Fat Pad Most Painful In The Knee? - I had a patient who came to our clinic recently complaining that his MRI showed that his patella (knee cap) cartilage had "worn out" completely but he di...
Friday, March 16, 2012
More On Hamstrung By Your Hamstrings
Here is a followup post to " Hamstrung by your hamstrings ?" based on the latest published evidence.
Published researched shows that there is a difference handling hamstring injuries if the injury is caused by high speed running or a stretching type injury (Askling et al, 2012).
High speed type running injuries to the hamstrings are much more common compared to the stretching types. Spinters, jumpers in track and field, footballers are all at risk to this type of hamstring injuries. This is normally near the proximal muscle-tendon juction involving the long head of the biceps femoris muscle (see picture below).
Stretching type hamstring injuries occurs during movements leading extensive lengthening of the hamstrings which can occur in high kicking, sliding tackles or while doing a split say in ballet. This usually involves the tendon of the semimembranosus muscle (which attaches to your sit bone or ischial tuberosity situated at your buttocks).
The strain to your hamstrings during high speed running will seem more serious and cause an obvious impairment at first, but it generally requires a shorter rehabilitation period compared to the stretching type strain.
As such, the 2 different types of hamstring strains will then require different approaches in terms of treatment and rehabilitation for the athlete/ patient. Hence it will be important for Physiotherapists who are treating hamstring injuries to determine the injury situation and injury location to determine how best to treat the injury as the rate of re-injury is high.
For the high speed type strains, it is very common for the athlete to experience a marked improvement 4-6 days after the injury as pain, strength and flexibility will all be better. This can be misleading for the athlete as healing is only just taking place. Slow jogging will be easily tolerated while eccentric strenthening needs to be gradually introduced.
For the stretching type strains, the rehab period is likely to be prolonged although there is little pain and functional limitations initially. A general rule of thumb is the closer the injury to the ischial tuberosity, the longer the rehabilitation period.
It would not be possible for me to outline the rehab for both types of hamstring injuries in this post. Please come and see us at Physio or Sports Solutions if you want to return to your sport quicker.
Askling CM et al (2012). High-speed Running Type Or Stretching-type of Hamstring Injuries Makes A Difference To Prognosis. BJSM. 46(2) : 86-87.