Your hamstring muscles run along the back of the thigh, joining your pelvis and hip to your knee. They are a group of three muscles, used in walking, going upstairs, running, squatting and many other leg movements. Your hamstrings control bending the knee, extending and rotating the hip joint. They are particularly susceptible to strain and hamstring injuries are the most common of all sporting injuries.
Causes of hamstring injuries
Hamstring injuries are particularly common in sports that involve running fast, such as rugby and football, sprinting or basketball. Deep squats can cause hamstring injuries, including activities like weightlifting and skiing, and extreme stretching is also a common factor, so ballerinas and other dancers may be at risk. Injuries occur when the muscles become stretched or overloaded resulting in a pulled muscle. You may be particularly susceptible to injury if your hamstrings are weak, tired or have poor flexibility. If your quadricep muscles along the front of the thigh are stronger than the hamstring muscles this may also make you prone to injury. Hamstring injuries occur more frequently as we age or if we’ve previously injured the same muscle group. For this reason it is very important to ensure you are fully healed from a hamstring injury before returning to sport.
Symptoms of hamstring injuries
If you pull a hamstring muscle, you will feel a sudden, sharp pain at the back of your thigh which may be accompanied by a tearing or popping sensation. You may see an abnormal lump or indentation at the back of your thigh and/or bruising and swelling. The muscles may feel weak and it might be difficult to put any weight on the affected leg. Hamstring injuries can make it hard to straighten or bend your knee, which may force you to walk stiffly, keeping your legs straight. You may experience a burning or stinging sensation behind your thigh (gluteal sciatica).
Diagnosing hamstring injuries
If you are unable to put weight on the injured leg or walk more than a few steps without pain you will need to seek medical advice. Your doctor will carry out a physical examination, checking for swelling and tenderness in the back of the thigh. They may move your leg into different positions to ascertain which muscles are injured and whether there is also ligament or tendon damage.
Hamstring injuries are generally graded from one to three – mild to severe.
- A grade 1 injury means the muscles overstretch but don’t tear. With this type of injury you can normally put weight on your leg.
- A grade 2 injury is a partial tear of the muscle or muscles. Your leg may be very painful and swollen which may prevent you from putting weight on your leg.
- A grade 3 hamstring injury is when the muscles tears away from the tendon or bone altogether and a piece of bone may even be pulled away (avulsion). This is the most severe form of hamstring injury.
You may be referred for an ultrasound or MRI scan to check for tears in the muscle or tendon. If your doctor suspects an avulsion fracture you may also be given an X-ray or a CT scan.
Treating hamstring injuries
Most mild hamstring injuries can be treated effectively at home using the RICE method:
- Rest the affected leg to give it time to heal.
- Ice packs several times a day can help to reduce swelling and relieve pain.
- Compression bandages can also be used to minimise swelling.
- Elevating the affected leg above the level of the heart is another way to bring down swelling.
Painkillers can help to relieve the pain and, once the pain has lessened sufficiently, gentle stretching and strengthening exercises can help to rebuild strength in the hamstrings. A physiotherapist can recommend a short exercise routine. Most hamstring injuries heal with rest and physiotherapy. However, you may require surgery for the most severe injuries – for example, bone avulsion or those where the muscle has torn away from the bone or those involving several muscles tears.
Preventing hamstring injuries
To reduce your risk of developing a hamstring injury make sure you do a proper warm up prior to exercise, involving stretching and strengthening exercises. Build your fitness levels gradually rather than suddenly increasing the intensity or duration of your workout. If you feel tired or experience pain while exercising, stop. And if you start to experience ongoing pain in the back of your thigh, see your doctor.
If you have sustained a hamstring injury and would like to discuss the best approach to diagnosis and treatment or if you would like to learn more about preventing this and other sports-related injuries, contact us.
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