurrent Hamsting injuries? is a post from: Musculoskeletal Consumer Review

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First 48hrs
Immediate post-injury 

Remember RICER. The ice and compression will prevent severe bruising and swelling. Resting your leg will minimise the strain and prevent further aggravation.

After 48hrs – 4days
Using a compressive bandage would be advised to continue for this period.

1. Ice massage over the area of strain might improve the rate of healing. You may also want to try using contrast treatment (i.e. alternate hot and cold compress).

2. Gentle static stretches for your hamstring should be done. Never stretch into the pain. Stretching at this stage helps to mobilise the scar tissue and prevent it from stiffening.

4. Non-resisted hamstring curl should also be done during this period to speed up rate of recovery.

4 – 8 days
 Start to strengthen your hamstring by doing a resisted hamstring curl. Begin with light resistance for about 15reps for 3 sets. Progress only when you feel the hamstring doesn’t feel achy after completing the 3 sets. Dynamic stretches should be done at least 3x/day. Light jogging can begin at about the 6th day post-injury. Normal activities should be able to be resumed after the 8th day.

Do i need to see a doctor?
Depending on the extent of the strain, one might need to seek a review with either a Sports Physician or a Sports Physiotherapist. The extent of the strain can only be diagnose through a real-time ultrasound imaging (RTUI), which can be done by an experienced Sports Physician. However, in some situation, an MRI might be ordered if the strain cannot be detected through the RTUI.

Moderate to severe hamstring strain will need a more extensive rehab and a longer period of recovery and a referral to a sports physiotherapist is highly recommended to get you back to sports as soon as possible.

Physiotherapy managment
In the acute stage of management, a sports physiotherapist would assess the site of strain and deep tissue mobilization might be required to break down the excessive scar tissues that have been laid down over the site of strain. A therapeutic ultrasound would also be used to speed up the rate of healing and manage the any swelling, if present. Gentle stretches, closely monitored by the sports physiotherapist, would be taught to help align the scar tissues. Kinesiotaping may also be done to aid the healing process.

Following the acute stage (about 1 week), your sports physiotherapist will start to progress your hamstring stretches to dynamic stretches and also to start you on resisted hamstring strengthening exercises. Before you’re able to return to sports, your sports physiotherapists will have put you through some form of agility drills to prepare your muscles for the gruelling demands of the game. This process may take about 2 – 4 weeks, depending on the extent of your injury.

Stretch to prevent a recurrence

The key to prevent a recurrence of this injury is to ensure that you adequately warm up your muscles with static and dynamic stretches before the start of your game and during the half-time break. You should ideally hold each stretch for 15-20 seconds for 3-6 repetitions for the static stretches, and at least 15-20 reps for the dynamic stretches. Read on here for static hamstring stretches.

Enjoy your game.

What can i do for a hamstring “pull” is a post from: Musculoskeletal Consumer Review

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Stretch A
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The better way to do this hamstring stretch should be with your knee bend at a slight angle and your ankle pointing downwards. This will still focus on the lower hamstrings but not your sciatic nerve.

Stretch B shown below focuses on the middle to upper part of your hamstrings.

Stretch B - step 2
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Stretch B - step 1
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The difference between Stretch A and B is that the former keeps the knee straight while bending from the hip; the latter straightens the knee while keeping the hip bent. This gives you more tension to the middle to upper fibres of your hamstrings depending on how much you bend your hip or knee during step 1.

Step 1 – Start off with your body close to your thigh and your knee about 90 degrees bent

Step 2 – Straighten the knee gently while keeping your body close your thigh.

These 2 stretches should be done regularly with a hold of 15 seconds for each repetition.

Stretching your hamstrings safely will help to increase your flexibility, prevent injuries and improve your sports performance.

Warning! Is this how you stretch your hamstring? is a post from: Musculoskeletal Consumer Review

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Common hamstring injury sites

For runners, the hamstring injury rarely occurs in the muscle belly. Hamstring injury in runners tends to occur more at the origin (ischial tuberosity), followed by at the insertion (tibial plateau) and the last site is the muscle belly. Due to the repetitive nature of running and the close kinetic chain on push-off, the tendon-bone junction at the origin or the insertion undergoes intensive stress thus are the common sites of injury.

Tearing of a muscle along the belly occurs when there’s an explosive action, e.g. jumping, sprinting, etc. However in long distance running, such an explosive action is not required thus explains why doing the hamstring curls in the gym would not help. Doing hamstring curls, either in prone or standing, would only increase the size of your sacromeres of the muscles, which are found in the belly of the muscles. At the origin and insertion of the hamstring, the make-up of the tendon is collagen fibers and not sacromeres. By doing hamstring curls in prone or standing, it not only does not strengthen these tendons, but puts it under a lot of strain and exposing it to injury.

Prevention

When stretching your hamstring, you would need to stretch from the origin of the hamstring. To perform the stretch, ensure that you “stick” your bum out to get a stretch in the hamstring at the origin. Maintain the spine in a neutral position and lean forward from your hip to stretch your hamstring. (Refer to video). Besides this static stretch, dynamic stretches are also essential in ensuring flexibility of your hamstrings. Swinging your leg forward and back and slowly progressing to its maximum distance.

Hamstring strengthening should be done through its available length. Placing an ankle weight of about 5kg around your ankle while lying prone. Curl your hamstring up and then proceed with lifting your hip upwards. This will enable your hamstring to be strengthen through the available range and prevent hamstring injuries whilst running.

Hamstring Exercises for Long Distance Runners is a post from: Musculoskeletal Consumer Review

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