Hamstring Injuries

Running Injuries

Hamstring Injuries

 It happens most commonly is sports that require bursts of speed, power and agility eg rugby, football, tennis.

Located at he back of the thigh, the hamstrings are made up of three muscles- biceps femoris, semi membranous and semi tendonosis.
They come from your "sit bone" at the back of he pelvis and travel down the back of the thigh to insert just below the knee joint. As they pass over 2 joints this makes them more susceptible to injury.

How does the injury happen?
If the hamstrings are stretched beyond their limit this will cause an injury. This can happen suddenly due to a sudden movement or force applied to the hamstring or it can come on gradually causing a strain to the muscle. 

Risk Factors
1. Sudden changes in direction.
2. Slowing down suddenly or accelerating quickly.
3. Previous hamstring injury
4. Poor strength of core and gluts
5. Lower back issues
6. Imbalance between quadriceps and hamstrings.
7. Poor flexibility.
8. Increasing age of player.
9. Muscle fatigue- many injuries happen towards the end of a game.
10. Not warming up properly.

Types of Injuries.
Hamstring injuries are usually graded from 1- 3.

Grade 1 - mild strain
This is when there is over stretching of the muscle fibres. There is no tear.
Muscle will feel tender and may not present itself until after activity.
There is very little loss of strength and flexibility.
There will be minimal or no bruising
There will be pain on stretching or applying resistance to the hamstring contracting.
Mild pain when walking.

Grade 2 - Moderate strain
There is a partial tear to the muscle.
Pain is immediate and you will be unable to continue with your sport or activity. 
Area will be painful and very tender to the touch.
Flexibility and strength are markedly reduced.
There will be swelling and bruising - will appear over a couple of days.
It is difficult to straighten the knee.
Walking is affected - you will limp.

Grade 3 - Severe tear
Sudden severe sharp pain at the back of the thigh. You will be unable to play on.
Might be a "popping" sound at time of injury.
Area will be extremely tender,swollen and bruising will be extensive.
Major loss of movement and function.
You may be able to feel a lump of tissue above the depression where the tear is.

So what do you do when you injure your hamstring?

Immediate treatment
R.I.C.E. Protocol - rest , ice, compression and elevation. 
This will limit bleeding and swelling and prevent further injury and should be carried out for 48-72 hours after the injury.

Another protocol that should be followed for first few days is the "H.A.R.M. Protocol.
No heat
No alcohol
No running or exercise
No massage

After the R.I.C.E and H.A.R.M protocols physiotherapy and gentle exercises can be introduced to promote healing and get the injured area of the hamstring fully healed.
As pain settles and strength returns it is essential that you get a specific rehab programme for the sport you play.
At PhysioWorksNI your injury will be assessed and an appropriate treatment programme will be put together. To achieve full flexibility and strength a sport specific rehab programme will be developed by your physiotherapist to get you back to your sport in the expected time frame. 
We will also assess you with regard to specific risk factors to prevent re occurrence.

Rehab and Return to Play

Grade 1
To rest from sport for 1-3 weeks. 

Grade 2
Rest from sport for 4-8 weeks

Grade 3
3+ months and you may need surgery and rehab.


For all injuries, don't be tempted to return to sport too soon. Follow the above guidelines as there is a high risk of re injury.
It is essential that you achieve full strength and flexibility in your hamstrings before returning to your sport.

Physio Works

Posted by Physio Works

PhysioworksNI aims to help people lead healthier, fitter lives. The practice is all-encompassing with a team that supports a range of health needs including physio, pilates, yoga & podiatry. The team provides an all around service for customers.