Friday September 23, 2016
A hamstring injury can be devastating for athletes, with sports people of all disciplines being wary of the dreaded hamstring tear. Remember Derek Redmond's dramatic hamstring tear, during the 400m semi-finals of the Barcelona Olympics of 1992, shattering his Olympic dreams?
But it's not just athletes who are vulnerable to hamstring injuries - as a private GP London Doctors Clinic sees patients from all walks of life suffering from such hamstring injuries! We walk you through the hamstring injury symptoms to look out for, as well as advice on how to prevent and manage this common sports injury!
Derek Redmond tore his hamstring during the semi-finals of his 400m race at the 1992 Olympics in Barcelona
What are hamstrings?
The term “hamstrings” is used to describe the three muscles and their adjoining tendons (attaching muscle to bone) at the back of the thighs. They run from the hips to below the knees and help in bending your knees. Your hamstrings are not very active during normal walking, but are used more extensively in running, jumping and other activities requiring power and sudden movement.
The hamstrings are the powerful muscles at the back of the thigh, especially involved in running and jumping
What causes hamstring injuries?
A hamstring injury involves straining or even tearing the hamstring muscle or tendons. It can happen when the muscles are overstretched, which can occur during sudden explosive movements, such as during sprinting or jumping.
This injury is also common amongst athletes in sports such as football, rugby, athletics and dancing. Slower movements that overstretch your hamstring can also lead to injury.
Who is more likely to suffer a hamstring injury?
Chances of suffering a hamstring injury are increased if:
- You’ve injured it before
- You don’t warm up properly before exercising, or
- Your quadriceps (muscles at the front of your thigh) are much stronger than your hamstrings (muscles at the back of your thigh)
- The quadriceps are responsible for the opposite movement to the hamstrings, i.e. straightening your knees, thus more powerful quadriceps can overpower and therefore overstretch the weaker hamstrings.
- Experienced trained runners aim to strengthen their hamstrings to avoid this.
One of the best ways to avoid hamstring injuries is to warm up thoroughly before exercise
Types of hamstring injuries
Hamstring injuries are common, painful and occur suddenly. If you are unfortunate enough to damage your hamstrings, the most commonly injured areas are the middle of the back of the thigh (this is where the muscle and its tendon meet) or just below the buttocks.
They are three grades of hamstring injury:
Grade 1: mild muscle strain (“muscle pull”)
- May take a few days to heal
- Often presents as a sudden pain at the back of your thigh
- Muscle strength should remain unaffected
Grade 2: partial muscle tear
- May take weeks/ months to heal
- Causes more pain and tenderness than a Grade 1 hamstring injury
- Possibility of some bruising, swelling and loss of some muscle strength
Grade 3: complete muscle tear
- May take weeks/ months to heal
- May cause abrupt severe pain which makes you unable to move, accompanied by a snapping sensation at the time of injury
- There may also be tenderness, cramping, bruising and swelling
- Grade 3 injuries are most common amongst active athletes, but overall are very rare and only account for ~1% of all hamstring injuries.
If you're struggling with any of the above symptoms, your private GP will be able to diagnose this injury by taking a thorough history and performing a physical examination of the injured thigh.
Treatment for hamstring injuries
Most minor hamstring injuries heal on their own, but it’s important to rest your leg for a few days following the injury, using the “RICE” steps below:
Rest: Keep your leg as still as possible and don’t participate in any physical activity.
Ice: Apply ice packs (don’t apply unclothed ice directly to your skin) to the affected area for 15-20 minutes every 2-3 hours during the day.
Compression: Use an elastic bandage to compress the thigh. This will help reduce swelling and prevent movement and thus further damage.
Elevation: Keep your leg elevated using pillows whenever possible to avoid more swelling.
Painkillers such as paracetamol or anti-inflammatory creams can also be used for pain relief. Oral anti-inflammatory medications like ibuprofen can be used short-term to further alleviate the swelling and inflammation. Please check medication leaflets to make sure the medicine is suitable for you.
As a Grade 3 hamstring injury may take months to heal, you will have to refrain from sports or training for this period. Most hamstring injuries actually heal without surgery; the severe ones may require you to use crutches. In rare, severe cases surgery may be required to fix a complete rupture of where the hamstrings join the pelvis.
Ibuprofen is an effective anti-inflammatory medication, that helps relive inflammation and swelling after a hamstring injury
Preventing hamstring injuries
Here are some tips to help avoid hamstring injuries:
It’s important to stretch and warm up sufficiently before taking part in rigorous physical activity, as well as stretching afterwards too
Increase the level of your physical activity in small increments, keeping it to a maximum of 10% increase per week
Stop physical activity if you feel pain in your hamstrings
Avoiding dehydration as this leads to muscle cramping
Balance quadriceps and hamstring strength by training your hamstrings too
Returning to fitness
Although rest is important to aid recovery and prevent further damage, abstaining from exercise for too long can lead to shrinkage of your hamstring muscles and growth of scar tissue around the damage. Therefore, gentle hamstring stretches a few days after the injury, when the pain has begun to diminish, can help in your return to fitness. Gentle exercise which strengthens your hamstrings should follow this, such as walking and cycling. You should only return to your normal level of activity once your hamstrings are strong enough again. Further advice can be gained from your private GP and referral to a physiotherapist if needed.
Do I need to see a GP?
Most hamstring injuries can be dealt with at home using the steps above. It may be advisable to book a private GP consultation if you think your injury is severe, is not healing, or your symptoms are worsening. Your GP can aid you with recovery exercises and refer you to a physiotherapist if needed.
By Sonal Srivastava