The hamstrings are a group of muscles at the back of the thigh. Hamstring strains are common in sports that require explosive stop-start running motions (eg rugby, netball and athletic sprinting events).
How do hamstring strains occur?
A hamstring strain is caused by an over-stretch, resulting in a tear or complete rupture of one or more of the three hamstring muscles (eg when sprinting from either a jog or a standstill position). Hamstring strains frequently occur:
- at the beginning of a game or training session due to inadequate warming up
- near the end of a game or training session when fatigue is a contributing factor.
Treatment
Apply the R.I.C.E.D. procedure.
Rehabilitation
Always seek the advice of a medical professional for a rehabilitation programme specific to you and your injury. Ensure you are completely rehabilitated before returning to competition to minimise the risk of re-injury.
Range of motion
Stretching the hamstrings will help to restore the length of the muscles. Initial stretching should be limited by pain. Longer stretches (10 to 20 seconds) held at positions of greater stretch should be performed as comfort permits.
Cardiovascular fitness
Non-weight-bearing activities such as swimming, cycling and arm ergometry (grinding) are good options at the beginning of rehabilitation.
Strength
Gentle strengthening should be started early on in the rehabilitation process to minimise muscle wasting and increase the speed of recovery. Pay particular attention to developing a good strength balance between the quadriceps (front thigh muscles) and the hamstrings. Strengthening of the gluteus maximus (buttocks) and gastrocnemius (long calf muscle) is also important.
Psychological status
Gradually attempting more difficult agility tasks and setting realistic goals and timeframes, may help rebuild sporting confidence.
Sport-specific rehabilitation
Speed training is the most important part of hamstring rehabilitation. Gradually increase straight line (forward) running speed from 1/2 speed to 3/4 speed, then full pace. Add rapid accelerations and decelerations, changes of direction (cutting at 45 and 90 degrees) and jumping.
Backwards running should be introduced between jogging and speed training.
Reduce the risk of re-injury
Always seek the advice of a medical professional before returning to sport. Inadequate rehabilitation will increase the risk of re-injury. You can reduce re-injury by:
- performing a general body warm-up followed by a sport-specific warm-up.
- stretching after exercise
- including stretching and strengthening exercises as part of a normal training routine
- wearing a neoprene sleeve to support the hamstrings and keep them warm during activity.
Fatigue is a major contributing factor for hamstring strains. Maintaining high levels of cardiovascular fitness and muscular endurance can help to prevent premature fatigue.
If hamstring strains continue to occur or if pain is persistent, consult a medical professional for advice on other possible contributing factors.
Resources
For more information, see Hamstring strains (PDF 183K).
Last updated: 20 April 2009