| Edward Staub, M.D. drstaub.com |
Orthopaedic Surgeon, Sports Medicine, Knee, Hip, Shoulder, Ankle, Spine
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HAMSTRING INJURIES/ RICE By Edward Staub, M.D. |
| The following medical articles are intended only for general patient information and education. They are not necessarily specific to any one patient's needs and, therefore, should not be construed as formal medical advice or treatment. Obviously, if you have a similar medical problem, you should consult a physician and not rely on these articles in lieu of treatment. If you reside in Dr. Staub's area, he will be delighted to accept you as a patient, but his ultimate opinion and recommendations will be based on his personal examination of you. |
Pulls or strains of the hamstring muscles are one of the most common sports ailments. They occur
often in running sports and are frequently caused by quick starts and stops—as in sprinting, baseball,
basketball, tennis, etc.
The hamstring consists of three large muscles in the back of the thigh. They begin at the pelvis and
end just below the knee. If you straighten and tense your knee, the fleshy part of the muscle can be
felt behind the thigh. If you run your hand behind the knee, you will feel the lower hamstring tendons
on each side. The hamstrings bend the knee. The opposite muscle in front of the thigh is the
powerful quadriceps which straightens the knee. This muscle is approximately one-and-one-half time
stronger than the hamstrings. People with weak hamstrings are more prone to injury.
Muscles tear as a result of sudden changes in tension. For example, a sudden start or stop can
stress the muscle. This is why sprinters are more susceptible.
When a hamstring tears, the runner feels a sudden pain in the back of his thigh. The sensation of a
“rip” or “tear” is also common. Pain will increase over the following hours and swelling and/or a large
black and blue spot (ecchymosis) may also occur from the bleeding of the injured muscle.
There are three grades of muscle tears:
Grade I: (mild strain) Less than 10% of the muscle is torn.
Grade II: (moderate tear) Up to 50% of the width of the muscle is torn.
Grade III: (severe) Over half of the width of the muscle is torn.
If you think you have injured the hamstrings, it is best to stop playing or exercising. Treatment can be
summed up with the acronym RICE, which stands for:
1. Rest—crutches may be necessary.
2. Ice—to stop swelling and relieve pain.
3. Compression—apply an Ace bandage to lessen swelling.
4. Elevation—helps decrease the swelling.
Treatment
Several days later, a warm whirlpool is soothing and aids in the healing process by increasing the
blood flow to the injured muscle. Mild strains will heal in a couple of days, while Grade II injuries may
take up to two weeks to heal. Grade III injuries take even longer (three to four weeks). You can
return to sports when it is no longer painful to tense the muscles. Before you start running, it is best
to rehabilitate the knee.
Initially, gentle motion to the knee should be done to regain motion. Next, when the pain subsides,
work out with light weights to re-strengthen the hamstrings. A simple exercise is to lie face down and
bend the knee with an ankle weight attached to the lower leg. Hold for a few seconds and then relax.
It is best to start with two to three pound weights and gradually increase the amount every week.
Before returning to full activity, you should first do slow, easy running or jogging. Running speeds
can later be increased.
Prevention: Exercises and stretches may help prevent hamstring pulls.
Hamstring pulls can frequently be prevented by proper warm-ups and preliminary stretching
exercises. The warm-ups increase blood supply to the muscles, making them less likely to tear. The
following are good hamstring-stretch exercises.
1. Lie on your back. Bring one leg up to your chest with the hip and knee bent. Cup your hands
behind the knee and push knee against the hand, straightening the knee. Hold the stretch for five
seconds. Repeat the exercise five times. Then do the opposite leg.
2. Kneel down with one knee and straighten the opposite leg in front of you. Bring your upper
torso over the outstretched leg, keeping your arms at your side and your back straight. Hold the
stretch for three to five seconds. Repeat five times. Next, stretch the opposite leg.
THE HAMSTRING MUSCLES FROM BEHIND THE KNEE AND THIGH
