Hamstring Injuries

Hamstring injuries are quite common among athletes. Hamstrings are the muscles from bum to to underneath the knees. The function of the hamstrings is to extend the hip and to bend the knee.

What are the hamstrings?

The hamstrings are the muscles on the back of your upper leg. Hamstrings consists out of three muscles: biceps femoris, semitentinosus and semimembranosus.

Levels of hamstring injuries

I split hamstring injuries up in three levels:

Strain
Microruptures in the muscles
Muscle rupture

Physiotherapy right after injury

Physiotherapy in the beginning phase of the revalidation is focussed on:

Protection
Rest
Ice
Compression
Elevation

This so called PRICE approach is focussed on facilitating the natural recovery process. This means creating ideal condition for the body to recover from the injury itself.

Physiotherapy hamstrings rehab

After 5 days we can slowly start using other treatments:

Strength exercises
Stretch extercises
Stability exercises
Electrotherapy
Massage
Mobilizing techniques

Strength exercises

It is important that the hamstring regain strength after a hamstrings injury. Strong muscles give more support and leads to smaller chances of another hamstring injury.

Crucial is to choose for a gradual build up of strength exercises. Below a build up of easy to hard exercises:

Donkey kick
Heel raise
Glute bridge

How often should I do strength exercises for my hamstrings?

8-12 repetitions
3 series
90 seconds rest between the series

The strength exercises should be that heavy that you are completely tired after around 10 repetitions. For example when you can do over 12 repetitions with the donkey kick, you have to make this exercises heavier by putting weights on your ankles. If you can make 8 repetitions with the donkey kick, because they are too heavy, you have to make the donkey kick lighter.

Stretch exercises

Stretch exercises will put the muscles fibers 'back in the right order'. An impact of your hamstrings could lead to a malalignement of the muscle fibers. Stretching the muscles will align the muscle fibers properly again.

While seated stretch out to toes
While standing reach out to your toes
Heal on a stable object around 1 ft above ground level. Bend through your standing leg.

How often do I need to do the stretch exercises for the hamstrings?

Maintain the stretch for at least 30 seconds en repeat this as often as possible. With stretching exercises there is no maximum of repetitions and maintaining the stretch. The longer you stretch, the better.

One note is that the bouncing stretching is not healthy.

Stability exercises

Stability exercises will help to prevent recurring hamstring injuries. Hamstring injuries often happen during running because of a misstep. Stability exercises will train the body to anticipate on missteps.

Skipping
Walking on toes
Walking on heels

These exercises can be made more difficult by:

Closing your eyes
Performing the exercise on softer surface
Carrying a weight in one hand

How often do I have to do stability exercises?

Parameters stability

10 meters
2 times a day

Electrotherapy hamstrings

Electrotherapy means little current flows to the muscles with a device called Transcutaneous Electric Nerve Stimulation (TENS). Especially with severe hamstring injuries TENS could be a useful treatment. After a severe hamstring injuries most exercises like glute bridges are too demanding. Tens could trigger the muscles in a safe way. The current flows to the muscles avoid loss of muscle mass.

Massage

Massage can give pain relief. Especially in the short term a massage relaxes the muscles and leads to less pain.

A massage can also help to align the muscle fibers again. This can be done with frictions. Frictions is the method of finding the sensitive spot and to massage that specific spot with pressure. Frictions stimulate the muscle to recover from the injury.

Mobilizing techniques

Mobilizing techniques means that the physiotherapist will increase the mobility in the joints by holding the joints in the end of the range of motion for 30 seconds and repeat this multiple times till there is no further increase in the range of motion.

A hamstring injury could make the muscles less flexible. Less flexible muscles means less range of motion in the joints. A physical therapist could help you to regain the mobility in your knee or hip.