If you are one of the many Edmontonians who enjoys an active lifestyle but you think you may have “pulled a hammy” as the saying goes, read on to find out more about hamstring injuries and how to deal with them so you can get back to doing what you love.

The hamstrings

The hamstrings are a large group of 3 muscles which share a common tendon and make up the bulk of the muscle in back of thigh. Three muscles are a part of the hamstrings: semimembranosus, semitendinosus and biceps femoris. These muscles arise off your ischial tuberosities (sit bones) and cross the back of your knee to insert on the bones of your lower leg.  The hamstring are responsible for extending  the hip backward and for bending the knee and as such play a pivotal role in running, walking and jumping.  The hamstrings are also in close proximity to the sciatic nerve, sitting just on top of it

Hamstring injury/hamstring tendon injury

Injuries to the hamstring are relatively common in certain people, namely those play tennis, football, soccer or basketball, or those who participate in dance or running and track events that require rapid bursts of speed. The most common type of hamstring injury is strain, tear or “pulled muscle.” Strains can impact the mid-muscle belly or the tendon of the muscle (tendonopathy). Usually strains occur when the muscle is overloaded and has to lengthen as it contracts – for example when running your hamstrings have to contract while simultaneously lengthening with your stride.

While hamstring injuries can happen to anyone there are some things which may make people more prone to injury including:

• Exercising or playing sports with fatigued muscles/inadequate rest periods
• Exercising with tight muscles/inadequate stretching
• Poor conditioning and muscular weakness
• Systemic muscle imbalances 
• Being an adolescent –because bones elongate faster than muscles, sometimes forces to muscles in growing teens make them vulnerable to tearing.

Seeing a physiotherapist, chiropractor, athletic therapist, kinesiologist or personal trainer may be helpful to identify and address early risk factors to better prevent some hamstring injuries.

What are hamstring injury symptoms?

• You may feel sudden pain or a popping or snapping feeling in your leg (but you may not experience instant pain and may develop discomfort over time)
• The site of injury may be tender to touch and you may notice bruising or swelling in the injured area
• You may have pain or limp when walking or running
• Your hamstrings may feel very tight or stiff

If you believe that you have injured your hamstrings see your medical doctor, chiropractor or physiotherapist as soon as possible. They will assess your injuries and if necessary refer you for imaging like ultrasound, electromyography, x-ray or MRI. They will also help to create a plan of management to get you feeling better sooner.

Hamstring injury treatment

If you have been injured you may be wondering how to recover from a hamstring injury or how to treat a hamstring injury. Hamstring injuries are usually graded on a scale from mild (grade 1) to severe (grade 3) and the grade of the injury typically determines the level of care you need and how long it will take you[h2]  to heal.

The good news is that many minor hamstring injuries will heal at home with little intervention needed. In the case of a minor injury, reducing aggravating activities and increasing rest periods, using ice and consulting with your pharmacist about appropriate pain relief medications, is usually enough.  Minor injuries usually heal in days to weeks.

If you have a more severe injury, treatment by a physiotherapist, chiropractor, massage therapist or a team of individuals may be necessary. More severe hamstring injuries can take weeks to months to heal. Some clinical treatments for hamstring injuries include:

• Guided stretching and targeted strengthening exercises
• Contrast therapy
• Ultrasound
• Soft-tissue therapy/massage/myofascial release
• Shockwave therapy – particularly good for treating hamstring tendonopathy and tends to reduce healing time and facilitate greater functional gains when used in conjunction with rehab exercise[h3]  and stretching. Is also minimally invasive and relatively low risk.

In cases of severe injury and in cases of avulsion (where the tendon rips away from the bone) your practitioner will refer you to an orthopedic specialist to discuss surgical repairs. After surgery, generally patients require weeks or months of physiotherapy to recover fully. 

Hamstring injury rehab

Rehab for a hamstring injury can take days to months depending on the severity of your injury. Rehab is directed at helping the injured area to heal as well as addressing underlying factors that led to the initial injury; typically this means correcting muscle imbalances and strength or flexibility deficits.  Rehab plans can be created and overseen by a physiotherapist, chiropractor, kinesiologist or athletic therapist and usually require patients to perform some “homework” as well.

Where do I get treatment for a hamstring injury in Edmonton?

The Unpain Clinic of course (we might be a little biased). We have a multidisciplinary team to meet your treatment needs and we offer both shockwave therapy and flashwave therapy to help enhance your healing. 

FAQs

How do I know if I have hamstring pain or sciatica ?

Hamstring strain	Sciatica
Usually linked to some clear mechanism of injury May have some weakness in the leg but generally have no neurological symptoms Usually felt more in the center of the posterior thighPain is generally localized to the region of the hamstrings More common in athletes and weekend warriors	May have a mechanism of injury (usually involving the back) or come on over time May be accompanied by neurological symptoms like altered reflexes, sensation or strengthUsually felt more in the lateral part of the posterior thigh Pain may radiate to the back, gluteal muscles, calves or feet

What are some hamstring injury exercises ?

Prone hip extension

• Lay on the floor or your bed face down in a comfortable position
• Keeping the knee straight, slowly raise one leg as high as is comfortable
• Lower the leg all the way in a controlled manner and repeat
• You can perform 10-20 reps of this exercise per leg
• As you get stronger you can add resistance tubing to this exercise to make it harder

Prone knee bends

• Lay on the floor or your bed face down in a comfortable position
• Slowly bend your knee as far as you can and then return it to the start position
• You can perform 10-20 reps of this exercise per leg
• As you get stronger you can add resistance tubing to this exercise to make it harder

Eccentric hamstring curl with tubing

• Anchor your tubing to a secure place in front of where you will be standing
• Attach the other end of the tubing around your foot or ankle
• Stand with good posture and use something for support (chair, counter, etc)
• Lift your heel up towards your buttocks as far as you can, bending your knee
• Very slowly lower your heel to the floor as your straighten your knee to end range
• Repeat 10-20 times per leg

Hamstring stretch on wall

• Lay on the floor in a doorway and raise your affected leg until it rests on the wall
• Move your body through the doorway until you feel a comfortable stretch in your hamstrings
• Hold for up to a minute and then stretch the other leg. You can repeat this 1-2 times more if desired.

Lunges

• Stand tall then lunge forward with one leg and then return back to standing
• Repeat with both legs. Try to perform 10-20 repetitions of this exercise per leg.

Chair bridge

• Start with feet up on chair or box, arms flat on the floor for support
• Keep knees slightly bent and then lift hips off the floor into a bridge position

Standing calf stretch

• Stand in front of a wall with one leg forward and one leg back
• Keep your back leg straight and don’t lift your heel
• Lean forward by bending your front knee until you feel a stretch in your back calf
• Hold for up to 1 minute per leg. You can repeat this 1-2 more times if desired
• Make sure you stretch both legs