Hhow often do we hear that an athlete is rested from a game because he or she has sustained a hamstrings muscle tear! What is the myth and mystery behind this group of muscles is what we will try to unravel today.
The hamstrings are the group of large muscles located on the back of our thigh. These muscles cross the hip as well as the knee and exert a dual-action. At the hip, they cause an extension or straightening of the joint and at the knee, they cause flexion or bending of the knee.
There are two ways a hamstring muscle can be injured: sprinting type injury and stretch type injury. The sprinting type of injury, as the name implies, results during an explosive muscle contraction sequence of the hamstrings tendons. Like the run, the hamstrings have to pull hard on the shinbone to decrease the impact of the foot on the ground. It is during this action that the muscle tears or gives way.
The other injury mechanism is that of a sudden stretch injury. These may occur in a variety of situations such as dancing, kicking, stretching, yoga, etc. There is a sudden stretch that is sustained by the contracted muscle that causes the fibers of the muscle to be ripped apart, resulting in an injury. If this has happened to you, consider consulting a professional who offers prp therapy toronto. They have treatments that can aid the healing process.
The main crux of this blog to know how to prevent this injury. And for this I would suggest the following:
- A proper warm-up – I think this cannot be but overemphasized. 99% of all injuries are due to a lack of a warm-up program. The ideal warm-up for the hamstrings should consist of light aerobic exercise followed with progressive stretches and more aerobic activity.
- Stretches and flexibility – These drills are of paramount importance to allow the muscle to reach its maximum length. The Straight Leg Raise or SLR test will determine the so-called ‘stretch-ability’ of the hamstrings muscle. For this, please lie flat on your back, keep the knee straight and then raise the straight leg above the ground. The normal hamstring should allow at least 80o of a straight leg raise. Anything less than 80 degrees should be considered as a ‘tight’ hamstring and this should necessitate the implementation of a ‘stretching’ program.
- Hamstrings strengthening – The strength of the muscle is as important as its flexibility. A weak muscle is more likely to get injured than a strong muscle. There are two modes of strengthening for the hamstrings muscles – concentric strengthening and eccentric strengthening. Eccentric contractions are those muscle contractions that occur as the muscle is trying to elongate or lengthen. This is so that the process of muscle lengthening is slowed down or controlled. In the hamstrings, these eccentric contractions are more likely to cause injuries, hence adequate eccentric muscle strength is more important than concentric muscle strength. The Nordic Hamstrings exercise is the best method for eccentric hamstrings strengthening.
- Endurance – The hamstrings muscle requires the capacity to keep contracting and relaxing for a long duration of time. This is to prevent tiredness and fatigue. A well-structured training program is essential to achieve this goal.
The key to return to full function after a hamstrings injury is the recognition of the severity of the injury. During the ‘Acute phase’ i.e. the first five days – the PRICE regimen is adopted. PRICE stands for Protection, Rest, Ice, Compression and Elevation. Gentle physiotherapy to help with pain and passive as well as active-assisted exercises are commenced during this stage. In the ‘Sub-acute phase’ between 1-3 weeks, active exercises are increased and some isometric contractions are initiated. The upper extremity-training program should now be initiated. In the ‘Remodeling phase’ and the ‘Functional phase’ the resistance training is increased and sport-specific exercises are stared. Manual therapy to stretch out scar tissue is useful and aqua therapy is also initiated. Return to play can occur anywhere between 3 weeks to 3 months, depending on the severity of the damage.
So, a hamstrings injury is best prevented. A four-point prevention program can be easily adopted in your exercise pattern.
Dr Sachin Tapasvi is one of India’s leading joint replacement surgeons. He practices in Pune and has been awarded several fellowships with experience garnered internationally as well as in India.
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