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Do you have problems with hamstrings?

What it is:

The common name for the large muscles on the back side of the thigh is hamstrings. The function of this muscle, which actually consists of several muscles, is to stretch (extend) the hip and to bend the knee.  This is a key muscle group involved in running and jumping, and has an important function in stabilisation of the knee joint. Hamstrings are frequently subject to strain injuries, due to a variety of reasons. Hamstring injuries may originate from many small ruptures in the muscles at thebackside of the thigh, and can also occur due to insufficient stability around the hips, pelvis and/or the lumbar.

Hamstring injuries are common in sports that require high speed running and quick accelerations – “explosive” sports like short distance sprint and football. However, also many runners who have been running for years, and those performing hard intervals and hill runs, are subject to this injury.

We divide hamstring injuries into 3 grades of seriousity:

    • Grade 1: a mild strain involving just a few fibres – likely to recover in a few days.
    • Grade 2: a moderate strain, involving enough fibres to significantly reduce the strength of the muscle.
    • Grade 3: a complete muscle tear – may take weeks or months to heal.

Symptoms:

  • Pain in the hamstrings during activity, in particular when running at high speed or when jumping.
  • Internal bleeding in the backside of the thigh.

The typical hamstrings injury occurs in the phase of the running stride when the knee is bent, the foot hits the ground and at the point when you are pushing to accelerate. In this phase the muscle must develop maximum power both over the knee and the hip, and it is this force that may be too big. The risk of damage is higher the more tired the muscle is. As soon as the injury occurs, it will be painful.

Caused by:

Hamstrings injuries typically occur due to two obvious mechanisms. The most normal mechanism is the sudden overload during high speed running. The other mechanism is a substantial stretch of the muscles, which often happens to dancers and gymnasts who have extreme ranges of motion.

Insufficient training basis, being exhausted and insufficent warming up are important dispositional factors, meaning that they increase the risk of hamstrings injuries.

Treatment and recovery:

Correct treatment in the acute, urgent phase is crucial to limit the extent of the damage. This means immobilisation, cooling down of tissue, compressing bandage and raising the thigh to a high level. Some medicines may be taken to limit the inflammatory reaction, however there are disagreements on the effects of this. Some claim that medicines may influence the healing of soft tissue injuries in a negative way. It is recommended to apply an elastic bandage around the thigh as long as there is a swelling of the tissue.

Rupture injuries requires a thorough recovery, since hamstring injuries have a tendency of returning after a while. This may lead to influence on minor nerve paths from the sciatica nerve, which may be painful for those affected. Previous damages is the most important dispostional factor, in particular if the recovery was insufficient.

For some it will be useful to contact a physiotherapist with specific competence within hamstrings recovery.

Despite the complex picture described above, the prognosis for recovery from hamstrings injuries is rather good, in particular if correct treatment has been given from the beginning, and if the recovery training has been performed with patience and correct progression. Preventive exercises are important, particularly if you had a previous hamstrings injury.

Prevention:

The “nordic hamstrings” exercise has proven to be a very efficient general exercise to prevent injuries in hamstrings.

Nordic hamstrings exercise

Some research have indicated that deadlift og kettlebell swing are good exercises to prevent injuries in the muscle semimembranosus, while the exercise catslide backside thighs and extension exercises for the hip are good to prevent injuries to the muscle biceps femoris. Other good exercises are:

  • catslide back
  • sideways plank with movement
  • strong groin exercise
  • hamstrings exercise
  • foam roll exercise

See videos below. The  strong groin exercise is primarily for strengthening the inside of the thigh, but it is also very effective for combining strength of the inside with stability of the pelvis and hip.

Videos:







Anatomy of the thigh

See a detailed description and 3D pictures of the thigh anatomy at these pages from TeachMe Anatomy.info:

3D pictures (at teachmeanatomy.info):

See more about running injuries, preventive exercises and videos here:

Author: Hege Erichsen

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