If you have injured your hamstring then this can be highly painful and also highly inconvenient. Of course hamstrings are very important for your every day movement and for you to walk, run, and jump and this means that you can be rendered practically immobile if you have injured your hamstring in some way. Here we will look at what hamstring injuries are, how they occur and what treatments are available to help the problem.
Your hamstrings, if you are unfamiliar with them, are the large muscles on the backs of your upper legs beneath your buttocks and above the inside of the knee. These large muscle groups are often called the ‘biceps’ of the legs and they are very important in a range of activities. Essentially their main roles are to bend the knee so that the lower leg flexes backwards, and to help move the thigh itself backwards from the hips. In other words without hamstrings you wouldn’t be able to bend your leg nor stretch it backwards.
Interestingly there is not one muscle on each leg that constitutes ‘hamstrings’. Rather the hamstring muscle is made up of three separate muscles and these are the semitendinosus muscles, the semimembranosus and the biceps femoris (so these really are the biceps of the legs!).
Almost all cases of hamstring injury are strained/pulled/torn muscles. When you strain the hamstring muscles what is happening is that you are tearing the muscle fibers. All muscles are made up of millions of tiny fibers, and these fibers all add up to make your muscle. While the muscle overall is of course very tough, the muscle fibers themselves are easily torn and ruptured and this is what causes us to be able to achieve muscle growth (through constantly tearing and re-building them). However when too much strain is applied too quickly this can cause too many muscle fibers to suddenly tear at once and this then becomes painful and immobilizing and makes it very difficult for the body to repair. This can happen in a range of activities but is most common in sports – sprinting, football, soccer, baseball etc.
Symptoms and Diagnosis
If you strain your hamstrings then you will feel a sudden pain in the hamstring region which can feel like a sudden tear when you are running in the gym etc. From here on you will then notice swelling and often bruising, and you will experience pain when you flex or stretch the muscle which limits your movement. In some cases where the pain is extreme you might actually be able to feel a physical gap in the muscle where it has been torn.
Strains will then be graded as grade 1, grade 2 or grade 3 by their severity. Grade 1 describes small tears within the muscle so just a collection of muscle fibers. Here you will likely feel tightness, have difficulty walking and experience some swelling. Grade 2 is where the tear is severe enough to be more recognizable on a visible level. Here the muscle is partially torn and this will cause a limp with sudden twinges of pain, swelling and pain to touch. You may also be unable to straighten your leg. Finally grade three is a completely torn muscle and in this case you will likely need crutches to walk and will experience considerable pain and swelling.
Treatment for pulled hamstrings is very important to make sure that the hamstring heals quickly and correctly and to prevent more swelling and bruising/tearing of muscle fibers. During the first 24 hours it is highly important to follow the following steps:
• What’s most important is rest. If you continue to use the leg you will place further strain on it and cause more of the muscle fibers to tear. This then will mean you are less able to heal it and it will take longer to do so. Likewise being upright will cause fluids to pool in the area, while you will also be more prone to other accidents due to the limp and pain.
• When resting you should try to elevate the leg above heart level. Achieve this by lying on your back and placing a cushion underneath the affected area. This will pad it against pain and it will also help to encourage the draining of fluids out of the area.
• Using some form of compression is also a good idea. This will again help to reduce swelling as well as limiting intra-muscular bleeding. It can also provide support for if you do want to walk on the limb.
• A cold compress is also an important way to help ease the swelling as well as the discomfort. Although it will be painful or uncomfortable at first the cold compress will eventually numb some of your neurons and thereby reduce the pain. Don’t use this for more than 20 minutes at a time though or you will cause further damage.
• Taking a painkiller is a good idea to help your body to recover. Ibuprofen or Aspirin are good as these are also able to help reduce swelling.
• While the limb recovers you should make sure to get lots of sleep and to eat plenty of protein to encourage the body to rebuild and restore the damaged tissue.
• It is also important to practice mobilization of the limb in order to restore normal movement and in order to encourage rehabilitation. This should involve putting the limb through a range of movements in order to improve strength, flexibility and movement and will usually be carried out by a physiotherapist, osteopath etc.
If these strategies are not enough and the injury is very severe then it may require further treatment and this can include the following:
• Ultrasound and electrical stimulation in order to encourage healing and repair and to break up muscle that is healing incorrectly.
• Crutches in order to help keep weight entirely off of the limb.
• MRI scan in order to ascertain the full extent of the damage to the muscle.
• Surgery in order to stitch the muscle back together.
In future it is of course easier to just prevent injury to the hamstring and you can achieve this in many ways – by stretching thoroughly, exercising and practicing in the warm, building up gradually to more difficult loads and improving general flexibility. Building up strength gradually in the hamstrings can also help to prevent strains, so it is a good idea to aim to improve muscle strength and endurance with exercise and resistance training.
You should also be aware of the various risk factors that will make injury more likely which include age, prior injury to the hamstring, low flexibility, low strength.