Injuries are commonplace in sport and in Gaelic football the hamstrings accounts for 32% of all muscle injuries. A hamstring strain or a pulled hamstring as it is sometimes called is a tear in one or more of the hamstrings muscles. There are various grades of hamstring injury and generally result in injury to one of the hamstring muscles which include the Semitendinosus, Semimembranosus and Biceps femoris. Hamstring strain can result from a number of risk factors which can work in tandem or in isolation. Age is a factor as the nerves which serve the hamstrings can be comprised as a player ages. The level of conditioning of the footballer is important as very often hamstring strains can occur late in a game or towards the end of a training session. The correct warm up procedures are essential with a gradual increase in the tempo and frequency of training. Flexibility and elasticity of the hamstrings, lower back and surrounding muscles is crucial as immobility can cause the muscle to be overextended and thus prone to strain or tear. Pelvic alignment, leg length, postural problems, lower back problems and the strength of various muscle groups also play a part. If you injure your hamstring you will feel a pinch or pop at the back of your leg, there may be pain when walking and stretching the muscle, it maybe bruised or partially discolored and if the rupture is severe you may feel a gap in the muscle. The next 48 hours are essential. Refrain from alcohol as this increases swelling and bleeding. Use cold therapy ice wraps or packs for 20 minutes and ice baths which help minimize swelling. Use a compression bandage to minimize swelling. Elevate the leg when sitting. Following this period there are a number of treatment techniques to speed up recovery which include deep tissue treatment allowing correct fibre alignment which also minimizes scaring to damage tissue. Ultrasound and electrotherapy can also be prescribed to aid the healing process. The rehabilitation program is dependant on the source of the problems and should address any underlying weakness or issue which maybe increasing the risk of re-injuring the muscle. Initial treatment should concentrate on regaining full flexibility, minimizing scar tissue formation, re-aligning damaged muscle fibers and gradually strengthening the muscle, back and core area. Core strength consists of training the lower abdominals, glutes and back muscles to ensure good pelvic control in mutli-directional sports. Such exercises as the plank, bridges, side plank and dynamic core strength training with exercise and medicine ball routines are common core strength training exercises.
Very often poor flexibility and mobility maybe responsible for initial strain so it is important to concentrate on regaining a full stretch in the muscle. Secondly it is important to work on mobility of the lower, back pelvis and hips during the rehabilitation program and this can be achieved by stretching the quads, hip flexors, adductors, glutes and lower back.
Gradually regaining a full muscle contraction is important and this should be achieved with mild to moderate and eventually heavy strengthening of the hamstrings. Mild strength exercises can be undertaken with thera-band and exercise band when lying, undertaking hamstring curls. This can be progressed to double leg bridges, single leg bridges, hamstring curls and bridges on the exercise ball. Following this the heavy strength work can be achieved in the gym with a leg curl machine while isokinetic eccentric strengthening on a biodex dynamometer is essential. Prior to the return to sport the hamstring should be 60% of the strength of the quadriceps. Rehab running sessions are also important and there should be a gradual increase in duration and intensity. In severe strains it is necessary to begin with a 10-15 min jog. A gradual introduction to change of direction work should be included and specific hamstring work such as ankle flicks and backwards running and striding should be introduced. You should return to sport and full sprinting following completion of a extensive treatment and rehabilitation period whereby you have undertaken a flexibility program, strengthened the hamstrings, undertaken a core strength program and undergone a rehab running program. Generally hamstring injuries can take between 2-12 weeks depending on their severity and remember correct treatment and rehabilitation programs are essential in preventing re-injury. Have a look at the services we provide at The SISM Clinic in Castlebar over at our website, and feel free to get in contact if you have any questions or wish to discuss your injury issues.
“Working with Martin has improved my strength, flexibility and mobility and relieved the persistent hamstring strains I was getting” Dara O Cinneide (Kerry All-Ireland winning captain 2004).