Hamstring injuries are very common in sports such as soccer, AFL and cricket, accounting for 11-16% of all injuries. Risk factors include speed training, insufficient warm up, age greater than 25, a previous hamstring injury and strength imbalances between the hamstrings and quadriceps.
There are two types of hamstring injuries:
- High speed injuries: these occur during rapid lengthening of the hamstrings, for example in sprinters
- Slow speed stretching injuries: these occur due to the hamstring being overstretched during a movement. For example, new dancers who attempt to perform the splits or raise their leg above their head
High speed injuries are painful and debilitating initially but tend to settle quicker. Whilst slow speed stretching injuries are less painful initially but take longer to recover.
Hamstring strains can be classified into three grades:
- Grade 1: no or minor tearing
- Grade 2: partial tearing
- Grade 3: complete tear
Phase 1: Pain Management
- Support and Protect: with the use of taping or bracing
- Rest: this does not mean ceasing all activity, rather it means to limit vigorous physical activity
- Ice: apply ice for 20-minute intervals every 2-3 hours
- Compression: using a tubi grip or compressive taping
- Elevation: raising and resting your hamstring above the level of your heart
- Movement: gradual and early movement helps to shift swelling, promote healing and avoid stiffening of the knee and hip joints.
- Medication: if required seek advice from your pharmacist or GP in regard to pain medication
- Gentle exercises
- Stationary cycling
- Proprioception/balance exercises
- Heel digs (isometrics)
Phase 2: Gradual Exercise Loading
- Pain free walking
- 2x daily 1.5-1.5kms
- Unloaded cardio: cycling, swimming
- Hamstring specific exercises. There are 3 levels, beginning with basic exercises at level 1, building up and increasing to the more advanced exercises in level 3. Please see the basic hamstring exercises below to get your rehab started.
- Level 1a
- Double leg squats 3×15
- Heel digs progressed 3×12
- Level 1b (progression)
- Double leg bridges 3×12
- Active range of motion 3×8
- Single leg squat 2×10
- Level 1a
We are often asked when you can return to running. A good indicator is if you are able to walk up a flight of stairs pain free. If you can then you are likely able to begin light jogging and a gradual return to running.
Phase 3: Return to Sport
Phase 3 focuses on return to sport with sport specific exercises.
Phase 4: Maintenance
As mentioned previously, a risk factor for hamstrings strains is a previous hamstring strain! Therefore, phase 4 is based on maintenance of hamstring length and strength to avoid recurrence of the injury.
If you have a suspected hamstring strain please see your physiotherapist for a thorough assessment and treatment, as well as a more tailored exercise program. We are more than happy to help! Click here to see our availabilities.