WHAT ARE THE HAMSTRINGS?
There’s a misconception that the hamstring is one large muscle running down the back of the thigh. The hamstrings are actually a group of three muscles: the semitendinosus, the semimembranosus and the biceps femoris.
The three muscles run from the bottom of the pelvis to the the knee joint, helping you bend your knees and extend the legs straight back. The hamstring tendons attach the muscles to bone.
COMMON HAMSTRING INJURIES
Hamstring injuries are common in athletes, especially those who play a sport with sudden stopping and starting. The most common sports hamstring injuries occur in are soccer, basketball, football, tennis, running and competitive-level dance.
Muscle overload is the primary cause of strain to a hamstring muscle. Overload occurs when the hamstring is stretched beyond its limits. It can also occur when the muscle is suddenly faced with a heavy load. Hamstring strains can be a simple pull, a small tear or a complete tear.
Hamstring strains are graded based on their severity:
- Grade 1 strains are mild and will quickly heal without much intervention.
- Grade 2 strains are partial muscle tears that take longer to heal.
- Grade 3 strains are complete muscle tears. They can take much longer to heal, sometimes months.
WHAT ARE THE SYMPTOMS OF A HAMSTRING STRAIN?
Hamstring strains usually cause instant pain in the back of the thigh. Some people report feeling a specific tearing or popping sensation when the injury occurred.
Many injuries result in tenderness in the hamstring, along with swelling. These symptoms can present within a few hours, but may sometimes be delayed. In some cases, bruising develops — although this is usually only seen in more severe injuries.
Severe grade 2 or 3 strains may make it difficult to put weight on the leg and walk.
WHO IS AT RISK FOR A HAMSTRING TEAR?
Hamstring tears can happen to anybody — sometimes they occur when doing yard work or simply picking up a heavy object. They are more common in specific groups of people though:
- Athletes such as football, soccer and basketball players, runners or dancers.
- Older adults who don’t regularly participate in sports, perhaps only on weekends.
- Teenage athletes who are growing — this is because muscle and bone doesn’t grow at the same rate. Bones may grow faster than muscles, excessively stretching the muscles.
The risk of a hamstring tear also increases if a person has extreme muscle tightness, muscle imbalances, muscle fatigue or poor conditioning. To reduce the risk of a tear due to one of these factors, it’s recommended that athletes stretch, correct imbalances with targeted strength training, take adequate time to recover and ensure the activity being performed is appropriate for their ability and fitness level. Not warming up properly before a practice or game can also increase the likelihood of an injury.
HOW IS A HAMSTRING TEAR DIANOSED?
Hamstring tears are diagnosed with a physical exam. Your doctor will look for swelling, tenderness and bruising and may order imaging tests to confirm the diagnosis.
Imaging tests include x-rays and Magnetic Resonance Imaging (MRI). If you have an injured hamstring tendon, the x-ray will show the doctor if the tendon has pulled a small piece of bone away, called a hamstring tendon avulsion. The MRI creates high quality images of soft-tissue, helping the doctor see how severe the injury is.
HOW ARE HAMSTRING TEARS TREATED?
The two main types of treatment for hamstring strains are nonsurgical and surgical. The course of treatment for your specific injury will be determined by the severity of the hamstring strain. At Mountainstate Orthopedic Associates, our main goal is to help you recover and resume all the activities you enjoyed prior to the injury.
Minor (grade 1) hamstring strains can often be treated at home with a very simple methods. You may have heard of the RICE protocol before — rest, ice, compression and elevation.
- Rest: Take time away from the activity that resulted in the injury and minimize movement in the leg.
- Ice: Ice can help with pain and swelling, but it should never come in direct contact with the skin. You can use it for 20 minutes at a time throughout the day.
- Compression: Elastic compression bandages can help prevent blood loss and any additional swelling.
- Elevation: Elevating the injured leg to be higher than your heart will also help reduce swelling. Make sure that you are resting and comfortable as you do this.
If the injury is more severe or not responding to basic treatments, your doctor may suggest immobilizing the injured leg by wearing a splint. The splint will keep the leg in a neutral position allowing it to heal.
After the swelling and pain has subsided, a physical therapy program can begin. The goal of physical therapy is to work toward restoring flexibility, range of motion and strength so you can return to your normal activities.
Surgical treatment is usually only needed when the hamstring strain is more severe. If your tendon has completely pulled away from the bone or the muscle is completely torn, then your doctor may discuss surgery.
Surgery always requires a period of rehabilitation and recovery. You’ll have to rest and keep weight off of the leg so that the repair can fully heal. This means using crutches and possibly wearing a brace.
Physical therapy will begin after an initial healing phase to help increase flexibility and range of motion. As this improves, the therapy will focus on building strength.
Every injury and patient has different recovery times. Your doctor will work with you to let you know when it’s safe for you return to normal activities and sports. At Mountainstate Orthopedic Associates, our patients usually regain full function after surgery and rehabilitation. To prevent the injury from reoccurring, it’s crucial to be careful and follow your doctor’s directions.
HOW MOA CAN HELP
Our surgeons at Mountainstate Orthopedic Associates, Inc., have been providing cutting-edge orthopedic care to Morgantown and North Central West Virginia since 1977. We frequently see hamstring injuries in our office — and our expert doctors know exactly how to treat them to get you back on your feet.
If you or a family member have recently injured a hamstring, contact us today to make an appointment.