Latest article from Mark Roe Sports Physio Academy
A hamstring injury is common in many sports such as football, where quick bursts of speed are required.
The hamstrings are the muscles which attach the back part of the pelvis to the back of the knee. When they are active they help to extend the leg backwards and bend the knee bringing the heel towards the buttock. Stretching the hamstring does the opposite (leg forward with a straight knee).
A tear to the muscle occurs when the muscle at the back of the leg is stretched beyond its limit and the muscle tissue then ‘tears’ or ‘pulls’. Commonly a sprinter will describe a sudden sharp stabbing pain in the leg, which prevents him or her from being able to continue. You may have seen footballers on television sprint or stretch for a ball then suddenly pull up holding the back of their leg.
A hamstring muscle tear is graded according to the severity and number of muscle fibres which are torn. A grade 1 tear is where only a small percentage of the fibres are torn, and this may take anything up to a couple of weeks before someone is back playing. A grade 3 tear can be almost or all of the fibres becoming disrupted and will result in several months out of action.
As with all muscle injuries, we treat a pull initially with P.R.I.C.E. (Protection Rest Ice Compression Elevation), then look to start stretching and strengthening after a couple of days depending on the severity of the tear. For further details on how to self manage this and other soft tissue injuries check out www.markroesportsphysio.co.uk self treatment page.
Following a hamstring muscle pull, there is usually pain when stretching the muscle and weakness when tensing it. A physiotherapist can feel or 'palpate' the muscles, observing areas of pain, tension or gaps within the muscle, and write an appropriate rehabilitation exercise plan to get you fit quicker.
If you suffer from pain in the hamstring area it is important to have an assessment from a Chartered Physiotherapist to verify the injury and to rule out other causes. To check to see if your physiotherapist is reputable check out the Health Professionals Council Register at www.hcpc-org.co.uk
A good physiotherapist should also be able to assess the biomechanics of how you move to suggest why the injury may have occurred in the first instance and give you a few tips on how to prevent a recurrence of the injury. For example, other things like sitting slouched for long periods (on your Play Station!) can have an effect on your symptoms.
It was reported that Michael Owen and Ryan Giggs suffered with hamstring pain and both were helped by changing their cars. The sports cars they drove changed the position of the pelvis and so tightened the hamstrings, and both were better in higher cars like Range Rovers.
Pain in the hamstring area can indicate a muscle strain, but it can also be a symptom of many other conditions, including, adductor (groin) strains, sciatic pain, referred pain from the pelvis or lower back, or tightness of the buttock muscle. Treatment for these other conditions will be different than that of a hamstring pull. For example stretching the hamstring if the pain is referred from the sciatic nerve may actually make the symptoms worse. This is why it is important to see a Chartered Physiotherapist who is qualified to differentiate a muscle pull from referred pain.
You may remember a few years ago John Terry suffered with his hamstring muscles for a good while, but the cause was actually a disc bulge in his lower back. His symptoms were only cured following surgery.
When you are working to rehabilitate a hamstring injury, it is worthwhile considering stretching the other muscles of the lower limb as well and adding some strengthening exercises. Ease in to running by starting slowly at first before increasing speed and adding short bursts of explosive sprints. If you have any pain or pulling sensation in the hamstring whilst running don't increase your speed.
Gradually introduce some football specific drills such as jumping to head the ball, starting with two legs and progressing to one as the hamstring feels stronger. This is also the same when striking a ball. Start with some short passes with the inside of the foot progressing to striking the ball hard from the instep.
Please remember that progression through the exercises may take a number of days or weeks depending on the severity of the tear, so don't try and do too much too soon.
As further commitment from the league to our players' fitness we have negotiated a discount for all players of the Sheffield and District Junior Sunday Football League who attend the clinic for treatment. Players from any team in the League will receive a discount of £10 off their initial consultation following injury, and further discounts should follow-up sessions be required.
Mark Roe
Senior Sports Physiotherapist
The Mark Roe Sports Physio Academy - Sheffield
0114 2390022