A hamstring strain is a muscle injury resulting from tearing or other damage to the muscles and associated fibres at the back of the upper leg. There are different grades of injury ranging from a grade 1 or mild hamstring strain (sensation of cramp or tightness) to grade 3 (tearing of the muscle). Another name for this injury is a “pulled hamstring”.
These strains are commonly experienced by athletes across a broad range of injuries, but are especially prevalent in track and field athletes like sprinters. They usually occur as traumatic as opposed to overuse injuries. Predisposing factors include muscle weakness or imbalance, poor flexibility, fatigue and poor running technique. Additionally, those who have previously experienced such an injury are particularly liable to experience one again.
The hamstring “muscle” is actually a group of three muscles running down the back of the thigh. This muscle group is responsible for bending the leg at the knee as well as extending the thigh.
A hamstring strain is the result of one or more of these muscles becoming overloaded. If the strain is at the severe end of the spectrum, the muscles may even be torn.
The following factors can increase the risk of a hamstring strain:
The symptoms of a hamstring strain can be anything from mild to being so severe (for a grade 3 injury) that walking or standing may be impossible. In general, victims of this injury will experience the following:
If you experience one or more of the symptoms listed above, you should seek a consultation with a doctor (ideally one with a sports medicine background).
A hamstring injury can be classified, depending on severity, into 1st, 2nd or 3rd degree injuries (or grade 1, 2 or 3).
In a grade 1 injury, there is no significant tissue disruption and no loss of function or strength.
A grade 2 injury is one in which tissue damage causes a reduction in strength with preservation of some residual function.
A grade 3 injury is present when there is complete disruption of the musculotendinous unit with complete loss of its function.
To make a diagnosis, the doctor will likely perform a physical examination of the leg. He or she may also ask questions about the nature and severity of the pain being experienced.
The doctor may also ask questions about the cause of the injury e.g. what was the patient doing when it occurred? Armed with this information, the doctor should then be able to make a formal diagnosis.
If the hamstring strain lies in the mild or moderate categories, treatment will generally follow the conservative P.R.I.C.E. protocol. This is usually adequate to heal most strains that are not in the most severe category.
The P.R.I.C.E. protocol will involve:
Apart from non-steroidal anti-inflammatory drugs like ibuprofen and naproxen, medications like paracetamol and topical anti-inflammatory preparations can also be used.
For a grade 3 hamstring strain that involves tearing of the muscles, a conservative approach as outlined above may not be sufficient. Surgery is usually needed when there is complete avulsion (severing) of the proximal hamstrings. The doctor may instead suggest surgery to repair the damaged muscles and reattach them.
Once healing of the hamstring strain is underway, the patient may be referred to a physical therapist who can devise an exercise program to stretch and strengthen the hamstring muscles. Following this rehabilitation program will help to reduce the risk of experiencing another hamstring strain.
This will depend on the severity of the injury and on the patient. The average hamstring injury will usually heal over a 2-3 week period. However, grade 3 injuries can take up to several months to heal. In order to keep the recovery time to a minimum, we suggest the following:
As with all other injuries, an ounce of prevention is worth a pound of cure. Hence, it is reasonable to ask how hamstring strains can be prevented in the first place. Although the risk of this unpleasant injury may be difficult to eliminate completely, athletes or physically active individuals can reduce it as follows:
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