Hamstring injuries are common in running sports such as Soccer, Rugby, Australian Rules Football, Gaelic Football and Athletics. Hamstring strains have been shown to be the single most common injury that occurs in the English Premier League (EPL), UEFA Champions League (UCL) and the Australian Football League (AFL). Hamstring injuries are also common in recreational athletes.
The hamstring muscle group is comprised of the semimembranosus muscle, semitendinosus muscle and the biceps femoris muscle, which is the most commonly injured. The hamstring muscles work to flex the knee joint and extend the hip during running and are most commonly over stressed while decelerating the thigh prior to the foot striking the ground when sprinting. This is often when a hamstring muscle injury occurs.
The first thing a person with a hamstring injury will ask a physiotherapist is ‘When can I return to sport?’ The question really should be ‘When can I safely return to sport without suffering a recurrence of my hamstring injury?’
Recurrence of hamstring injury has been reported to occur in 12-63% of athletes who suffer an initial hamstring injury. Most of these recurrences occur within the first month following return to sport, although the risk of recurrence remains higher for up to a year following a hamstring injury. Research has shown that supervised rehabilitation with an experienced physiotherapist can reduce the risk of re-injury following a hamstring injury.
In elite level athletes return to play has been reported between one week and eight weeks following hamstring injury, with the mid-range return to play reported at four weeks. Almost half of elite level athletes had returned to competition within three weeks. However, two thirds of those athletes who returned to play within 3 weeks suffered a recurrent hamstring injury within a week of being back.
There is an opportunity with a first time hamstring injury to rehabilitate the injury so that the tissue fully recovers and there is no increased risk of re-injury. A thorough understanding of muscle injury healing is essential, so that the tissue can be loaded appropriately during the rehabilitation. Based on research findings and clinical experience then only a small number of minor hamstring injuries can return to play before three weeks. Moderate level hamstring injuries are likely to take around four to six weeks before an athlete can safely return to competition.
As well as using treatments to facilitate tissue healing, your physiotherapist will also address issues related to dynamic flexibility, core stability, hip mobility and gluteal muscle activity to ensure that the hamstring muscle group is not being habitually over-stressed during functional activities which can lead to muscle damage during high speed running.
Better still, ensure that you have your dynamic flexibility, spinal stability, functional trunk muscle strength, gluteal muscle function and hip, knee and ankle mobility assessed and addressed by your physiotherapist to ensure optimal function and reduction of the risk of sustaining a hamstring injury in the first place.
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