Hamstring strains are very common in spring sports in Northeastern Pennsylvania in great part due to our climate. Each spring, as the season begins, many athletes suffer from pain in the back of their thigh when they pull or strain the hamstring muscle from aggressive activity in cold temperatures, following a long winter layoff. Even for those involved in winter sports, the muscle may not be accustom to working in the same manner as required for the specific spring sport. This week’s column presents the cause and symptoms of a hamstring strain. Next week will be dedicated to the diagnosis, treatment and prevention of this injury based on new research supporting specific training techniques.

What is a Hamstring Strain?

A hamstring strain is a tear of the muscle fibers of the muscle group in the back of the thigh called the hamstring. The hamstring muscle is a group of three muscles that run from the back of the hip (lower pelvis), crossing the back of the knee and attaches to the knee bone (tibia). The hamstring muscles work to extend the hip and bend the knee during running and walking activities. They are very active when an athlete changes direction, especially forwards and backwards or decelerating. This injury, like others, varies in intensity. Severe hamstring strain occurs when many muscle fibers are torn. In very severe cases, the boney attachment can be pulled so strongly that a small fracture can occur. Healing time can be as short as a few days or as long as weeks or even months.

Common Causes of Hamstring Strains

• Overuse – every time the knee is bent the hamstring muscles must contract. If there is not adequate time allowed for rest between workouts or competition, then the muscles may be fatigued and become vulnerable to injury. Also, overuse of the same muscles without rest may make them irritated and inflamed.
• Inadequate Warm-up – a warm muscle stretches like a piece of gum warmed up in your mouth. When you pull the warm gum, it stretches. However, if you drink an ice cold drink with gum in your mouth and then stretch the gum, it will tear instead of stretch. A good warm-up will prevent tearing and prepare the nervous system for sudden movements and changes in direction.
• Sudden Movement – quick sprint, sudden change in direction, quick turn with an unexpected force or slip.
• Poor Body Mechanics – especially when moving or lifting a heavy load away from your center of gravity.
• Forceful Contact or Loss of Traction – when a leg is forced away from the body by an outside force (tackle in football) or slip on grass or ice.

Symptoms of Hamstring Strain

• Pain - usually occurs gradually. However, a sudden onset can occur, especially when associated with a sudden twist or fall. Movement of the hip or knee or a change in direction reproduces pain in the buttocks or back of thigh. Touching these areas reproduces pain.
• Swelling/Discoloration – swelling and black and blue coloration can occur in the buttocks or back of thigh after increase activity at the end of the day.
• Stiffness – in the buttocks, back of thigh and/or knee is more noticeable in the morning and improves with movement. However, overuse can create more pain and swelling and lead to stiffness also.

• Weakness – associated with pain in the buttocks, back of thigh and/or knee can lead to occasional buckling of the hip or knee when walking or climbing steps or getting in or out of a car.
• Loss of Function- is associated with pain, swelling, weakness and stiffness, which limit walking, stair climbing and participation in sports activities.

SOURCES: Journal of Physical Medicine & Rehabilitation and American Academy of Orthopaedic Surgeons

Visit your doctor regularly and listen to your body.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: “Hamstring Strains – Part II.”

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.