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The Role of Hamstring Muscles
The hamstrings, located at the back of the thigh, consist of three muscles: the semitendinosus, semimembranosus, and biceps femoris. These muscles are essential for bending the knee and extending the hip—movements critical for activities like walking, running, squatting, lifting, and climbing. Due to the high demand placed on these muscles during physical activities, hamstring injuries are common, especially among athletes and active individuals.
How Physical Activity Affects the Hamstrings
Hamstring strains or tears often happen during high-speed activities that involve sudden stops, turns, or jumps. These injuries are more frequent in individuals who fail to warm up properly, have weak hamstrings or quadriceps, or have had previous injuries. The biceps femoris is the most commonly injured hamstring muscle, followed by the semimembranosus and semitendinosus.
Hamstring injuries can range from mild to severe and typically cause pain in the back of the thigh, especially when bending the knee or extending the hip. Recovery is often slow, with a high likelihood of recurrence—around 33% of people who suffer a hamstring injury reinjure it within a year.
Symptoms and Grading of Hamstring Injuries
Hamstring injuries are categorized into three grades based on severity:
Grade 1: Mild pain, no muscle tear, and minimal or no loss of function.
Grade 2: Partial muscle tear, significant pain, swelling, and reduced function.
Grade 3: Complete muscle tear, severe pain, swelling, and total loss of function.
Symptoms can include swelling, bruising, a burning sensation, or even sciatica-like pain. Clinicians will rule out other causes, such as referred pain from the lower back or hip, before diagnosing a hamstring injury.
Point Of Care Ultrasound
Combining diagnostic ultrasound with a physical examination in our practice allows us to develop an evidence-based treatment program that will relieve your symptoms and help you return to the activities you love.
An ultrasound scan will be able to give you the following information:
Which part of the tendon is injured
How severe the condition is and if there is inflammation present.
If there are any tears in the tendon.
If there are any other structures involved.
If you would like to book an appointment including an ultrasound scan, please ensure you inform us when booking.
Treating Hamstring Injuries: Evidence-Based Approaches
The primary goal of treating a hamstring injury is to restore function and minimize the risk of re-injury. Effective treatment includes physical therapy and rehabilitation programs tailored to the injury's severity. Two common approaches are:
Extracorporeal Shockwave Therapy (ESWT): This non-invasive treatment uses shockwaves to promote healing and reduce pain. It is especially beneficial for athletes, helping them recover faster and return to training with better muscle flexibility and strength.
Manual Therapy: Techniques like deep tissue massage and joint manipulation help reduce pain, improve blood flow, and restore mobility. This is particularly important in severe cases (Grade 3) where scar tissue can limit movement.
The MEAT Protocol for Acute Hamstring Injuries
In the early stages of a hamstring injury, the MEAT Protocol is often recommended for quicker recovery. MEAT stands for:
Movement: Controlled, gentle movement helps maintain circulation and prevents stiffness, promoting faster recovery.
Exercise: Light exercises that target the hamstring encourage healing by keeping the muscles active without overloading them.
Analgesics: Pain relief, such as over-the-counter medications, helps manage discomfort without relying too heavily on anti-inflammatories, which could interfere with the body’s natural healing process.
Treatment: Includes therapies like ESWT, manual therapy, and physical therapy to reduce pain and restore function.
The MEAT protocol contrasts with the more traditional RICE (Rest, Ice, Compression, Elevation) method by emphasizing early movement and rehabilitation rather than just rest, which can speed up recovery for athletes.
Preventing Future Hamstring Injuries
Preventative strategies focus on addressing the root causes of hamstring injuries, such as muscle weakness or lack of flexibility. Strengthening the hamstrings, particularly through eccentric training, can significantly reduce the risk of future injuries. Eccentric exercises, which lengthen the muscle under tension, are highly effective for building strength and flexibility.
Training twice a week for 20-30 weeks has shown to be particularly effective in reducing injury recurrence. In addition to eccentric exercises, neuromuscular control training helps improve the coordination and strength of muscles, which is key for reducing re-injury risk.
Takeaway
The hamstring muscles play a vital role in everyday movements like walking and running, but they are also prone to injury, especially during intense physical activity. Effective treatments for hamstring injuries include physical therapy, shockwave therapy, and the MEAT protocol, which promotes faster recovery through movement and rehabilitation.
Preventing hamstring injuries requires strengthening the muscles, improving flexibility, and following proper warm-up routines. Understanding the role of these muscles and incorporating preventive training strategies can help reduce the risk of injury and improve athletic performance.
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