Hamstring Injury – Causes, Symptoms & Treatment

Hamstring refers to both, the set of three muscles that are at the back of the thigh stretching from the hip to the point above the knee, as well as the tendons that connect these muscles to the pelvis and shin bone. While the hamstring is not used a lot for everyday activities like walking, they do play a huge role in anything athletic that involves lunging, knee bending, running, etc.

A hamstring injury is painful but most often it can be relieved with rest and medication. It rarely requires aggressive forms of intervention.

Causes of Hamstring Injury

• A hamstring injury is quite common among people who play a lot of sports.
• Any kind of sudden and jerky movements can result in a hamstring injury i.e., any movement that overloads the hamstring muscles and tendons.
• The muscles might also suffer a tear as a result of overload.
• Sudden bursts of running and coming to a sharp halt often injure the hamstring.
• A gradual injury to the hamstring is also possible and it need not necessarily be sudden.
• Other than athletes, even dancers are prone to hamstring injuries.
• It is essential to warm up before an activity to prevent a hamstring injury.
• Weak gluteus muscles also indirectly contribute to a hamstring injury as the hamstrings get overloaded.
• Once the hamstring is injured, there is always the possibility of it getting injured again.

Symptoms of Hamstring Injury

The symptoms vary depending upon the severity of the injury. They can be classified into 3 grades:

• Grade 1 or a mild hamstring strain will be experienced as pain at the back of the thigh. While walking might result in pain, the strength of the leg remains unaffected.
• Grade 2 or partial hamstring tear will be more painful than grade 1 and will have some accompanying inflammation. There will be some loss of strength in the affected leg.
• Grade 3 or severe hamstring tear will be extremely painful with even standing proving to be a challenge. It will not be possible to use the injured leg in any way. Possibly, a popping sound at the time of injury would have been heard.

If bruising is present, it is better to consult a doctor immediately instead of waiting to see if the injury heals.

Risk Factors:

• Tight muscles are more vulnerable to tears. Hence, regular stretching is advised.
• Muscle weakness also reduces the ability of the muscles to withstand the strain experienced during exercises and they tear.
• Adolescents are also susceptible to a hamstring injury. This is because, for an adolescent, the bones and muscles grow at different rates. As a result, when they experience a growth spurt, the bones elongate and the muscles do not keep up. Hence, when they perform sporting activities that involve sudden movements, the muscles might tear.
• Aging too plays a role as people over 40 years are more at risk for hamstring injuries.

Diagnosis:

• A thorough physical examination will help your doctor determine the type of injury.
• The point of pain and its severity will help the doctor determine the injury grade.
• The doctor might also suggest an x-ray or an MRI in case of severe injury.
• This is because in severe cases the muscle can completely tear away from the point where it is connected to the bone. Sometimes, a small piece of the bone itself might also tear away along with the muscle. This is called an avulsion fracture. Hence to detect this, imaging tests might be required.
• X-rays help in fracture diagnosis while an MRI can diagnose muscle tears.

Treating Hamstring Injuries

Once again, the treatment depends upon the severity of the injury.

• A mild injury will get better with rest. RICE therapy will help. RICE stands for rest, ice, compression and elevation.

Rest: Rest your leg and do not continue activity just because the pain is mild. For the pain to not progress further, resting it is essential.

Ice: Ice the injured area with an ice pack. Wrap the pack in a thin towel and then begin icing. Do not apply ice directly to the area. You can ice once every couple of hours for 15-20 minutes.

Compression: Wrap the thigh to help with the swelling as well as to immobilize the injured part. Bandages can be used for the purpose.

Elevation: Keep the injured leg raised as this will help to bring down swelling.

• Walking aids can be used to avoid putting pressure on the injured part.
• If the pain doesn’t improve, it is necessary to consult a doctor.
• The doctor might prescribe painkillers and might also suggest wearing a knee splint to immobilize the area for it to heal.
• While rest during pain is advised, once the pain has subsided it is important to start off with gentle stretches. This is to avoid the possible formation of scar tissue around the injured area which will limit normal movement.
• Following stretches, hamstring strengthening can also be done. It is best to learn these exercises from a professional so that they are done the right way and further harm is prevented.
• Return to sports should be made only after a complete recovery as otherwise the possibility of recurrence is high.

In case of a complete muscle tear, surgery might be required. Professional sportspeople and sprinters usually undergo surgery to get back to their activities.

Surgery for Hamstring Tear

It is more common for the muscle to tear from the area of attachment to the pelvis than to tear from the area of attachment to the shin bone.

• Surgery involves reattaching the tendon and removing scar tissue.
• After surgery, putting pressure on the injured leg is to be avoided. Use of walking aids and immobilization with a brace maybe advised. The period for which these will be required depends on the injury.
• Following surgery, physical therapy will commence which will be followed by a strengthening program.
• Recovery after surgery may take around 3-6 months.

It is necessary to get the doctor’s approval before returning to sports.