Introduction:
Hamstrings are the taut bands of the tissue (tendons) present at the back of the thigh which join the thigh muscles to the thigh bones. Starting from the hip to just below the knees, there is a group of three muscles that runs along the back of the thigh, which are termed 'Hamstrings.' These muscles are biceps femoris, semitendinosus, and semimembranosus. These muscles are not used much in daily life while walking, sitting, and standing. Hamstring muscles are actively used by athletes during activities like running, jumping, and other sports involving the bending of the knees. A sudden, powerful stretch or overstretching of these muscles while activities such as sprinting can result in injury to the hamstring muscles or a pulled hamstring.
What Is a Pulled Hamstring?
A hamstring injury, or pulled hamstring, is associated with injuries affecting the back muscles of the thigh. Hamstring injury is mostly observed in sports persons involved in sprinting sports such as football and basketball. It can involve a single or group of muscles. Overloading or overstretching of these muscles can result in a pulled hamstring.
What Are the Signs and Symptoms of a Pulled Hamstring?
Signs and symptoms associated with hamstring injuries are:
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Sharp or intense pain suddenly while leg movements.
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The feeling of popping sensation at the back region of thigh muscles.
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Difficulty in moving or bending of legs.
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The feeling of loss of strength in legs.
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Swelling or inflammation of the thigh muscles.
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Bruises (an injury appearing as a patch of stained skin on the body, produced by a blow or impact rupturing underlying blood vessels) at the back of thighs.
What Are the Types of Hamstring Injuries?
Hamstring injuries are divided into three types based on severity:
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Grade 1: A very mild strain or muscle pull associated with less or no pain. Loss of muscle strength is absent.
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Grade 2: Partial muscle tear associated with moderate to severe pain. Swelling or bruises are observed at the back of the thigh. Difficulty in leg movements with loss of strength in the leg is usually present.
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Grade 3: Complete muscle tearing and severe strain associated with severe or non-tolerated pain. Severe swelling and bruising are observed. Difficulty in moving the legs is observed. Standing and sitting activities cannot be performed.
How to Diagnose Pulled Hamstring or Hamstring Injuries?
Pulled hamstrings are diagnosed by doctors by performing a complete clinical or physical examination of the injured legs to rule out muscle tenderness or bruises at the back of the thighs by palpation. X-rays or magnetic resonance imaging (MRI) can be performed by the doctor to rule out pulled hamstring tendons and to determine the severity of the injury.
How Much Time Does It Take a Pulled Hamstring to Recover?
The time span required for complete healing and recovery of the hamstring injury depends completely on the severity of the injuries.
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Grade 1 Injuries: It usually recovers in a few days.
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Grade 2 Injuries: It may take two to three months to repair.
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Grade 3 Injuries: This grade of injury might take three months or more to heal completely.
How to Manage Hamstring Injuries or Pulled Hamstring?
The severity of the injuries usually determines the time span for complete healing and resuming back to daily work. Pulled hamstrings are managed by different methods, such as:
Initial Therapy: Initial management starts with 'RICE' therapy (rest, ice, compression, and elevation). RICE therapy involves:
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Rest: It is mandatory to give the leg muscles a complete rest.
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Ice Packs: The application of ice packs or cold gel packs on the site of the injured hamstring intermittently for every 20 min every three hours a day helps in relieving pain. It is advised to wrap an ice pack in a towel before applying. Avoid direct ice application on the skin.
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Compression: To stabilize the thigh muscles or for immobilization (avoiding further leg movements), a compression bandage or elastic bandage can be applied to the thighs. Elastic bandages or tubular bandages for thighs are easily available at the pharmacy.
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Elevation: Keep two pillows below the injured leg to support the legs and keep the leg raised. It also resolves the swelling in the legs.
Medicinal Therapy: Over-the-counter medications like NSAIDs (Non-steroidal anti-inflammatory drugs) such as Ibuprofen (oral use), Paracetamol, and other topical gels can be used for alleviating pain.
Splint Therapy: A knee splint is mostly advised by the doctor to keep the leg stabilized and avoid further injury. It can be worn for a few weeks as advised by the doctor. Knee splints aid in the healing of the injury.
Physiotherapy: A trained physiotherapist can help with a few stretches and exercises for early mobilization and recovery, like slow cycling, walking. However, excessive strenuous exercises and over-exertion can result in further worsening of the symptoms and condition. Starting exercise gently or at a slow pace under the supervision of a trained physiotherapist is recommended. It is advised to avoid self-exercising at home without the recommendation of a physiotherapist. Avoid sports activities for at least three weeks after the injury as it can result in scarring of the tissue.
How to Prevent Hamstring Injuries?
A pulled hamstring or hamstring injury can be prevented by:
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Try to perform good warm-up exercises before sports activities or heavy exercises.
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Avoid continuous activities that overload or overstretch thigh muscles. Avoid overdoing any sports activities that trigger hamstring muscles or initiate severe pain.
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Perform hamstring strengthening exercises in case of weak glutes or imbalance in the size of thigh muscles (quadriceps muscles).
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Avoid poor techniques while performing sports activities. Improper techniques while running or other sports can result in the overloading of hamstring muscles.
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Avoid strenuous exercise soon after the injury. Give the muscles a minimum of three to four weeks of time after injury to heal and recover completely.
Conclusion:
Pulled hamstring is a result of overstretching or overloading of the hamstring muscle group. A hamstring strain can be mild to severe and can result in difficulty in leg movements or performing daily activities. Visiting a trained physiotherapist for early mobilization and recovery is recommended. Returning back to sports activities soon after the injury can result in further worsening of the condition. An ample amount of leg rest and following healthcare advice are the only keys to managing hamstring injuries.
