Hamstring Strain Injuries – What Can I do and When Can I Return to Sport?
Written by Dr. Jordan Hirae
A hamstring strain is defined as tearing of one of the muscles composing the hamstring group. The hamstring muscle group consists of three different muscles; bicep femoris, semitendinosis and semimembranosus. Typically, you will experience a “pulling sensation or pop” during an explosive activity such as running, jumping or cutting. You may notice some bruising, localized pain with stretching and activation, stiffness, cramping and possibly difficulties with walking.
What Can I Do When I Have a Hamstring Strain?
In the acute phases of the injury, the goal will be to control inflammation and to re-establish pain free walking and neuromuscular activation. Typically, exercises that can be performed during this phase are short to mid range hamstring isometrics, gentle stretching, core strengthening, weight shifting and gait re-training. During the next phase, exercises that focus on increasing strength demand and building resistance to fatigue are the primary focus. Exercises focused on progressive stretching, eccentric and concentric strengthening, as well as end range isometrics. The last phase will focus on more explosive activity utilizing plyometrics, running, cutting, changing direction and jumping for return to sport. A recent clinical practice guideline supports the use of a Nordic Hamstring Curl in conjunction with comprehensive strengthening and eccentric program, stretching, and progressive agility and trunk stabilization.
When Can I Return to Sport Following a Hamstring Strain?
This is always the toughest question for a physical therapist and most likely the answer you will get is, IT DEPENDS. Return to play is dependent on severity of injury, hamstring length and strength symmetry, confidence with explosive movement and other factors. There is moderate evidence that supports predictors in time to return to sport that include: pain at time of injury, days till pain free walking, knee flexor strength, and size of area tenderness to palpation at evaluation. However, the big picture is that each and every injury is different and your progression should be individualized to your needs and capabilities. In fact, one of the biggest predictor for hamstring strains is having a previous hamstring strain. Thus, it is important that you get the proper individualized rehab to prevent future recurrent strains. Here at Physiostrength, we provide individualized on-on-one service and will develop a comprehensive rehabilitation program based on current evidence to not only get you back on the playing field, but also to prevent future injuries. If you’d like to schedule an evaluation with one of our providers, click the link below and we would be more than happy to help you through the rehab process.
References
1. Martin, R. L., Cibulka, M. T., Bolgla, L. A., Koc Jr, T. A., Loudon, J. K., Manske, R. C., … & Dauber, J. A. (2022). Hamstring Strain Injury in Athletes: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy and the American Academy of Sports Physical Therapy of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy, 52(3), CPG1-CPG44.