How they happen The way in which you injure your hamstrings has been found to have a direct impact on the duration of rehabilitation you need. The most common way of injuring the hamstrings is during running/sprinting where the leg is elongated out in front of you with a bent hip and straight knee. The other main way to injure the hamstrings is with over-stretching, for example stretching to get the ball in a tackle, playing football.
Immediate management If you are unlucky enough to injure your hamstring, how are you best to manage it?
Your best immediate response is to RICE (Rest, Ice, Compression, & Elevation) in the first 72hours. Our sports injury advice blog explains this in more detail. You may have some difficulty walking & sitting on hard chairs/the loo, but this should resolve quickly with good management. Avoid anti-inflammatories as they have been shown to slow the healing process.
You can then move on to the extender exercise at 48hrs (as long as it is pain free)
Lie on your back with your hip at 90º, then straighten your knee to its comfortable range without holding a stretch, repeat this 12 times by 3 sets, once a day.
What about stretching? Recent research no longer supports the use of stretching in the early stages and now identifies that it is important to begin a specific eccentric strengthening routine to obtain full muscle fibre healing.
The following eccentric exercises can start at the 5th day after injury.
The diver: – standing on the injured leg with knee slightly bent, reach forwards in an attempt to bring the trunk and opposite leg horizontal. Keep your opposite leg in full extension. This exercise should be done once every other day, 6 reps x 3 sets. Start slowly initially until you can control this movement.
The slider: – start in a standing position with one hand holding on to a support. Put all your weight on the heel of the injured leg. Then slide backwards on the uninjured leg, stopping before your pain begins (using a sock on lino floors makes the sliding motion easier). Then return to standing by using your arms to help you up. This exercise should be done once every third day, 4 reps x 3 sets. Again start slowly and increase the speed as your ability to perform the exercise improves. All three exercises above should be completed within pain free range of movement.
Sport specific programs These exercises are an ideal start to your rehabilitation, followed by a specific program for your sport (which can be expertly designed by a team of excellent physio’s at ocean view physiotherapy).
Runners will be pleased to know you can make a return to an interval running as soon as a few days after injury, as long as it’s symptom free. Amazingly, running can feel more comfortable than walking at this point. Icing for 20 minutes afterwards in the early stages is encouraged to limit an inflammation.
How long will I be out for? Recovery times has been found to depend on how the hamstring was injured, with over stretching injuries taking approximately twice as long as sprinting injuries. In most cases you can be back to sport between 3 and 7 weeks.
Are you ready for training? Prior to returning to full training, the Askling H-Test can be performed to establish any feeling of insecurity in the hamstring. The test is completed by performing a high velocity straight leg lift whilst laying on your back. If any feeling of insecurity is felt then you should continue with your physio exercises and test again in 3 – 5 days.
Following thorough rehabilitation you should find that you once again have happy, healthy hammies!
If you need powerful hamstrings once again to prevent injury, give us a call, we will tailor a specific program to your sport & activity.
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