Hamstrung?

Hamstring injuries are common injuries in sports, especially among runners. When I think of a hamstring injury I think of the American 400 m legend Michael Johnson racing against Donovan Bailey in that wacky 150 m made-for-TV race at the then-named Sky Dome. Halfway through the race with Bailey pulling away, Johnson clutches one of his hamstring muscles and doesn’t finish the race.

The hamstring muscles run down the back of the leg from the pelvis to the knee. The hamstring muscle is actually comprised of three muscles - the biceps femoris, the semitendinosus and the semimembranosus. The “typical” injury is recognized by a sudden, sharp pain in the back of the upper leg. If you have had this injury you know it may stop you in mid-stride due to the intense pain. A hamstring injury can vary from a minor strain to a complete rupture (i.e. Grade 1, 2 or 3). After this type of injury, the knee may not extend (i.e. straighten) more than 30-40 degrees short of a straight knee without intense pain.

Common causes of a hamstring injury include: too much/too intense exercise too soon, poor flexibility, and poor muscle strength, imbalance between quadricep/hamstring strength/flexibility, fatigue and improper warm-up.

Treatment may depend on severity and availability of therapy. Generally the following tips are suggested for most muscle strains:

¬ PRICE – Prevent pain range of motion, Rest, Ice, Compression, and Elevation.

An anti-inflammatory may be helpful early after the injury.

® A stretching program begun soon after the pain, bruising, and swelling subsides.

¯ A strengthening program to rebuild and balance strength.

° Therapy in the first few weeks immediately after injury such as electrical muscle stim, ultrasound, Active Release Technique ® (ART) (to break up adhesions/scar tissue), PNF stretching, pelvic mobilization/manipulation when appropriate will accelerate recovery and reduce re-injury risk.

± Seek a health-care provider knowledgeable in current musculoskeletal care or one willing to refer.

Prevention is the key to a successful season. Warm up and cool down thoroughly is strongly suggested. Other ways to minimize injury risk include avoid too much/too aggressive workouts too soon, avoid drastic increases in intensity/duration (i.e. 10 percent rule) and get proper rest, nutrition and therapy.

Remembering these key points will help to ensure a successful, injury-free season! Good luck.

Dr. Erin A. White