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Common Conditions

Hamstring Tear/Strain

25/09/2020

Hamstring Strains 

Aches and pains on the back of the legs may be a sign of a hamstring injury. The hamstring is a group of muscles located on the back of the thighs. Strain in these muscles is relatively common especially in people who play sports that involve sprinting, like soccer, basketball or track.

The main cause of injury to the hamstring is muscle overload. Strains and tears happen when the muscle is lengthening as it contracts or shortens. They may also happen if the muscle is stretched too far or is taxed too suddenly. For example, when one sprints, the hamstring muscles must contract repeatedly as the leg lengthens with the stride. All this lengthening and loading of the muscles creates a perfect environment for injury. Anything from sudden pain, to a popping or snapping feeling in the leg may be felt. Hamstring may also feel tender and may have bruising at the site of the injury.

There are several risk factors for hamstring strain. Athletes who have particularly tight muscles may be more likely to experience an injury. Muscle imbalances, where certain muscles are stronger than others and if the muscles are weak, they will be less able to deal with the demands of certain sports or exercises, causing hamstring strain.

Hamstring Tears

A hamstring tear injury is a rip in the hamstring muscles. It happens when the hamstrings are overstretched or overloaded with too much weight. Depending on the injury, the hamstring can tear partially or completely. The injury can affect one or more of the muscles in the hamstring muscle group. These muscles include the semitendinosus, semimembranosus and biceps femoris. These muscles which are in the back of the thigh help with bending the knees during activities like jumping and running. While anyone can tear their hamstring, the injury is most common in athletes.

Typically, a hamstring tear occurs during physical activity. Most torn hamstrings are caused by extreme stretching or overload during a sport. The injury often happens to people who play sports like soccer, football, and ice hockey. Training too hard can also overload the hamstrings and cause tears. Past hamstring injury as well as poor flexibility can also result in a torn hamstring.

In addition to athletes, older people are prone to hamstring tears because flexibility often declines with age. Adolescent athletes who are still growing, are also at risk. Since bone and muscle grow at different rates, the growing bone can tighten the hamstring muscles, making them more susceptible to injury.

The symptoms of a torn hamstring depend on the severity of the injury. Sharp pain and tenderness may be felt. A “popping” sensation at the time of injury may also be felt along with swelling within the first few hours and bruising within the first few days.

Depending on their severity, hamstring injuries are categorized into one of three grades.

Grade 1 is mild hamstring strain, which is also called a pulled hamstring. It happens when the hamstring muscles overstretch but do not tear. If the hamstring stretches to the point where it rips, the injury is considered a tear. Grade 2 hamstring tear is a partial muscle tear. This means the muscle has not fully ripped. Compared to a grade 1 strain, a grade 2 tear is more painful. The legs will feel somewhat weak and will likely limp. The most severe hamstring tear is a grade 3 hamstring tear. It occurs when the hamstring muscle rips completely or tears off the bone. A tear that pulls the muscle off the bone is called an avulsion. With a grade 3 tear,  a “popping” sound or sensation will be heard when the injury happens. The back of the thigh will also be extremely painful and swollen.

For hamstring injuries, the initial goal of physical therapy is to reduce pain and swelling. On top of manual therapy to reduce inflammation, a physical therapist may recommend using crutches to avoid putting full weight on the injured leg, applying ice packs several times a day to relieve pain and reduce swelling, wrapping the injured area with a compression bandage and resting with legs elevated above the level of the heart to improve drainage. After the initial pain and swelling of a hamstring injury subside, a physical therapist will prescribe specific exercises designed to improve flexibility and strengthen the hamstring muscles as well as functional training to avoid recurrence of injury. If in doubt, seek professional advice.