MHSAA Health & Safety

Health & Safety Resources

HAMSTRING INJURIES

In order to understand hamstring injuries, it is important to be familiar with the muscle and how it works. The “Hamstring” muscle is actually a group of three muscles on the back of the thigh or upper leg. These muscles are the Biceps Femoris, Semimembranosus, and Semitendinosus. The three muscles all have a common attachment on the lower part of the pelvis at what is called the ischial tuberosity, and travel down the back of the leg to attach just below the knee.

Where these muscles attach is very important in understanding their function and how they are injured. The muscles cross two joints, the hip and knee. Therefore they have certain functions at both. They help flex (bend) the knee and extend the hip (bring the upper leg backward). However these are not the most important motions to consider when thinking about hamstring injuries. The hamstring muscles work best and are most active during 'Eccentric' muscle contraction. Eccentric contractions of the hamstring help slow down or decelerate movement at the hip and knee joints during activity.

You can think of an eccentric muscle contraction like the action of a bungee cord during bungee jumping. If you were to jump off a bridge with a bungee cord attached to you, the cord would pull you back up toward the bridge when you reach the bottom of your jump. But, during your fall toward the ground, the cord slows you down by using an upward pull while stretching toward the ground at the same time. This puts a great amount of tension on the cord. It is this type of eccentric force that most commonly injures the hamstrings.

The hamstring muscles are most commonly injured in running sports, especially those which involve lots of sprinting such as track and soccer. During the running gait they help to eccentricly slow down the bending (flexion) of the hip and straightening (extension) of the knee as you swing your leg forward for your next step. In this position the hamstrings can be injured because they are at the point of maximal stretch while at the same time contracting to slow down movement. These muscles are also very active during jumping activities like basketball and volleyball. They propel with great force during jumping and help to absorb shock eccentrically during the landing phase. But also remember this muscle group is very important during the use of your lower extremity overall and can be injured during any sport.

How do you recognize hamstring injury?

There are certain signs and symptoms associated with hamstring injury:

Sharp pain in the muscle
Tightness or spasm
Swelling (may be seen or felt)
A knot or lump in the back of the leg
Bruising
Inability to bend knee fully due to weakness or pain
Inability to straighten knee fully
Soreness or pain when stretched
Pain with walking

Treatment of hamstring injuries

It is very important to notice and treat hamstring injuries quickly to decrease loss of muscle function and flexibility. Several things can be done:

Have the athlete see your certified athletic trainer, if your school has one
Rest the injured leg
Ice - decreases pain, swelling, and spasm
Compression Wrap - for support
Crutches - may be needed if walking is difficult
Gentle range of motion/stretching - Must be done in pain free range in order to not cause more stress to the muscle.
Gentle strengthening of the leg muscles - exercises such as straight leg raises can be used to keep your leg muscles active while allowing the injury to heal.

As the injury becomes better your certified athletic trainer should be able to progress the athlete to specific strength and flexibility exercises designed to help improve the muscle function while it is still healing. And, if need be, they can refer the athlete to an orthopedic physician.

Prevention of Hamstring injuries

Prevention of Hamstring injuries involves several things:

Increasing flexibility - Lack of flexibility can force the hamstring to work at the limits of its motion, increasing its chance of being injured.
Increasing hamstring strength - Weak muscles are injured easier because they do not have the strength to move the body with the extreme forces required in athletic activity
Avoid Quad/Hamstring imbalance - The Quadriceps muscles perform opposite the hamstrings. They tend to be more powerful. If quads are too dominant relative to the hamstrings they may generate more force than the hamstrings are able to counteract.
Proper Warm-up - One of the most important things to do for the body in general is to prepare it for activity. Doing light aerobic activity and gentle dynamic stretches gets the body and hamstrings ready to accept the forces of sports activities.

These tips can help you understand how to deal with an athlete’s hamstring injuries. But for best results and fastest return to play, consult your certified athletic trainer or a sports medicine physician. If not handled correctly, this injury can hamper an athlete’s performance during an entire season. Your sports medicine professional is equipped with the knowledge and techniques necessary to speed your recovery from this common injury.

For more information on this topic or for priority appointments for sports injuries please contact Henry Ford Center for Athletic Medicine at 313 972-4216.

Henry Ford Health System’s Center for Athletic Medicine offers a comprehensive approach to sports medicine, including surgical and non-surgical care, sports rehabilitation, injury prevention, and performance enhancement programs. The HFHS treatment team includes sports medicine fellowship trained orthopedic surgeons, sports medicine fellowship trained primary care physicians, as well as certified athletic trainers and physical therapists. These health care professionals are supported by the HFHS nationally recognized bone and joint research facility, including the prestigious Herrick Davis Motion Analysis Lab. HFHS is proud to be health care providers to the Detroit area’s premier sports programs including professional, collegiate, and high school athletes.