Hamstring Injuries: Do’s and Don’ts

Anatomy

The hamstring is a group of 4 muscles that originate on the ischial tuberosity (butt bone) and extend down past the knee to insert onto the tibia.

The four main muscles are the biceps femoris long head, biceps femoris short head (which are more on the outside portion of the back of your leg), & the semitendinosus and semimembranosus (which are more related to the inside part of your knee/leg).

The main job of the hamstring muscle group is to bend the bottom portion of your leg into a flexed position (ie – bring your heel to your butt) & also to assist the entire leg in extending the hip (ie – trying to point your leg backwards like a ballerina).  This muscle group is sometimes referred to as a posterior chain muscle group.

Injuries

The most common form of a hamstring injury is a pulled muscle.  A few other contributing injuries would be Piriformis Syndrome, Sciatica, Pes Anseri Tendonitis & IT-Band Syndrome.

Tight hamstrings are also a common contributer to lower back pain.  Prolonged sitting can cause an increase in hamstring tightness which will pull on your butt bone.  In response, the lower back muscle will tighten to counteract the hamstrings and cause pain in the lower back.

Most hamstring injuries are a result of a quick movement that results in an individual feeling a pull to the back of the leg.  This is very common in any activity that requires running, jumping and/or heavy weight lifting.

Typically, hamstring injuries are graded 1-3 with grade 1 being a minor strain, grade 2 being a bad strain with possible tearing, and grade 3 being a tear or possible rupture of the muscle or tendon.

Physical diagnosis can determine the level of the tear.  Sometimes an MRI is ordered if there is bad swelling and/or bruising.

Do’s and Don’ts

Do’s

1. Get an evaluation from a qualified provider
2. After determining the severity of the injury, select the proper treatment.  Typically, hamstring injuries will take 4-8 weeks to heal.  Once a hamstring injury becomes chronic, it can take months to properly return the hamstring to its normal state.

Grade 1:  rest, ice, compression, hawkgrips, Active Release Technique, mild band stretching, Range of motion exercises, ultrasound, laser therapy and/or electric muscle stim therapy

Grade 2: rest, ice, compression,  hawkgrips, Active Release Technique, ultrasound, laser therapy and/or electric muscle stim therapy

Grade 3: Rest, ice, compression, ultrasound, laser therapy, and/or electric muscle stim therapy

Dont’s

• Do not force exercise on an injured hamstring.  Professional athletes are out for 4-8 weeks with hamstring injuries so running or any intense exercise on the injury is a big mistake
• However, don’t sit around too much unless it is considered a grade 3.  Movement helps to encourage blood flow into the area. Keeping completely inactive is not recommended.  Find a safe activity that promotes blood flow without intense muscle contraction or intense stretching.

**If you are already injured, it is recommended to see a physician first for an evaluation.