Runners are often guilty of showing their hamstrings no love, until they demand it. Hamstring issues usually arise because the muscles are weak. Long and weak or short and tight hamstrings all pose injury risks, as do muscle imbalances with over-powering quadriceps on the front of your thigh.
The hamstring consists of 3 muscles, that run down the back of your thigh from your buttock to just below your knee. They work over two joints – both flexing (bending) the knee and extending (straightening) the hip joint.
The hamstrings work throughout each stride, but are especially active when you are bending your knee and extending your hip at the same time, for example when driving yourself up hills, and powering into the finish. Approximately 7% of running injuries are hamstring-related. Pushing through hamstring pain can morph into a debilitating tear.
Anatomy
Hamstring Complex
Biceps Femoris
Semitendinosus
Semimembranosus
All 3 of the hamstring originate from the ischial tuberosity. (The Sitting Bone). The bicep femoris has two heads that come together and attached onto the fibula. The semitendinosus attaches to the medial surface of the tibia. The semimembranosus medial tibial condyle.
Causes
They often occur during sudden, explosive movements, such as sprinting, lunging or jumping. But they can also occur more gradually, or during slower movements that overstretch your hamstring.
Past hamstring injury. If you’ve torn your hamstring in the past, you’re more likely to tear it again. The risk is higher if you do intense activity before you’re fully healed.
Overtraining. Training too hard can overload your hamstrings and cause tears.
Poor flexibility. If you have limited flexibility, certain movements may stretch your muscles too far.
The strain is graded:
Grade 1 – minor tear of a few muscle fibres
Grade 2– tearing of a larger number of fibres but muscle still intact
Grade 3 – complete rupture of the muscle
Symptoms
- Sudden onset of pain whilst running
- Sharp, stabbing, possibly even a snap or pop sound
- Bruising on back of the thigh
- Swelling
- Can have associated back and buttock pain
- In Grade 2 or 3 injuries you may have difficulty walking
Treatment & Prevention
Acute phase:
Resting from activity initially. Light range of movement and icing.
Massage and manual therapy to release tight surrounding structures and address any underlying back or hip issues.
Exercise therapy – slow and progressive over stages depending on the severity of the initial tear.
Rehabilitation:
Strengthen pelvis and core including the gluteus (buttock) muscles as they work together with the hamstrings.
Manage any muscle imbalances in weakness or flexibility through exercise correction
Progression to full leg strengthening exercises, squats, deadlifts and finally eccentric strengthening of the hamstring.
Training:
Complete rest may be advised depending on severity of injury. Otherwise reduce intensity and training volume.
Avoid speed and hill work.
Find a comfortable pace and distance that elicits no pain and stick to tat 3 x week with a rest day in between.
Train on softer surfaces like grass and dirt roads.
Cross train with cycling, water running, swimming, elliptical trainer.
Address underlying contributing factors like biomechanics (do you need orthotics for your arches?) or a leg length discrepancy.
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- Charlotte@rehabontheroad.co.uk
- 07971448719