Hamstring Injuries – A Pain In The Butt

How to “kick” this injury for good!

Author: James Cleal (Physiotherapist (APAM, BPhysio, Level 2 Sports Therapist)

Most runners, sprinters and kicking sport athletes have had a hamstring issue or two.

Some near the butt, some in the muscle, others near the knee, however one thing remains consistent - the pain and frustration for the sports person trying to return to their chosen athletic pursuit, it’s a pain!

The hamstring is a wonderful muscle designed to do many things.

Humans have evolved and are built to run – long, slow, distance.

African hunters have made this a way of life with some tribes continuing to literally “run” their prey to exhaustion.

However what we aren’t built to do is sprint, kick and be knocked off balance at the same time (eg playing sport).

 

Can the hamstring adapt?

When trained well with specific attention to training load, volume and recovery, the Hamstring will develop in strength and its ability to resist fatigue and stretching under load, called “eccentric loading”.

It is this eccentric loading in particular that is most problematic for injury due to the need for the hamstring to act as a spring and a braking force during sprinting and kicking.

More often than not, we see people presenting with new injuries, aches and pains as the result of increasing their training, starting a new sport or activity, or returning to training following a period of rest (holidays spent laying on the beach in particular) – Summer holidays anyone?

We are approaching the common pre-season commencement for many winter sports (AFL, Rugby, Football) involving, kicking, running and sprinting, and nearly all of these pre-season training camps involve rapid increases in running and kicking designed to get fit for the season.

Very few – particularly at the amateur level – pay any attention to strengthening and injury prevention.

 

Hamstring injury prevention

The time to start that is now – before you commence pre-season training with the team and these exercises should continue throughout the season to keep your muscle fit and strong.

Maybe incorporate them into your warm up or cool down sessions as well – You do warm up and cool down right? (No, a beer after the game and an ice pack at home does not count)

Try these out and see how you go:

  • Bridge with foot walk out
  • Lay on your back, knees bent.
  • Push through your feet to raise your hips up
  • Keeping your hips up, slowly walk your feet away from you in small increments.
  • Go as far as you can keeping hips off the ground.
  • Slowly walk your feet back in (1 rep)
  • Nordic Hamstring Curl (Grab a partner and do this together)
  • Partner holds your feet in a kneeling position.
  • Using your hamstrings, fall forward and control it and lower as far as possible (1).
  • Eventually your hamstrings will not be strong enough and you will fall completely, catch yourself into a pushup type position (2).
  • Return to start position and try again for 5 repetitions. As you get stronger you will be able to control and lower further before fatigue and collapse.

 

Advanced hamstring strengthening

Without over simplifying it, the Hamstring needs to be strengthened to cope with loading in a lengthened position and there are many wonderful and challenging exercises that your Physiotherapist can recommend.

One of the simple ways to avoid injury is for you to gradually increase your running distance and speed intervals without overdoing it.

Waiting till pre-season will mean you rapidly increase your volume and sprinting repetition thus the best time to start is now, by going for a few longer, slower runs before introducing some faster, shorter intervals before pre-season gets into full swing.

 

Summary

Due to the complex nature of the muscle, injuries to the Hamstring can be very different for each person.

It always pays to see your Physiotherapist as soon as you get any niggle, to address the issue before it becomes a full blown injury.

Interestingly, nearly 1 in 5 (20%) of Hamstring injuries show no changes on MRI investigation and nearly all respond to an appropriate load and strengthening program.

So before you race off to your GP for some pills and a scan, save your money and see a Physiotherapist instead.

If you need a Physiotherapist – Come and see the team at Terrace Physio Plus (we’re at 5 different locations 6 days a week!)