Thursday 5 January 2012

This month I am going to talk about hamstring stains. This injury has made the news recently when Leicester Tigers RFC of the Aviva Premiership lost two of their stars – Manu Tuilagi and Louis Deacon both with hamstring strains during their win over Worcester on December 27th.



There have been many studies looking at the frequency of hamstring strains in sport. Studies have found that as a percentage hamstring injuries peak at 33% of lower limb injuries in 16-25 year olds and they most often occur in sports where the hamstrings can be stretched eccentrically at high speed (1, 2).  A study into injury rates found that out of 1614 individuals in Australia who suffered hamstring injuries it made up 54% of rugby injuries, 10% of football injuries and 14% of athletics injuries. But less than 2% of tennis, squash, ballet and gymnastics injuries (2).

Muscles of the posterior thigh
What is a Hamstring Strain?
It is actually a tear in one, or multiple hamstring muscles. The hamstring in made up 3 main muscles: Semitendinosis, Semimembranosis and Biceps Femoris. The role of the hamstring is to flex the knee and extend the hip.

Symptoms of a Hamstring injury
  •      Sudden, sharp pain at the back of the leg, during activity.
  •      Pain when stretching the muscle
  •    Pain when contracting against resistance
  •      Possible swelling and bruising
  •     If severe, a gap maybe present in the muscle which can be felt
  •   Bruising after a hamstring tear
Hamstring injuries are graded in severity, based on the damage. A Grade 1 tear would consist of a minor tear within the muscle. Grade 2 is a partial tear of the muscle and a grade 3 tear is a complete rupture of the muscle.

Treatment
At the time of injury:
Injured hamstring 2-3 days post injury
It is important to stop activity and apply the R.I.C.E principle of Rest, Ice, Compression and Elevation.

After 24-48 hours, it is important to see an injury specialist such as Sports Therapist or Physiotherapist who can correctly diagnose the injured muscles and begin a rehabilitation program. The treatment would include the use of Ultrasound, sports massage, progressive loading and stretching of the muscle as well as promoting early mobilisation of the limb.

References:
Clark RA. Hamstring injuries: risk assessment and injury prevention. Ann Acad Med Singapore. Apr 2008;37(4):341-6

Kujala UM, Orava S, Jarvinen M. Hamstring Injuries. Current trends in treatment and prevention. Sports Med. Jun 1997; 23(6): 397-404

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