Muscle injuries can be painful and distressing. Muscles are resilient and adaptable structures that produce the forces through their attachments onto bone via tendons in order to create movement and control to joints. Muscles are responsible for both high speed and power movements like sprinting, and slower movements like squatting. They are capable of working at different ranges or on different levels of stretch. Some muscles are more susceptible to strains and tears than others.
These include: the hamstrings, quadriceps, adductors (groin) and calf muscles which span across two joints. These injuries commonly occur in people engaged in running and jumping sports. One of the more common muscle strains is to the hamstrings (a group of three muscles at the back of the thigh). We use the hamstring as an example here to describe how muscle strains occur and how best to manage them.
The key is to know that if you take a disciplined approach with your rehabilitation program – it will get better over time. The key role for the physiotherapist is to act as a coach on the journey. This journey could take as little as a week for a grade one muscle injury or two to three months for a muscle injury with tendon involvement.
If you have experienced a muscle injury, or for any other condition or service, get in touch with our friendly team today.
- How common is it?
- Hamstring injury risk factors
- Myths & facts about hamstring injury
- Approaching hamstring injury
- Assessing hamstring injury
- Treating hamstring injury
How common is hamstring strain?
A hamstring strain is an injury to part of one or more of the muscles at the back of the thigh. Muscle injury occurs when the force demand on the muscle exceeds the strength or length tolerance of the muscle. This represents the balance between the demands of the movement/activity you want to do, and the capacity of the muscle to produce the forces required for that activity.
An injury to the hamstrings can occur as a result of high level forces such as sprinting or slow repeated stretching forces as can occur in dance.
The hamstring muscle group are made up of three muscles which span from the pelvis to the shin bone and act on both the hip and the knee joints:
- Bicep femoris (long & short heads)
Hamstring injuries (strains or tears) remain the most common injury in sports. The severity of the injury is commonly graded based on how much of the muscle is injured (Grade 1-3) as well as where in the muscle the injury has occurred (involving the tendon, junction, muscle sheath).
What are the risk factors for hamstring strain?
There are a number of risk factors for sustaining a hamstring muscle injury:
- Previous hamstring injury
- Older age
- Rapid increase in training volume and loads
- Poor conditioning for sprinting or endurance loads
- Poor muscle length
- Poor muscle strength
- Poor recovery and fatigue
- Poor nutrition
- Poor general health
Myths about hamstring muscle injury and treatment
✖ Muscle injury usually means the muscle needs complete rest
✖ Muscle injury usually means a scan is needed
✖ If loading the muscle hurts, then it means that the movement / activity should be avoided
✖ If I load the muscle it might snap
✖ Stretching and massaging muscle is all that is needed for recovery
✖ A muscle tear means surgery is needed
✖ An injection will fix my muscle tear
✖ Muscle injuries never regain their strength
✖ The amount of pain related to the injury is an accurate measure of tissue damage
Facts about hamstring muscle injury
✔ Muscle injuries are very common in sport
✔ Most people return to sport and activity after muscle injury
✔ Scans don’t predict how much pain you feel or how disabled you are
✔ Scans are usually only needed if there is suspicion of full rupture
✔ Complete rest is not helpful for muscle injuries.
✔ Gradually loading the muscle makes them stronger and more resilient. In the beginning this can cause some pain – however it is not harmful and pain reduces with time.
✔ Injections often don’t play a role in the recovery from a muscle injury
✔ Muscles love graduated strength training through to hard and heavy loads. This increases the muscles’ capacity to withstand the demands of the tasks you want or need to do
Approaching hamstring injury
The first step is understand how and why the muscle injury occurred, the degree of tissue damage involved, your body control and conditioning as well as your individual goals for recovery. Together we build a plan to get you back to full capacity.
Hearing your story
- We undertake a full history in order to hear your story, how the muscle injury occurred, any previous history of injuries and pain, understand the demands of your daily life and activities (work or sport), and to identify other potential contributing factors to your presentation
- We ask you about other aspects of your health such as your sleep, fatigue, training volumes and conditioning program.
- We also want to understand your training goals.
This includes an assessment of:
- the sensitivity and load capacity of the structures to touch, move and load;
- the way you perform the postures, movements and activities that are painful
- the ability to engage and activate the muscles surrounding the injury.
- the strength, power and endurance of the muscles that surround the injury.
Based on this information we can:
- diagnose the type and severity (grading) of muscle injury and determine whether you need a scan or not.
- provide an accurate estimate of your recovery time and what the process involves
Treatment of hamstring muscle injury
The great news is that there are lots of effective treatments that our team of physiotherapists at Body Logic Physiotherapy can offer for a hamstring muscle injury.
First is to identify the key factors contributing to the injury and working out what structures specific structures within the muscles are affected in order to build a plan that is tailored to your personal needs.
Body Logic physiotherapists use the above information to explain to you the following:
- where the pain is coming from
- the factors that are contributing to your pain
- develop a rehabilitation plan and determine milestones to return to sport and activity
- discuss the best treatments options available to you.
Exercise rehabilitation program
We will develop a graduated strengthening exercise program to get you back to your activity or sport as soon as possible. Recent research shows that early exercise rehabilitation speeds the process of recovery.
This usually involves a graduated program that includes:
- A tailored program based on the severity of the injury
- Gradual loading and strengthening of the injured muscle (as well as the surrounding muscles) to increase the load tolerance of the muscle in all domains (strength, endurance and power) and different muscle lengths
- Starting slow and gradually build up the program to match the demands of your sport / activity sports specific exercises
- Exercise program to keep you fit and conditioned as you recover
Return to sport program
- Careful progressions to build running speeds, change of direction, sports specific tasks like kicking / jumping depending on sport
- Determine milestones for the adequate timing to return to training and to return to play
Injury prevention program
We know prevention is easier than cure…so after a rehabilitation program we will provide you with an injury prevention program. This will include:
- an exercise program to maintain the strength of the muscles surrounding the injury
- an exercise program to keep you healthy, fit and match your capacity with the demands of your lifestyle
- To organise timely follow ups and communicate with your coach or trainer to assist with the continuation of this program moving forward.
Other strategies that are helpful to treat muscle injuries are:
- Improving sleep
- Managing stress
- Healthy eating
- Caring for your mental and physical health