Being an avid football fan, I have been around some of them for years, and there are many injuries that they sustain but in most instances don’t pay much attention to. A common injury is the hamstring. As one footballer who was recently injured confessed, “it happened while I was playing a game. I reached a bit late and missed part of the trainer’s warm up session. Being a star player, I was part of the starting eleven and within 20 minutes into the match, I ran backwards for a few metres and it popped. Falling to the ground in pain I had to be carried off the field on a stretcher. It wasn’t the first incident I had with this same injury, and I realised that I neededto treat with it properly this time around.”
What are the hamstrings?
The hamstrings are the tendons that attach the large muscles at the back of the thigh to the bones. The hamstring muscles are the large muscles that pull on these tendons. It has become common to refer to the long muscles at the back of the thigh as the “hamstrings” or “hamstring muscles”, the medical terms are the posterior thigh muscles and the biceps femoris muscles. These muscles span the thigh, crossing both the hip and the knee. They begin just below the buttocks, arising from the bone on which we sit. They connect by means of their tendons onto the upper parts of the lower leg bones (the tibia and the fibula).
You may be more likely to get a hamstring injury if you play football, basketball, tennis, are a track and field athlete, or any similar sport that involves sprinting with sudden stops and starts. A hamstring injury can also occur in dancers
Signs and symptoms of a hamstring injury include:
- A sudden, sharp pain in the back of your thigh during an activity
- A popping or tearing sensation in the muscle
- Swelling and tenderness within a few hours of the injury
- Bruising or discolouration along the back of your leg
- Muscle weakness or inability to put weight on your injured leg.
Complications of hamstring injury may include:
- Re-injury of your hamstring muscles – Returning to strenuous activities before your hamstring muscles are completely healed might set you up to repeat the injury. In some cases, a recurrent hamstring injury may be more severe than the original injury.
- Permanent decrease in muscle strength. In some instances, you may never regain full muscle strength in your injured leg and may be unable to perform activities at the level you once did.
How are Hamstring Injuries Treated?
Most hamstring injuries heal without surgery. In rare cases, where there is a complete rupture, surgery may be necessary. The aim is to restore muscle function and prevent scar formation. Treatment consists of rest, ice, compression, and elevation (RICE). In severe cases, crutches or splinting may be necessary. A short course of non-steroidal anti-inflammatory medication is sometimes recommended.
As soon as pain permits, it is important to begin a programme of stretching andrange-of-motion exercises. This is necessary since prolonged immobilisation and inactivity could result in muscle shrinkage (atrophy), and scar tissue (fibrosis). Excessive scar tissue is incompatible with healthy muscle function. Atrophy and fibrosis are best avoided or reduced by a programme of motion and stretching, implemented early in the rehabilitation process.
It should be emphasised that an early rehabilitation programme does not mean a quick return to the usual activities. Given the type of individual that usually sustains a significant hamstring injury, it is usually an extremely difficult task to keep athletes off the field. Re-injury is quite common and is often due to avoidable premature return to the sport. Re-injury not only prolongs recovery, it also increases the risk of permanent damage. People with these injuries should be advised early in the rehabilitation programme about the risks of re-injury.
After pain and swelling have been controlled and acceptable range of motion and flexibility has been attained, a gradual strengthening programme should follow. Once adequate strength has returned, then a gradual return to the desired activity is attempted. Full return is usually possible only after maximal flexibility and optimal strength have been obtained. Depending on the severity of the injury, the entire rehabilitative process could take several months.
As part of an overall physical conditioning programme, regular stretching and strengthening exercises can help to minimise your risk of hamstring injury. Try to be in shape to play your sport; don’t play your sport to get in shape. If you have a physically demanding occupation, regular conditioning can help prevent injuries.
Your feet mirror your general health . . . cherish them!
Originally published in the Trinidad Express Newspaper on August 22, 2011