 | Denny Gillard is Director of Physical Therapy at Girard Medical Center. Denny’s background is in manual therapy, sports medicine, orthopedics, neuro rehab, wound care, and work hardening. He has been a therapist for 13 years. Denny graduated from KU with my Masters in physical therapy, and is currently working on his Doctorate in Sports Medicine. |
Health & Wellness
2011-04-01 10:42:00
How to treat and prevent hamstring strains
Question: I am a runner and I have had multiple hamstring strains. What is the best course of action to prevent these from happening or at least reduce the occurrence?
Answer: Hamstring strains are a very common injury among runners, sprinters and jumpers. Healing time for this injury is very slow, symptoms are persistent and the rate for reinjury is very high. Because of this, the best way to prevent reoccurrences of these strains is to get a thorough evaluation by a physical therapist to discover the possible cause and develop a treatment that will treat and prevent further injury.
We don’t really know what causes the injury to the hamstring. One theory is that it is the way that muscle is physically arranged in our bodies. The hamstring is a 2-joint muscle and its job is to bend the knee and to assist in the straightening of the hip. The hamstring slows the extension of the knee when running and doing explosive movement of the leg. The hamstring is suppose to slow the leg down, but if the quad is a lot stronger than the hamstring, slowing it can put strain on the muscle. The thought is that this is where the injury can occur.
A Physical Therapist (PT) can recommend appropriate rehabilitation programs to avoid or reduce the rate of reoccurrence. There are 2 different approaches that exist for exercise guidelines. The most common approach utilizes static stretching and progressive resistive strengthening exercise. The other utilizes progressive agility like balance, plyometrics and abdominal strengthening exercises. Both have shown the same amount of time for an athlete to return to sport, but only progressive agility has shown promise to reduce the amount of reoccurrence of hamstring strains.
A PT can help the injured person regain proper motion and flexibility through monitored exercises such as biking and swimming, depending on the severity of the patient’s injury. Active range of motion and light strengthening will aid the injured person in regaining muscle strength. This early intervention will reduce adhesions that may form with the healing process.
The next phase of treatment will incorporate dynamic balance (like plyometics, bosu and swiss ball activities), stretching and strengthening exercises in the return to sport activities. This can occur anywhere within 3 weeks to 6 months after the injury, depending upon the severity. I have found that with good hamstring flexibility, and balance between the quad muscle and hamstring muscle strength of the injured leg, at discharge, has helped in lessening the reoccurrence of my patients’ hamstring strain.
You may also look at your running shoes and orthotics for your shoes. A good time to change shoes with long distance running is 3 months or every 300 miles. This may also be contributing to the reoccurring injury with your hamstring.
You should see a PT as soon as possible after injury; however, there are some immediate rehab practices to alleviate some of the pain until you can get in to the office. Begin with the RICE principle (rest, ice, compression and elevation and gentle massage), for the first 72 hrs after the injury. This will allow the reduction of swelling in the muscle and allow it to heal faster.
