Hamstring muscle injuries are something Dr. Brett DeGooyer will see in his OrthoArizona office two to three times a month.
While a lot of people think of athletes as the ones who suffer from this injury, it can happen to anyone at any age.
“The hamstring muscles run down the back part of your thigh and there are three main muscles that make up the hamstrings,” DeGooyer said. “The most commonly injured is the biceps femoris muscle that runs along the outside part of your back leg. The other two muscles are semimembranosus and semitendinosus that make up the inside part of the back leg. The actions of the hamstring muscles are to help flex the knee and extend the hip.”
People are put at risk of injuring their hamstring when the sport or activity they participate in puts their hip or knee under extreme flexion or extension.
“We think of runners and hurdlers getting injured because the speed of those sports puts them in high-risk situations where they are really flexing their hips and fully extending the knee to get over the hurdle,” DeGooyer said.
Dancers are also put at high risk of a hamstring muscle injury due to high kicks during stretching and performance routines.
Some other risk factors include not warming up properly and overtraining.
“If you’ve been overtraining and not just increasing the volume, but increasing the amount of time, and you don’t give your body the appropriate recovery time, this puts your muscles at a disadvantage,” DeGooyer said. “The muscle gets fatigued easily and when fatigued easily, it can start to rebel and become injured from over-use.”
Inflexibility is another risk factor.
“If you haven’t worked on stretching and other exercises that can improve motion and movement, you’re going to be at increased risk of injury too,” DeGooyer said.
The doctor said some symptoms people experience with a hamstring muscle injury are pain when walking, straightening or bending the back part of the leg, burning sensation, swelling and bruising.
“If it’s a bad injury like a complete tear, we look for signs of muscle bulging like a ‘Popeye’ deformity in the muscle belly. This usually means a tear at the very top muscle attachment where it connects into the pelvis bones, or there may be a tear down at the lower attachment towards the knee,” DeGooyer said. “Where the muscles attach past the hip or knee joints the muscle retracts after an injury (tear) and creates a bulge in the back of the leg.”
“More frequently there is a tear in the muscle belly itself and so you don’t get that same ‘Popeye’ deformity, but will get swelling and tenderness over the muscle,” the doctor continued.
When it comes to treatment options, DeGooyer said it depends on the severity of the hamstring muscle injury, which can be a pull, partial tear or complete tear.
Hamstring muscle injuries are graded according to the severity.
Grade 1 injuries are considered a small tear and DeGooyer said treating them means using the RICE method or PRICE method.
P = Protection
R = Rest
I = Ice
C = Compression
E = Elevation
“It’s rest for the first 48 hours, icing several times a day for the first three days,” DeGooyer said. “You can then throw in gentle stretching and taking over-the-counter anti-inflammatories.
“Usually over a period of two weeks for those that have a Grade 1 tear, they can get full strength and full range of motion back and then attempt to return to their activities,” DeGooyer continued.
If someone has a Grade 2 or Grade 3 hamstring muscle injury, the recovery process is a lot longer.
“Those injuries take more time and, depending on their desired sport or activity, recovery won’t be as quick as two weeks,” DeGooyer said. “I’ve often seen recovery be six to eight weeks.”
“If they have a bad injury, Grade 3, it is a complete rupture of the muscle or tendon, or what we call an avulsion fracture, which is a tear at the bony attachment itself,” DeGooyer continued. “In an avulsion fracture the tendon contracted hard enough that it pulled bone away from bone, and those can take three to six months to completely heal.”
If much more serious, then surgery is another option to reattach the tendon.
Some advice DeGooyer had about not reinjuring your hamstring muscles is make sure you don’t over-train and to appropriately stretch.
It’s also important to see a sports medicine specialist or orthopedic specialist before the pain gets really bad.
“The sooner you get in to see a doctor, the more complete of a diagnosis can be made,” DeGooyer said. “This then activates accurate rehabilitation efforts tailored toward a specific patient and helps them return to their sport and daily activities faster. It also will help determine what other factors contributed to the injury in the first place.”
For more information, visit www.orthoarizona.org