Hamstring

An injury to the hamstring muscle at the back of the thigh, is the most frequently seen muscle injury in the body. It is commonly seen in rugby players, runners, sprinters and soccer players.

More than 40% of all muscle strains in rugby are due to hamstring strains.

Anatomy

The Hamstring consists of 3 muscles; semimembranous, semitendonosis and biceps femoris and their primary function is to extend the hip and flex the knee. Deep within the hamstring muscle lies the sciatic nerve, which runs the length of the hamstrings from the buttock to the knee.

Predisposing Factors

Some of the factors contributing towards Hamstring Strains are:

Mechanism of Injury

Hamstring strains are mainly related to the eccentric phase of the muscle action i.e. when the muscles are working as they lengthen. A typical example would be a player who has not warmed up properly, is not fit enough or is tired at the end of a practice or game. He is sprinting down the field and as his foot touches the ground, he suddenly experiences pain of such intensity at the back of the thigh that is causes him to stop sprinting.

Treatment of Acute Injury

The primary treatment objectives are to:

Further treatment objectives should include to:

The so called RICE technique is the treatment of Choice in the Acute phase.

  • Rest immediately stop running
  • Ice apply ice every 2 hours for a minimum period of 20 – 30 mins in the first 72 hours of the injury
  • Compression by using Elastoplast 75mm, Elastocrepe one can achieve the compression desired, as well as keeping the ice in position for the 20mins.
  • Elevation of leg by lying player down on his back and lifting up the affected leg
    •

    Further treatment would include treatment by the physiotherapist and the biokineticist to ensure the final stage of rehabilitation to obtain a correct hamstrings/quadriceps ratio to return to rugby with no ill effects.

    Chronic Hamstring Injury

    An injury to a hamstring becomes chronic when the treatment of the acute phase has been inadequate or incorrect and as a result the healing process has resulted in too much scar formation.

    When this happens to the hamstrings, the Sciatic nerve is often affected. If the blood and tissue fluid reach the sciatic area, they will cause an irritation to the outer layer of the nerve. The nerve may even stick to the surrounding hamstring tissue.. Scar tissue is harder and less elastic than muscle tissue and as it heals it shrinks. The player with a chronic hamstring problem will explain that the muscle feels tight and even though he is continually stretching it, it still remains tight. Obviously the player will experience pain in the hamstring area and if the problem is allowed to persist, he may develop pain in other areas, such as his calf, lower back and or buttocks.

    How Can One Cure This Problem?

    Physiotherapists trained in the diagnosis and treatment of neural (nerve) syndromes will be able to help players with this problem. The aim of the treatment is to move and gently stretch the injured nerve in order to allow it to move freely through the hamstring muscles. To achieve this, the physiotherapist will use mobilization and exercises techniques as well as other physiotherapy modalities. Cold will aggravate the condition and it is imperative that the thigh area be kept warm when the player returns to practice.

    Finally, on returning to rugby, the player must warm-up correctly. Research has shown that a lack of flexibility may lead to muscle injuries. The player’s stretching regime is of utmost importance and must include stretching exercises for the back, buttocks, hamstrings and calves. There are a number of exercises which are used by rugby players which are in actual fact potentially harmful. A physiotherapist, biokineticist or fitness advisor will assist the player by giving him the correct, safe exercises.

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