Hamstrings are one of the most common muscle groups injured among sportspeople. An injury to the hamstring, depending on the severity, can be very painful, debilitating and cause a considerable amount of time away from sport or activity. This blog post details the best Physiotherapy advice on how to treat a hamstring injury and how to prevent hamstring injuries in the future.
The hamstring is made up of three different muscles: the semitendinosus, semimembranosus and biceps femoris. They cover the region from the ischial tuberosity to the head of the fibula and medial tibial condyle (underneath the bum cheek to just below the knee crease on the back of the thigh). It is worth noting that the hamstring helps move two joints, the hip and knee, and therefore can be particularly disabling when injured.
How do hamstring injuries happen?
The function of the hamstring is to flex the knee and extend the hip, which in layman terms, means to bring the heel towards the bum and assist in taking the leg backwards. The most common cause of hamstring injury, regardless of the sport, is usually sprinting. When sprinting, there is a higher force, velocity and power required than walking or jogging. Thus there is an increased demand on the muscles which, if weak or tight, significantly increases the risk of injury.
Treatment for the first few days after a hamstring injury
Best practice after sustaining a hamstring injury is to take pain relief and follow the P.R.I.C.E rule (Protection, Rest, Ice, Compression, Elevation) for the first 72 hours. It is also advisable to use crutches in the early stages if it is very painful when walking. Visit a Physiotherapist after the first three days have passed, as the injury will likely be too painful to assess or treat properly. The Physiotherapist will then assess it, accurately diagnose and create a treatment plan for recovery. You can book an appointment with Next Level Physiotherapy through our contact form here.
Exercises to do after a hamstring injury
The following exercises can be attempted on the fourth day following the injury, provided they do not increase the pain. If pain does increase, it is advisable to stop and contact a Chartered Physiotherapist, such as Next Level Physiotherapy, for a full assessment. These exercises should be done in pain-free range a few times a day (5-8 reps approximately to begin with) guided by the pain. This means the pain should be minimal while doing the exercises and resolve quickly afterwards.
Knee Flexion: Lie on your back, bend your knee and slide your foot towards your bum, then straighten your knee and repeat. You can use a towel on a wooden or tiled floor. Repeat 5-8 times, 2-3 times daily as pain allows.
Knee Extension: Lie on your back bring your injured leg to a 90-degree angle at the hip and knee then bend and straighten your leg up and down. Repeat 8-15 times in a pain-free range, 2-3 times guided by your pain.
Straight Leg Raise: Raise the injured leg a few inches off the floor or bed and down again, keeping your knee straight. Repeat 5-8 times, 2-3 times daily as pain allows.
Isometric Hamstring Hold: Sitting up or lying on your back with the knee straight and push your heel into the bed or floor, starting with 50% effort and build up. Hold for 3-5 seconds and repeat 5 times, 2-3 times daily, guided by your pain.
Hip Abduction: Lie on your side, keeping your knee straight with the affected side on top, lift your leg up and down. Repeat 10-12 times, 3 times daily.
Hip Extension: Lie on your front with your knees straight, slowly raise your injured leg a few inches of the floor. The movement should come from the hip. Repeat 5-10 times, 2-3 times daily as pain allows.
Further hamstring injury Physiotherapy exercises
Later in the rehabilitation stage, you could try the following as guided by a Chartered Physiotherapist:
- Hamstring stretches
- Double leg bridge, progress to single leg
- Squat (bodyweight)
- Step up (bodyweight)
- Lunge (bodyweight)
- Single leg Romanian deadlift (no weight to begin with)
- Deadlift (start with light weight and build up)
- Nordic curls (see video: Hamstring Exercise – Norwegian Curl)
- Sport-specific drills: changing direction, sprinting, jumping and landing
Healing timeframes for a hamstring injury
Recovery time after a hamstring injury is dependent on the severity of the hamstring strain or tear. Hamstring injuries are most commonly graded 1-3. Grade 1 is mild, meaning a mild number of muscle fibres have been torn. A Grade 2 is a moderate number of muscle fibres have torn. Grade 3 is severe and is a complete tear of one of the muscles mentioned earlier.
To identify the grade of a hamstring strain, it would be advisable to visit a Chartered Physiotherapist, such as within our Next Level Physiotherapy clinic in Cork city centre. A full Physiotherapy assessment will establish the severity of the injury and advise you on how to treat your hamstring injury.
The following is an approximate recovery time frame, depending on what grade the Physiotherapist determines the hamstring injury is. It is important to note that each case is different and factors such as age and previous injury can influence the speed of the recovery process.
- A Grade 1 injury would take approximately 2-4 weeks
- Grade 2 would take approximately 4-8 weeks
- Finally, a Grade 3 injury would take approximately 12 weeks
How to prevent hamstring injuries
Keeping the hamstrings strong and flexible significantly reduces the risk of injury. With regards to strength, the hamstring should have approximately 80% strength of the quadriceps (the muscle on the front of your thigh). The hamstrings need to be strong eccentrically and concentrically. Concentric is strengthening the muscle as it shortens. For example, a standard leg curl machine achieves this by bringing the heel to the bum. Eccentric is strengthening the muscle as it lengthens. For example, with the leg curl machine, it is strengthening the muscle as the leg is straightened again. This must be in a slow and controlled manner to get the full benefits of it. One of the best exercises currently found to reduce injuries in the hamstrings is the Nordic curl. In my opinion, it is definitely worth including into your strength and conditioning routine.
Strength is important, but without matching this with flexibility there is still a higher risk of injury. There is a wealth of medical literature debating stretching exercises, which ones are best and how frequent to do them. As a best practice, I would recommend dynamic stretching before taking part in an activity. Follow this with 30-40 seconds of static stretching of any muscle that feels ‘tight’. Yoga is also great for keeping flexibility in tip-top shape.
Thanks for reading my blog on how to treat a hamstring injury. If you found it useful, then please feel free to share with friends and family and on social media. If you have any specific questions regarding treatment after a hamstring injury or any other sports-related injuries then please book an appointment with me at Next Level Physiotherapy Cork city.