The hamstring muscles are a group of 3 muscles located at the back of your thigh called Biceps femoris, Semimembranosus and Semitendinosus. Biceps femoris is the largest of the hamstrings and the one that gets injured most often. All three muscles begin from a part of your pelvic bone called your ischial tuberosity (or sit bone as it is sometimes referred to) and attache to the upper part of the two long bones in your lower leg, the tibia and the fibula.
What do the Hamstrings do?
The hamstrings are a two joint muscle crossing both the hip and knee. They have two main actions: extending the hip (bringing the whole leg back) and bending the knee. This means that your hamstrings are active when you come up from a squat, get ready to kick a soccer ball, and even just while walking.
How can the Hamstrings get injured?
There are two commons ways that your hamstrings can be injured:
- High speed mechanism: This type of injury involves the simultaneous contraction (shortening) and lengthening of the hamstrings during running which occurs right before your foot strikes the ground.
- Slow speed mechanism: This type of injury involves extreme stretching of the hamstrings when your hip joint is flexed (bent up) and the knee joint is extended (straight).
What are the signs and symptoms of a Hamstring injury?
The following non-exhaustive list presents typical signs and symptoms of a hamstring injury:
- Pain in the back of your hips, thigh and/or knee
- Swelling and/or other signs of inflammation in the back of your hips, thigh and/or knee
- Stiffness/reduced range of motion at the hip and knee joint
- Weakness of the hamstring muscles
- Difficulty with walking or running
- Pain with sitting
- Audible “pop” during injury
What are the risk factors for Hamstrings injury?
- Risk factors you can modify: weak, fatigued or tight Hamstrings; thigh muscle strength imbalances; and poor core strength and control
- Risk factors you cannot change: previous Hamstring injury and age
How long does it take to heal?
Healing time depends on the mechanism, location, size, and severity of the Hamstring injury. It also varies widely from person to person. Your physical therapist or medical doctor can assess your injury and provide an estimated healing time with appropriate activity restrictions.
Return to play or work are based on the specific tasks and demands required of you. Your physical therapist can tailor your rehabilitation program to fit your work and/or sport.
The physiotherapy approach to rehabilitating Hamstring injuries
Your physiotherapist will take a thorough history and conduct a comprehensive physical exam before treating your injury. In some cases, physiotherapy may not be appropriate and you will be referred to the appropriate healthcare provider by your therapist. Physiotherapy is a client centered medical profession and incorporates your goals into the rehabilitation program. The ultimate goals of physical therapy are to return to your pre-injury level of function free of pain, and to minimize the risk of re-injury.
You and your therapist will decide on the treatment choices according to the specifics of your injury, current evidence based research, and your response to the treatments. Your therapist may offer some of the following treatments options:
- Thermal and electrical modalities (like hydrotherapy and EMS)
- Acupuncture or dry needling
- Soft or deep tissue mobilization and massage
- Joint mobilizations
- Graduated strengthening and flexibility exercises
- Gait re-training (the dynamics of how you walk)
- Sport or work specific physical training
Education regarding your injury such as your diagnosis, prognosis, self-care, and prevention of re-injury are always an important part of your care.
If you suspect you may have an injury or are looking to prevent an injury, come on in and we’ll take a look!
Written by: Binudith Warnakulasooriya, Masters of Physical Therapy Student
Edited by: Andrea Giacobbo BScPT, BA
Baheti, N. D., & Jamati, M. K. (2016). Physical therapy treatment of common orthopedic conditions. New Delhi: Jaypee Brothers Medical (P) Ltd.