Old: Hamstring Strains
“I think I pulled a muscle” is probably a phrase everyone has heard before, but what does it truly mean? Most of the time, it means they have a hamstring strain. It may sound like it isn’t that big of a deal but the truth is, it can be. Hence, it is important to learn the causes, symptoms, preventions, and further research about it.
What is a hamstring strain?
To use the term “a pulled muscle” is a really poor way of describing things. In reality, a strain is more of a tear that is caused by a pull, rather than a pull of a muscle out of its position.
A hamstring strain is when one or more of the muscles of the hamstring (biceps femoris, semitendinosus, and semimembranosus muscles) get stretched too far and tear. This injury can be mild if the tear isn’t that bad, but if the muscle completely gets detached, it could take months to heal.
Etiology (causes and mechanism of injury)
The main cause of a hamstring strain is what one can call: “muscle overload”. This mechanism tends to occur when your leg is fully stretched out right before the foot strikes the floor. As the foot strikes the ground, the weight causes the hamstring muscles to tear. To be more specific, this injury may occur in sports such as track and field, soccer, football, lacrosse, and especially basketball.
Causes
Not warming up: If you don’t warm up, you leave your muscles tight, making them more prone to being torn. This is because when you don’t warm up, your body is rigid, and hence less movement is required to cause the hamstring strain than normal.
Out of shape or overworking: Being out of shape causes your muscles to get weaker, and obviously, weak muscles are more prone to a tear as they don’t have enough strength to endure all that weight. Overworking can also damage your hamstring as it weakens your muscles as well.
Imbalance in leg muscles: This mainly occurs as your quadricep muscles are bigger and stronger than your hamstring muscles. So, for example, when you run you are using both muscles equally, however, since your hamstring muscles are smaller than your quads, they get tired faster and are more prone to strain.
Improper technique: You must always use proper technique in your exercise. That's not just to get you stronger, it also gets you safer as bad technique can increase the stress on your muscles and put them in a horrible position where you can tear them.
Improper care: This one is very important, especially amongst athletes. Please don’t return to physical activity unless told so by your doctor or athletic trainer. Returning quickly to the field can cause harm as your muscles are weaker than usual.
Symptoms and Diagnosis
The main symptoms of a hamstring strain can be broken into the severity of the injuries.
Grade 1 (mild strain): Causes sudden pain and tenderness at the back of the thigh. Although it may be painful to move your leg, the strength of the muscle should not change.
Grade 2 (partial tear): Causes stronger pair and a higher level of tenderness. You might have lost some strength in your leg and it might be swollen and bruised up.
Grade 3 (severe tear): Extremely painful, tender, swollen and bruised. There might be a “popping” sensation at the back and you will be unable to use the leg at all.
The specific diagnosis can be done based on palpations at the specific muscles of the biceps femoris, semitendinosus, and semimembranosus. Based on these, if the symptoms align with the symptoms above, they can be diagnosed properly by an approved medical professional.
Treatment
Specific treatment of a strain can take days, weeks, or even months depending on how severe the actual strain is.
Initial Treatment
Rest: You should rest as much as possible
Ice: Apply cold packs for 20 minutes every 2 to 3 hours
Compress: Bandage or compress the thigh to limit any possible swelling or movement that might cause further damage.
Elevate: Keep your leg raised and suppressed to prevent further swelling
**It is important to note that according to recent studies, the RICE method may not be effective after the first day of injury so it is important that you consult your medical professional**
You can also take painkillers to reduce the pain as instructed by your medical professional.
Long Term Treatment
Gentle exercises and stretches are essential during this recovery period. Returning to strenuous exercise too quickly can lead to further damage, and to prevent this, you should start the stretches after a period of time of your injury as instructed by your medical professional.
You can take part in exercises such as walking, cycling, and other recommended hamstring-strengthening exercises. To avoid further injury, you must only return to full activity if your hamstring muscles are fully healed and strong again as advised by your doctor.
Surgery
Surgery is necessary to address a full hamstring tear, as it won't naturally heal. In the case of a tear in the proximal hamstring (the tendons connecting the hamstring to the pelvic bone), sutures will be employed to reattach the tendons to the point where they separate from the pelvic bone.
For optimal outcomes and safety, it is advisable to undergo surgery for proximal hamstring tears within the first two to three weeks following the injury. Thus, an early diagnosis is crucial.
Conclusion
Although most of the time a hamstring strain is nothing to worry about, it is important to be cautious as grade 3 tears can lead to surgery and recovery that might take months. It is extremely important to be honest with your medical professional as dishonesty can lead to misdiagnosis and more which can cause further damage. This article is written so that this mistake can be avoided as the most important thing is: to consult your doctor/athletic trainer before you do anything!
Sources
“Hamstring Strain (for Teens) - Nemours Kidshealth.” Edited by Timothy Duer, KidsHealth, The Nemours Foundation, June 2016, kidshealth.org/en/teens/hamstring-strain.html#:~:text=A%20hamstring%20strain%2C%20sometimes%20called,surgery%20and%20crutches%20for%20weeks.
NHS. (n.d.). NHS choices. https://www.nhs.uk/conditions/hamstring-injury/
Hamstring tear & surgery. University of Utah Health | University of Utah Health. (2023, May 23). https://healthcare.utah.edu/orthopaedics/specialties/hip-pain/hamstring-tear-surgery
