Hamstring strains and how physiotherapy can treat them
Hamstring strains (a.k.a. “doing a hammy!”) are one of the most common injuries seen by Northern Beaches physiotherapists. Hammy strains are most prevalent in sports that use a combination of dynamic movements like sprinting, Australian Rules football (AFL), soccer, dancing, surfing, rugby league and other activities where quick eccentric contractions, when the leg is being straightened and the hamstring is working hard, occur frequently such as slowing the leg down after kicking a ball. In AFL hamstring strains are the most common injury with a rate of 6 injuries per club per season combined with the highest rate of re-injury at over 30%. Musculoskeletal physiotherapists know that it is perfectly normal for two people to tear exactly the same muscle but recover at different speeds. Recovery time is dependent on the grade of the injury with a grade 1 injury possibly healing in only a few days, while a grade 3 injury could take months and, in extreme cases, even require surgery.
“My hamstring is ok but derogatory and sexist comments aren’t”
Most hamstrings will have torn well before this point so all can admire the incredible strength and flexibility of Tayla Harris during the AFLW 2019 season.
What are the hamstrings and what do they do?
The hamstrings are a group of muscles and their tendons at the back of your upper leg. They are made up of three different muscles: the biceps femoris, the semitendinosus and the semimembranosus. You use your hamstrings for all kinds of things: walking, running, dancing and jumping. They enable you to flex your knee and extend the hip at the beginning of each step you take. Your hamstrings play a large role in many movements of the legs and hips which is why physiotherapists have spent so long studying them and how to reduce the occurrence and length of injuries.
How do hamstring injuries occur?
Like most injuries, hamstring strains or injuries can be classified as being caused by either primary or secondary factors.
- Primary factors include:
- Poor timing coordination in the hamstring (the swing phase of the leg in sprinting)
- Lack of strength and stiffness in the hamstring
- Muscle imbalances
- Increased neural tension through the sciatic nerve
- Common secondary factors include:
- Overstriding or poor pelvic control when running
- Improper warm-up to prepare hamstring muscles
- Lower back problems
- Prior hamstring injuries
What are the symptoms of a hamstring strain?
The nature of hamstring strains means that symptoms can vary greatly between injuries. Mild hamstring strains could present as tightness or a mild ache in your hamstring. While a severe strain can be extremely painful, with some people describing it like being shot in the back of the leg even making it impossible to walk or even stand. If you have any of the following symptoms get in to see your Dee Why physio ASAP:
- Hamstring tenderness
- Pain or difficulty running, walking or standing
- Pain in the back of the thigh or lower buttock
- Bruising or swelling
- Sudden severe pain while exercising, with a popping sound or snapping feeling
How physiotherapy helps treat hamstring strains
If you have had a hamstring injury your best course of action is to consult with a physiotherapist that has an expert knowledge of sporting and musculoskeletal injuries. Due to the high rate of reinjuring your hamstring, there is no substitute for high quality initial care and rehabilitation. Physiotherapy helps patients with a hamstring injury to speed up the healing process and ensure the best outcome. They will be able to assess and treat your strain and help you to minimise their recurrence in the future.
- Acute or initial phase of a hamstring injury
Your physio will likely recommend the trusty RICE (Rest, Ice, Compression, Elevation) method for the first few days. This will help to reduce swelling and minimise pain. I like the saying ‘the early bird gets the worm’ and when it comes to intervention for hamstring injuries the early bird getting treatment always recovers quicker and more effectively. An expert sports physio will also get you loading your hamstrings in a variety of different ways, even in the early stages!
- Your physio will then comprehensively assess:
- Your range of motion
- The strength and mobility of your lower back
- Your gait
- Your flexibility
- If possible, your running, jumping and sporting techniques
How to prevent another Hamstring Strain
If you’ve ever had a hamstring strain I can pretty much guarantee you won’t want another one, they certainly don’t tickle. Dealing with a hamstring injury once it’s already happened is much harder than preventing it. Here are some tips:
- Stretch before and after physical activity
- Increase the intensity of your physical activity gradually
- If you feel pain, stop exercising (it’s not all ‘no pain, no gain’)
- Stretch and strengthen hamstrings as a preventative measure
Whether you have recently suffered a hamstring injury and are in need of immediate physical therapy or you have suffered a hamstring injury in the past, a physiotherapist is able to assess and recommend the best activities and stretches to help speed along your recovery and reduce the likelihood of experiencing further strains.
 Sutton G. Hamstrung by hamstring strains: a review of the literature*.J Orthop Sports Phys Ther. 1984; 5(4):184-95.
 Orchard J, Seward H. Epidemiology of injuries in the Australian Football League, season 1997–2000. Br J Sports Med2002;36:39–44.
 Schunke M., Schulte E., Schumacher. Anatomische atlas Prometheus: Algemene anatomie en bewegingsapparaat. Nederland: Bohn Stafleu Van Loghum, 2005.