Updated: May 20
How many times have we seen a football player or sprinter pulling up suddenly grasping the back of their leg and pulling up ?
Are hamstring tears serious injuries ?
This injury is the curse of the fast twitch athlete and at the other end of the spectrum the masters athlete who is back to relive the glory days of old. It can be a complex and fustrating problem to rehab and requires attention to detail with examination and constructing an effective rehab program.
Here is one of the most famous , (and heartbreaking), hammy tears at the 1992 olympics;
Do hamstring tears heal ?
One of the biggest risk factors in sustaining a hamstring tear is not rehabbing the initial one properly. It can be a sneaky little injury as quite often we can get back to jogging or mid pace running with no pain very quickly , less than 3 weeks. This is usually an indicator to the individual that all is well and they can get back to full on activity again.
However if it hasn’t been tested at maximum speed in match conditions we really are living in hope. In fact in Elite sprinters have shown that the strength of the hamstring is as follows;
· 70% at 2 weeks post injury
· 85% at 3 weeks post injury
· 90% at 6 weeks post injury
· 100% at up to 16 weeks !!!!
That's right it can take up to 16 weeks to get the strength and function of the hamstrings back to 100%.
ANATOMY OF THE HAMSTRING GROUP
The hamstrings refer to three separate muscles located in the back of the thigh;
· Bicepsfemoris (which consists of two components, a long head and a short head)
· Semitendinosis (ST)
· Semimembranosis (SM).
There are numerous theories on how this muscle group derived its name, but it appears to originate from the early Germanic language as well as the butchery trade.
The pigs were hung from these strong tendons, hence the reference to ‘ham’ (meaning ‘crooked’ and thus referring to the knee, the crooked part of the leg) and ‘string’ (referring to the string-like appearance of the tendons).
From their proximal insertions at the ischial tuberosity at the pelvis, Semimembranosis, Semitendinosis pass behind the hip and knee joints, while biceps femoris is mono-articular, crossing only the knee joint.
Why do hamstring tears occur and who is most at risk
The following is a list of factors that are influential in hamstring injuries:
History of previous hamstring injuries. This is the number one reason behind recurrent hamstring injuries. Athletes have been found to be 2-6 more at risk of re-injuring their hamstring up to 8 weeks post injury.
Location of the injury. The closer it is to the pelvic origin then the longer it takes to rehabilitate as a rule of thumb.
Hamstring weakness. Individuals who have a short and eccentrically weak , (that is the muscles ability to resist lengthening under load.).
Flexibility. The lack of relative flexibility of the hamstrings and the opposing muscle groups to the hamstring ,quadriceps and hip flexors are potential risk factors.
Inadequate rehab of previous hamstring tears or history of hamstring injury.
Balanced training. Lack of or too much training at maximal speed is now thought to be a potential contributing factor. Its getting the dose right that is key, like Goldilocks not too much , not too little its got to be just right !
Age, the older the individual the more at risk they are of a hamstring tear. Hello Masters sport.
Weight, a BMI > 25 in individuals engaging in explosive / speed based activities are at greater risk.
Fatigue towards the end of training or a match.
Top 5 hamstring exercises
Good news is that there are really awesome return to play protocols and tests to determine readiness to return to sport. We've put together some of the best hamstring strengthening exercises to get back on the pitch or track .
In ascending order of difficulty
Early stage isometric hamstring work
4 sets x 5 reps x 10-20 sec holds.
The start position is exactly the same as that used in the video of our number 3 exercise, hamstring bridge on the step,
The action involves pulling the heels down into a step so the hamstrings are activated,
In the early stages of rehab the effort to put in is one that does not increase symptoms.
Deadlifts And single leg deadlifts.
The hex bar offers the entry level of this variation, but is a great lower leg strength builder. Its not just about the hamstring.
Below are videos of deadlift exercises that progressively challenge the hamstrings.
Try 4-5 Sets x 8 - 12 reps, 60 sec rest. To make it harder on the hamstrings slow down the lowering phase of the lift.
These are best started with both legs using a stable surface and then progressed to single legs and then onto unstable surfaces.
I recommend doing reps of 8 , with 2 sets at 2-3 different knee angles.
Check the video below for ideas.
The nordic hamstring exercise
Sets of 8 are all that are needed. Not for the faint hearted , but also not the be all and end all of hamstring rehabilitation. You can read more about the nordic hamstring exercise here and also progressions for ou to use.
The hamstring leg slide.
This exercise has one of the highest muscle activity and fibre recruitment , and boy does it hit the mark. Here is a `progression of body weight exercises to lead into the slide exercise.
Add some of these to your routine and prevent the hamstring from going ham..ping !
(Yup i really did just do that !)
If you are struggling with a hamstring or lower limb injury you can book in here to see one of us and get your recovery up to speed.