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Hamstring Muscle Injuries

Pulled hamstring


Straining of the hamstring, also known as a pulled hamstring, is defined as an excessive stretch or tear of muscle fibers and related tissues. Hamstring injuries are common in athletes participating in many sports and are very difficult to treat and rehabilitate. Track and field athletes are particularly at risk, as hamstring injuries have been estimated to make up 29% of all injuries in sprinters.
Two images of the same strain. One of the pictures was shot through a mirror.

The biceps femoris long head is at the most risk for injury, possibly due to its reduced moment of knee and hip flexion as compared to the medial hamstrings.


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Predisposing factors to injury

There have been many other proposed predisposing factors to injury. These include muscle weakness, muscle imbalance, poor flexibility, fatigue, inadequate warm up, poor neuromuscular control, and poor running technique. One of the few predisposing factors that most researchers agree upon however is previous hamstring injury. The athletes most at risk of a hamstring strain are those with a previous history of such injury.


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Grades

Grade 1

Sensation of cramp or tightness and a slight feeling of pain when the muscles are stretched or contracted.

Grade 2

With a grade two hamstring strain there is immediate pain which is more severe than the pain of a grade one injury. It is confirmed by pain on stretch, swelling and contraction of the muscle.

Grade 3

Bruising due to strained hamstring, horizontal lines show where bandage was.

A grade three hamstring strain is a severe injury. There is an immediate burning or stabbing pain and the individual is unable to walk without pain. The muscle is completely torn and there may be a large lump of muscle tissue above a depression where the tear is.

After a few days with grade two and three injuries a large bruise may appear below the injury site caused by the bleeding within the tissues.


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Treatment

Recommended treatment for this injury consists of the RICE protocol — rest, ice, compression and elevation. The RICE method is primarily used to reduce bleeding and damage within the muscle tissue. Lower grade strains can easily become worse if the hamstring is not rested properly. Complete ruptures require surgical repair and rehabilitation.

Initial treatment of the injury, regardless of the severity of the strain, is the same. Within the first five days, the hamstring is rested in an elevated position with an ice pack applied for twenty minutes every two hours. A compression bandage is applied to limit bleeding and swelling in the tissues. After five days of rest, active rehabilitation begins.

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