Structure and Function:
- Three muscles
- Crosses two joints; they start above the hip and below the knee.
- Complex balance of concentric and eccentric actions.
- Greatest function is eccentric and very demanding; control.
- Acute hamstring injuries come from sprinting most often. People feel something rip – like carpet tearing.
- Check the spinal movements e.g. sciatica as hamstring pain can often be neurological rather than something genuinely wrong with the muscle.
- Grade 1 – microscopic damage; mild muscle pull or strain
- Grade 2 – majority of tears; partial muscle tears
- Grade 3 – one bit torn away from the other; complete muscle tear
- How much of the muscle is involved?
- Strength; will hurt them, assess strength and pain
- Stretch; also going to hurt, assess flexibility and pain
- MRI; looking for the size of the injury, not the size of the edema
- Rehabilitation – a lot more options available
- RICE – limit secondary muscle damage
- Strengthen – weights, open and closed chain; look what strength they have within a comfortable range.
- Return to function
- Low level of activity: knee flex and extend hip so leg raise. Hamstring and gluteals extend hip so need to strengthen glutes to prevent future hamstring injury.
- Build up to low resistance flexion with the rubber bands around ankles or hips and a post.
- Resisted weight machines as these are closed chain activities; it strengthens the muscle but it is not functional.
- Put the closed chains together, making it open chained, so squats, lunges, and dead lifts.
- Must be able to walk before they can run.
- Cycling – mainly concentric, low risk, protects cardiovascular fitness and gets muscle working.
- Cross trainer is a good progression from walking with reduced loading compared to running, but is a similar action.
- Walking then uphill or backwards then jogging.
- Acceleration/deceleration are very important in sports but likely to damage hamstring, so this must be put into rehab
- Can use GPS tracking to get a look at speeds etc
- The quicker you push an injured athlete and harder, more likely they will break
- Have to introduce sport specific skills e.g. spring to this cone then kick a ball
- If fibres heal shorter than others then they will take all the stress so need to make sure they’re flexing and lengthened