We had a softball tournament this weekend and I finally started figuring this game out. I was learning the rules and placements and starting to do pretty well, until the last day when sprinting for first a felt a pop in my hamstring and that was that. I tore both my hamstrings in my Grade 12 year. I was doing competitive cheerleading and was really pushing my muscles to get flexible fast. The tear on the right hamstring (the one I pulled this weekend) had a huge black bruise running up it for about 9 months and I still have some weird bumps where the tears healed on it.
Anyhoo, our last game sucked because I am not a good hitter and have always relied on my sprinting to get me to first and trying to hobble to first base didn’t work out for me. And being as competitive as I am, I am PISSED! I do NOT like being slow at all. So I am doing everything I can to heal this fast and I thought I would share the information I learned with you. I have Grade 2.
Symptoms of a Pulled Hamstring:
- A sudden sharp pain at the back of the leg during exercise-most probably during sprinting or high velocity movements.
- Pain on stretching the muscle (straightening the knee whilst bending forwards).
- Pain on contracting the muscle against resistance.
- Swelling and bruising.
- If the rupture is severe a gap in the muscle may be felt.
- Click here for information on how a hamstring strain is assessed.
Severity of a Pulled Hamstring:
Strains are graded 1, 2 or 3 depending on severity. Grade 1 consists of minor tears within the muscle. A grade 2 is a partial tear in the muscle and grade 3 is a severe or complete rupture of the muscle.
Grade 1: What does it feel like?
- May have tightness in the posterior thigh.
- Probably able to walk normally however will be aware of some discomfort
- Minimal swelling.
- Lying on front and trying to bend the knee against resistance probably won’t produce much pain.
Grade 2: What does it feel like?
- Gait will be affected-limp may be present .
- May be associated with occasional sudden twinges of pain during activity.
- May notice swelling.
- Pressure increases pain.
- Flexing the knee against resistance causes pain.
- Might be unable to fully straighten the knee.
Grade 3: What does it feel like?
- Walking severely affected- may need walking aids such as crutches
- Severe pain- particularly during activity such as knee flexion.
- Noticeable swelling visible immediately.
Treatment of a Pulled Hamstring:
What can the athlete do?
It is vitally important that treatment for a pulled hamstring starts immediately following injury. The most important phase for treatment is the first 48 hours post-injury. In this time the following can be carried out by the athlete themselves:
- Use Cold Therapy (Rest, Ice, Compress, Elevate) technique
- Use a compression bandage to minimize intra muscular bleeding.
- Early mobilization of the injured lower limb is vital for the correctrehabilitation of the muscle. This includes stretching andstrengthening exercises throughout the pain free range. These can aid with decreasing the swelling in the area. In addition, exercise will ensure that any new material will be laid down in correct orientation thus reducing the risk of subsequent injuries.
- See a sports injury specialist.
What can a Sports Injury Specialist do?
- Use sports massage techniques to speed up recovery- these are extremely important in the rehabilitation of the injury as massage breaks down the new collagen network allowing for correct fibre realignment and minimizing scar tissue. In addition massage can increase the blood flow to the injured area. Visit our sports massagepage to learn specialized massage techniques for a pulled hamstring.
- Use ultrasound and electrical stimulation.
- Prescribe a rehabilitation program
- Advise on specific stretches
- Provide mobility aids such as crutches
- Provide an MRI scan to ascertain the amount of damage sustained
- In severe ruptures surgery may be needed to repair the damage
How is the Hamstring Strained?
During sprinting the hamstring muscles work extremely hard to decelerate the tibia (shin bone) as it swings out. It is in this phase just before the foot strikes the ground that the hamstrings, become injured as the muscles are maximally activated and are approaching their maximum length. A pulled hamstring rarely manifests as a result of contact -if you have taken an impact to the back of the leg it should be treated as a contusion until found to be otherwise.
Preventing a Pulled Hamstring:
One of the most important methods of preventing a pulled hamstring is to warm-up correctly- this has been scientifically proven to reduce the risk of hamstring strain. This should consist of some light aerobic exercise followed by stretching and sports specific drills with gradually increasing intensity.
Other factors which increase the likelihood of suffering a hamstring strain include:
- Age: The older the individual the greater at risk to a pulled hamstring.
- Previous Injury: Prior injuries to the hamstrings or adductor muscles can greatly increase the chance of future injury.
- Flexibility: Research suggests that the greater the flexibility of the hamstrings the less prone they are to injury.
- Hamstring strength: Similarly studies have shown that lack of hamstring strength is strongly linked to hamstring injury.
- Lumbosacral nerve impingement: Nerve impingement in L5-S1 can lead to associated hamstring muscle weakness.
- Tiredness and fitness: When a player is fatigued he/she loses coordination between certain muscle groups. The biceps femoris muscle is known to become damaged due its two portions being innervated by two separate nerves. In states of tiredness, lack of synchronization between these two nerves can lead to a mismatch in firing resulting in a pulled hamstring.
- Heating pad
- Chair / Stair Steps
The hamstring muscle is located at the back of the thigh. A pulled hamstring is really a torn muscle. Proper treatment depends on how severely you tore the muscle. Generally speaking, if you can still walk with mild to moderate discomfort it is a mild tear. If you are unable to walk, heard a “popping” noise or see a bruise in the back of the leg, seek medical advice.
Do not stretch or massage for 3 to 5 days. Use ice for no longer than 20 minutes 3 times a day for about 2 days. Afterward, you may switch to a heating pad for 20-30 minutes three times a day but not more. Allow the muscle some time to heal and knit together.
Once you are able to walk better and feel the area is on the mend then begin gentle stretching. It is best to stretch the calf (the back of the lower leg) first then proceed to the hamstring muscle. Why? Releasing the calf will take pressure off the knee allowing you to get better results when stretching the hamstring.
How to stretch safely and effectively. Place your leg on a chair or second step of a stair case. Keep your lower back straight and slowly lean forward until you feel a mild stretch in the hamstring muscle.
Don’t stretch more than 15 seconds. Stretching should not hurt. No pain no gain…does not apply here. Begin stretching until you feel a mild tension in the muscle then stop. You can gently contract the muscle without moving then relax the muscle and move forward a little more until you feel the natural tension build in the muscle. This “give and take” method fools the nervous system and allows the muscle to relax more. The last thing you want to do is tear the muscle as it is healing.
After one to two weeks (depending on the level of injury) it is safe to start massage. If you massage the area too quickly you can cause more bleeding and create a problem known as myositis ossificans traumatica. This is a condition where the muscle becomes calcified. It is not too common but why increase your chances by rubbing too vigorously on an injured muscle.
Do not return to high level activities too quickly. If treated properly a hamstring pull should heal within 3 weeks. If you don’t give the area enough time to heal you can tear it over and over, extending the treatment time.