Firstly, what are your hamstrings? Your hamstrings are tendons that attach a group of three muscles situated at the back of your thigh to bone, hence the name ham strings. These three muscles (the biceps femoris, semitendinosus, and semimembranosus) run from your buttocks down the back of your thigh to just below your knee. Your hamstring tendons are pulled by these three hamstring muscles.
You don’t actually use your hamstring muscles much when walking or standing. It is only when you run, jump or climb that they spring into action, as these activities involve bending your knee thus engaging your hamstring muscles. It is when one of your muscles is overloaded that light injuries such as a strain happen or even serious injuries such as a hamstring tear occur.
Causes of a Hamstring Injury
This is where the hamstring muscles are strained, become overloaded and can even begin to tear.
These injuries are put into different categories, ranging from grade 1 which is a minor strain, where you could feel pain in the back of your leg however your muscle strength should remain.
Grade 2 is a partial tear or rupture, which can also cause bruising or swelling. You might also experience a lack of strength in the affected leg.
Grade 3 is where you have severely torn/ruptured your hamstring muscle/s. You may experience what can be described as a “popping” feeling at the time of injury, along with swelling and bruising in the aftermath. Unfortunately, you may find you are completely unable to walk on the affected leg.
The more extreme injuries are most commonly found amongst athletes or those who train in sports like football, soccer, baseball, tennis or track events like sprinting and long distance running.
Anything that involves a great deal of stop-starting and acceleration movement can also lead to a potential hamstring injury. If you have previously experienced a hamstring injury, there could be a bigger chance of this being more prone to reoccurring.
When your foot contacts the floor during any activity and your hamstring muscles are unable to absorb the shock and rebound, this is when problems could occur. Improper warm up can also trigger a hamstring injury as the muscles need to be prepared for the forces applied to them. When training/playing on slippery surfaces this also adds to the possibility of a hamstring injury due to slipping.
Who Gets Hamstring Injuries?
Most commonly injuries occur in teenagers to those in their forties of both sexes. In teenagers, when the body experiences growth spurts, their bones may grow faster than the muscle, which, in turn can pull the muscles too tight. This causes the muscles to be stretched too far during sporting activities, resulting in a strain or tear.
Although hamstring injuries are certainly not limited to this age group alone, and typically affects those who are athletes and play sports, it can even be brought about by a brisk walk or not warming up properly before a gym session. If you are out of shape or push yourself too far during training, this may also lead to an injury. Equally, if you are already recovering from a previous hamstring injury and return to activities too soon, you run the risk of being more likely to injure it once again.
How Serious is It?
Depending on the level of your injury, there are varying ways your hamstring injury could affect you.
The general duration for recovery times are; Grade 1 – 1 to 3 weeks, Grade 2 – 4 to 8 weeks and Grade 3 – 3 to 6 months, with the additional time of potential surgery and recovery time in the case of Grade 3.
Different levels of injury will result in a variety of pain levels. You may not be able to put pressure on your affected leg, causing you to have a slight limp, or you might be unable to walk entirely without the aid of crutches. Also, you may not be able to straighten your leg out all the way, stopping you from driving or even sitting without the aid of some sort of elevation.
There might be swelling or bruising. If your hamstrings recovery is a long drawn out one, it is important to keep a positive mindset as this may also affect you mentally as well as physically.
According to your pain threshold, if pain persists, you may want to take anti-inflammatory painkillers such as ibuprofen for short term use or non-steroidal anti-inflammatory drugs (NSAIDS for short) to reduce any swelling and help with the pain. Also speak with your doctor to see what they would advise.
The recommended ATLPhysio formula for self-help as soon after the injury has occurred is ‘RICE’, which stands for Rest, Ice, Compress, Elevate.
Rest; try to avoid putting weight on your leg and limit walking down to a bare minimum.
Ice; as soon as is possible, use a bag of ice wrapped in a towel or a cold compress to put on the area of discomfort to reduce any swelling. Do this as often as possible for the first 48 hours then for 30 minutes every 3-4 hours thereafter until you feel the swelling has gone.
Compress; Your doctor may have a preferred recommended compress treatment for this, consult with them first. Elastic compression bandages can greatly help aid in reducing the swelling. They are also easy to manage as you can adjust them as you see fit.
Elevate; Keep your affected leg elevated as often as possible. Do this for when you are either sitting or lying down. At its most extreme, you may need surgery so the surgeon can repair and reattach muscles where they have torn. Your doctor will be best placed to advise you if this is a suitable option for you.
Recommended Rehabilitation and Supporting Equipment
To improve your legs flexibility without further additional pressure or strain, there are a few exercises that can help your leg’s strength and flexibility. These could also prevent the injury from re-occurring, therefore we’d advise you try some of these techniques and exercises.
Please note, these should only be implemented several days or a week after the injury, and after consulting with your medical professional. Never stretch a hamstring injury shortly after suffering it!
Hamstring Foam Roller Massage
Lie down on your back on a yoga mat. Take your foam roller and position it under the affected leg where the upper part of your hamstring is, just below your buttocks.
Hold the foam roller on each side with your hands. Now, gently roll the foam roller downwards towards your foot. Your foot should flex downwards as you do so, then roll it back up to just under your buttocks again and repeat for up to a minute. You also may wish to also move the foam roller to the sides of the affected hamstrings and repeat the same exercise. This should have the same effect as a deep tissue massage, releasing tension and tightness in your hamstring muscles.
Hamstring Curl Stretches
Lie face down on a yoga mat so your stomach is flat on it and your knees are straight. You may want to place a supportive pillow under your stomach and a small folder hand towel, just above your knee for extra support.
Gently bend the knee of your affected, leg moving your foot towards your buttocks. If at any point the pain is too uncomfortable, stop and slowly lower your foot again. You can retry by lifting your leg not so high the next time.
If you feel capable, then proceed to move your leg up and down ten times or as many up to this number as you can manage. If you get to a stage where doing this becomes easy then add some resistance – you can do this by using an exercise band. Tie the exercise band so it makes a loop and attach one end of the loop to a sturdy unmovable object, then loop your leg through the other end. Make sure the exercise band loop is positioned on your lower affected leg.
Then, repeat the instructions as above.
Sitting Hamstring Stretches
Regular hamstring stretches should be of great benefit when trying to reduce the tightness in injured hamstrings. Slow, gentle stretches as far as feels comfortable will help reduce the tension.
Sit upright on the floor, with both legs out in front of you. Bend one knee and bring in your foot towards your groin. You may hold this foot gently in place if it makes it easier to perform.
Reach forward with the same side arm to the outstretched leg and try to touch the end of your foot. If this proves too far, reaching for your ankle or as far down your leg as you feel capable will also be effective.
Perform 10 reps on each leg, switching alternatively as you go. Stop at any point if there is any discomfort.
Standing Hamstring Stretches
Stand upright, both feet facing forwards. Take a large step outwards with your right leg bending your knee when your foot is placed on the floor. Keep both your feet facing forwards. Lean over and rest both hands lightly on your right leg, you should feel a stretch in your left hamstring.
Swap over and repeat on the other side, alternating to do five each side holding for thirty seconds each time. Stop if you feel discomfort. This exercise should help to relieve the tightness and pain in your injured hamstring.
Glute Bridge Exercise
The glute bridge exercise will help to strengthen your hamstring muscles. Firstly, position yourself laying down on your back on the floor. Bend your knees and lie face up on the floor, with your knees bent, keeping your feet flat and forwards on the ground. Let your arms rest by your sides palms down.
Then, proceed to lift your hips off the ground towards the ceiling, stopping when your hips and shoulder are in a straight line. Hold this position for 10 seconds or shorter, as long as you feel comfortable. Repeat these 20 times, or less if you experience any discomfort.
Hamstring Wall Stretch
Firstly, find a doorway with an unobstructed wall next to it. Open the door and position your yoga mat halfway between the open door and wall next to it.
Lie on your back on the yoga mat, placing your good leg through the open door, with your heel on the floor and your toes pointing to the ceiling. Then, slowly bring your affected leg up straight up against the wall, so your heel is on the wall face, but do not point your toes.
Be careful not to arch your back at any point and do not bend either knee. Hold this pose for as long as up to five minutes, as feels comfortable. Then slowly bring down your affected leg. Try to repeat this up to three times a day, you should feel a good stretch in your hamstrings.
According to the stage of pain you are at with your hamstring injury a good therapist can recommend specific appropriate treatment choices. Physical therapy can give you exercises to continue at home which will help gently strengthen your hamstring muscles. For this, you may want to find a therapist who specializes in sports injuries.