What is a torn Hamstring?
A hamstring strain occurs when muscles fibres in the back of your thigh become damaged or torn. This happens when the muscle is working beyond its flexibility and strength capabilities. It can happen in both acute situations and in those performing repetitive sports/activities overtime.
The muscle fibre can tear anywhere from just underneath your buttock to your mid-thigh or just above the back of your knee.
Grading of Hamstring tears:
Grade I: This is when less than 10% of fibres have been torn. Usually you will feel pain and a pulling sensation but you will still be able to walk and even run.
Grade II: This is when between 10-50% of the muscles fibres are torn. You will usually have to stop your activity due to pain and weakness and you may find it difficult to walk normally. Those with more severe GII injuries will only be able to walk on their heel and will have some bruising present.
Grade III: When more than 50% of the muscle fibres have been torn. More likely in those competing in elite or amateur sports that involve running and jumping. You will usually have major bruising and be unable to weight bare without support due to pain and weakness.
Signs & Symptoms of a Torn Hamstring
Sharp, sudden pain
Cramping
Painful walking and running
Bruising
Limping or weakness
Inability to sprint
Pain with sitting
If you are experiencing any of these signs book in to see a Physiotherapist.
Immediate management of a hamstring tear
The POLICE protocol:
Protection - avoiding aggravating activities
Optimal- pick only activities that promote healing - like exercises prescribed by your physio
Loading - perform low load exercises to maintain strength
Ice – ice area for 10 minute at time
Compression – to reduce swelling and bruising
Elevation – to reduce swelling
No HARM protocol - This means avoiding:
· Heat
· Alcohol
· Running/activity
· Massage
We also recommend to avoid using any anti-inflammatories for pain relief as this can increase bruising.
When should you see a Physio?
Immediately! Evidence show that commencing physiotherapy "early" as in "day 1" will reduce pain and improve healing time
Return to sport after a Hamstring Tear?
In General:
- Grade I hamstring Strain = 1-2 weeks
- Grade II hamstring Strain = 3-6 weeks
- Grade III hamstring = 6- 12 +weeks
What will recovery look like?
Goal 1: pain free walking
- Reduce pain by offloading the hamstring using tape or crutches.
- Gentle muscle activation
- Avoid Stretches
Goal 2: Restore Strength
- Double leg hamstring strengthening
- Progressing to eccentric and concentric movements
- Progressing to single leg hamstring strengthening adding
- Commence flexibility program
Goal 3: Return to pain free activities
- Progressive strengthening
- Flexibility program
- Commence plyometric exercises
- Return to training/specific sports related skills
Goal 4 : Prevent re-injury
- Maintenance of flexibility and strengthening programs
- Maintenance of plyometric exercises throughout pre-season- off season
- Education and correct management of training volume/load
These exercises are only examples and should be prescribed and performed under the guidance of a Physio.
Written by Brittany Taylor, Physiotherapist
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