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Hamstring Injury

Overview

Hamstrings are a group of muscles ( semimembranosus, semitendinosus, and biceps femoris) present in the back of your thigh region. An injury to these muscles during physical activity is known as a hamstring injury. It is more common among sports players. Sports that involve sprinting at high speed with sudden pauses, such as football, basketball, soccer, tennis, etc., can put you at risk. It can also occur among people of other professions that involve intense physical activity. Mild to moderate injuries can be treated by rest, icing, and compression. In a severe hamstring injury, surgical options may be considered to repair the damaged muscle. 

Causes

Hamstrings are an important set of muscles in your leg. They run behind the thigh, and their purpose is to bend and stretch the knee. These muscles are used to run, climb, lunge, sprint, jump and stretch your legs. One of the most common reasons for a hamstring injury is overstretching the muscle. It is common among sports players. Sports such as football, basketball, soccer, etc., involve sprinting across a large field. During these games, the players also have to pause and start rerunning multiple times. This can pull your hamstrings beyond the limit in some scenarios, resulting in a tear or injury.

 

Beginning an intense physical activity without warming up your leg muscles is another cause. A hamstring injury can also result from a direct blow to the muscle. Insufficient pre-conditioning program before participating in an activity can be another reason. High-intensity workouts can also fatigue your muscles and make them weak. Dehydration and electrolyte imbalance can contribute to the weakness of muscles. 

Risk Factors And Epidemiology

Participation in high-intensity sports activities such as football or basketball is one of the major risk factors. Dancers and other athletes can also develop this injury. If you had a previous hamstring injury, you are at a higher risk of developing another one. This is common among players who resume their activities before the injury has time to heal. Muscle strength and flexibility are also important factors. People who have weak muscles or are not trained enough may not be able to withstand the force of intense physical activities. 

Signs And Symptoms

The symptoms of a hamstring injury depend on the grade of injury. There are three grades of a hamstring injury.

Grade 1 injury presents with strain. There is a sharp pain in the back of your thigh that radiates. You will still be able to move your leg, but it can become difficult because of pain.

Grade 2 injury presents with a partial tear in the hamstring muscle. In this case, the pain is even worse than in grade 1. You will experience swelling, bruising, and loss of strength on the affected side.

Grade 3 injury is the worst form of a hamstring injury. There is a complete tear of the hamstring muscle. It presents with stabbing, intractable pain that completely limits movement. There may be a slight depression at the site of the tear. If a partial or complete tear occurs, you may hear a popping sound when it happens.  

Diagnosis

The diagnosis of hamstring injury is usually made based on symptoms. Your doctor will examine your leg to look for possible signs of damage such as swelling, bruising, tenderness, etc. The range of movement is also noticed along with pain intensity. In some cases, a small fragment of bone may fracture when the tendon pulls tightly. X-rays can be used to determine the site and extent of such fractures. In case of severe injury, ultrasound or MRI can be used to visualize the extent of muscle damage. 

Differential Diagnosis

In majority of the cases, it is easy to diagnose hamstring injury based on the history of intense physical activity and presenting symptoms. However, in some cases, symptoms may resemble a few other diseases such as adductor strain, piriformis syndrome, avulsion injury, sciatica, hamstring tendinitis, or ischial bursitis. Differentiation can be done on the basis of diagnostic imaging tests. 

Treatment

The initial treatment measure is the same for all muscle injuries. RICE protocol is followed, which stands for Rest, Ice, Compression, and Elevation. The purpose of this treatment is to reduce swelling and improve the strength of muscle tissues. Rest is a basic factor that is often ignored by competitive sports players. Following the initial treatment protocol is essential because the injury may worsen otherwise. Ice should never be applied directly. Instead, an ice pack is the preferred option. Grade 3 injuries are repaired by surgery. Once the initial symptoms have been reduced, it will still take a few weeks or months to recover, depending on the extent of the injury. Physiotherapy is suggested afterward to restore normal movement.

Medications are only prescribed to reduce pain. Over-the-counter medications such as acetaminophen, aspirin, ibuprofen, etc., can be taken to reduce pain and inflammation. 

Prognosis

Grade 1 injuries take almost 3 weeks to heal, while grade 2 injuries require 4 to 6 weeks to heal completely. Grade 3 injuries are more severe, so that can take up to 3 months to completely restore structure and function. Rest is recommended, and it is suggested to use clutches in the healing period to avoid putting excess strain on your muscles. 

Prevention

It is better to warm up your body before beginning any intense routine. If you are about to go for a run, do a warm-up for 10 minutes and stretch out your legs. This is also recommended before any sporting event, dance, or gym workout. Hydrate yourself well and maintain a balanced diet to avoid the risk of muscle damage.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 07, 2023.

 

References

https://orthoinfo.aaos.org/en/diseases--conditions/hamstring-muscle-injuries

https://www.nhs.uk/conditions/hamstring-injury/

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