A hamstring strain is a partial tear of the small fibers of the muscles of the hamstrings group. The hamstrings are the large group of muscles in the back of the thigh. They consist of three muscles that run from the hips to the knees.
Causes
A hamstring strain can be caused by:
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Stretching the hamstrings beyond the amount of tension that they can withstand
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Suddenly putting stress on the hamstrings when they are not ready for the stress
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Using the hamstrings too much on a certain day
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A direct blow to the hamstrings
Risk Factors
A risk factor is something that increases your chance of getting an injury. Risk factors for a hamstring strain include:
Symptoms
Symptoms include:
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Pain and tenderness in the back of the thigh
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Stiffness in the hamstrings
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Weakness in the hamstrings
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Bruising on the back of the thigh (if blood vessels are broken)
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Popping or snapping sensation as the muscle tears (possibly)
Diagnosis
The doctor will ask about your symptoms and medical history, your recent physical activity, and how the injury occurred. The doctor will also examine your thighs for:
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Tenderness and/or bruising directly over the hamstrings
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Pain and weakness when contracting the hamstrings, particularly against resistance
Muscle strains are graded according to their severity:
Grade1
Grade 2
Grade 3
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Complete tearing (rupture) of muscle fibers.
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Recovery can take more than three months.
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Surgery may be needed to repair the torn muscle fibers. This is very rare.
For severe hamstrings strains, you may have an MRI scan to see if the tearing requires surgical repair. Professional and collegiate athletes sometimes have MRI scans to help predict the length of their recovery.
Treatment
Treatment depends on the severity of the strain.
Treatment usually includes:
Rest–Do not do activities that cause pain, such as running, jumping, and weightlifting using the thigh muscles. If normal walking hurts, shorten your stride. Do not play sports until the pain is gone.
Cold–Apply ice or a cold pack to the hamstrings area for 15-20 minutes, four times a day, for several days after the injury. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
Pain Relief Medications–Take aspirin, ibuprofen (Advil, Motrin), or acetaminophen (Tylenol) to help relieve pain. Ask your doctor if you have any questions about using these medications. If you still have tenderness in the hamstrings while taking these drugs, do not return to physical activity. First, check with your doctor before returning to activity.
Compression–Wear an elastic compression bandage (eg, Ace bandage) around your thigh to prevent additional swelling. Be careful not to wrap the bandage too tight.
Elevation–Keep your leg higher than your heart as much as possible for the first 24 hours or so to minimize swelling. A couple of days of elevation might be recommended for severe strains.
Heat–Use heat only when you are returning to physical activity. Then use it before stretching or getting ready to play sports.
Stretching–When the acute pain is gone, start gentle stretching as recommended by a healthcare professional. Stay within pain limits. Hold each stretch for about 10 seconds and repeat six times. Stretch several times a day.
Strengthening–Begin strengthening exercises for your hamstrings as recommended by a healthcare professional.
Prevention
To reduce the chance that you will strain your hamstrings:
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Keep your hamstrings strong so they can absorb the energy of sudden physical stress.
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After a short warm-up period, stretch your hamstrings.
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Learn the proper technique for exercise and sporting activities. This will decrease stress on all your muscles, including your hamstrings.
RESOURCES:
American Academy of Family Physicians
http://www.aafp.org
American Council on Exercise
http://www.acefitness.org
References:
American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org/.
American Orthopaedic Society for Sports Medicine website. Available at: http://www.sportsmed.org/.
Exercise and Sports Sciences. Lippincott Williams and Wilkins; 2000.
Hamstring strains: expediting return to play. Phys Sportsmed. 1996 Aug.
Nicholas Institute of Sports Medicine and Athletic Trauma website. Available at: http://www.nismat.org/.
Sports Injuries: Basic Principles of Prevention and Care. Blackwell Scientific Publications; 1993.
