Hamstring Injuries – How Exercise Can Prevent and Heal Them

If you’ve ever pulled your hamstring, you know how painful it can be. A hamstring injury can put you out of commission for weeks. If you have a full muscle tear, you might even require surgery. The good news is that there are ways to prevent these kinds of injuries. We’ll also take a look at what you can do to speed up your recovery if you pull your hamstring.

Plus, we’ll examine the controversy surrounding the merits of preworkout warmup and stretching. Believe it or not, the benefits aren’t so clear.

What Is the Hamstring?

A hamstring is a group of three large muscles located at the back of your thigh. The hamstring muscles are named:

  • Semitendinosus
  • Semimembranosus
  • Biceps femoris

These muscles are anchored to your pelvis at the ischial tuberosity. They run down the back of your leg, past the knee and attach to the bones just below the knee. The function of the hamstring is to allow you to bend your knee and to raise your leg straight back behind you.

How Does a Hamstring Injury Occur?

All muscles are similar to rubber bands that stretch and pull back to cause movement. If the muscles are stretched too far, they can become damaged. Hamstring injuries typically occur in certain situations, such as:

  • Sports activity: Especially common during explosive motion, such as sprinting, extreme stretching like dancing, gymnastics and martial arts or during repetitive movements like running on a treadmill and cycling
  • Past injury: If you injured your hamstring in the past, this increases your chance for future injury
  • Poor conditioning and flexibility: Injury may occur in people who don’t exercise much and suddenly push their muscles too hard; proper warm-up may prevent hamstring pulls
  • Young age: During adolescence, your bones grow faster than muscle, which causes a continuous muscle tightness that increases injury risk
  • Older age: As you age, your muscles may become less flexible and take longer to recover from exercise

Muscle Imbalance Theory

There is some controversy about this cause of hamstring injury, but it deserves mention. Your skeletal movement occurs due to an intricate system of muscles and bones that create tension. If one muscle group is too strong, this imbalance can increase the risk of injury to the weaker muscles. You can think of it as a tug-of-war between muscles.

For example, if your quadriceps muscles at the front of your thigh are too strong, they may overwhelm your hamstring. Also, if your glutes or hip muscles are too weak, they may transfer some of their workloads to your hamstrings. Muscle imbalance helps us understand how to prevent hamstring injury, as we will see later in this article.

Symptoms of Hamstring Injury

The classic hamstring injury is during a sprint when you feel a sudden pop or sharp pain. It can stop you dead in your tracks. Later, you might notice swelling, bruising and/or tenderness at the back of your leg. You could also experience weakness in the leg. With more severe injuries, you might feel consistent pain, which is made worse when walking.

Hamstring Strain Types

Muscle strains are often graded, from 1 to 3, by the severity of the injury. A grade 1 strain is mild and typically heals quickly; a grade 2 strain is in between and may take a week or so to heal; and a grade 3 strain is a complete muscle tear and may take months to heal.

Another type of problem is chronic hamstring strain due to repeated micro-tears in the muscle. You might mistake this for normal post-exercise soreness. If you keep exercising, however, this could turn into a more serious problem or even increase your chances for a full muscle tear. Hamstring strain might be due to overtraining, so it’s important to recover properly and listen to your body.

Diagnostic Tests

In the majority of cases, a physical exam by an experienced doctor can determine if you have had a hamstring strain. In more serious cases, tests might be ordered to establish the extent of the damage. These tests may include:

  • X-rays: Can determine if the muscle has been torn away from the bone
  • MRI: Detects how much of the muscle has been torn

Hamstring Injury Treatment

For nearly all hamstring injuries, doctors recommend the RICE treatment strategy (rest, ice, compression and elevation):

  • Rest: Discontinue strenuous activity; for severe injuries, you may need to use crutches
  • Ice: Apply cold to the area for 15 to 20 minutes a day every six to eight hours; ice should be in a pack wrapped in a moist towel and never apply ice directly to skin
  • Compression: An elastic bandage may prevent more swelling; be careful not to wear the bandage too tight, although it should be snug
  • Elevation: When at rest, keep the leg elevated with your ankle above the level of your heart

A more serious injury might require physical therapy. Treatment may include gentle stretching, heat and ice. As you progress, your therapist will introduce exercises gradually to regain strength and function.

Surgery for Hamstring Muscle Tears

Most hamstring injuries do not require surgery. However, if the muscle has completely torn away from the bone, you may need to have it surgically corrected. Also, complete tears in the belly of the muscle may require surgery. These injuries are fixed by stapling or stitching the muscle to the bone or rejoining the muscle with stitches.

Platelet-rich Plasma for Hamstring Injury Treatment

Platelet-rich plasma (PRP) is being investigated in the treatment of hamstring tears. The procedure takes plasma from your own blood donation then injects it at the site of injury. PRP is rich in growth factors which some researchers believe speeds up healing. This treatment is still in the research phase.

Does Warming Up and Stretching Help Prevent Hamstring Injury?

General overall fitness goes a long way in preventing hamstring strains. Still, even world-class athletes suffer from this injury. There have been several studies looking at the benefits of stretching and warm up to prevent injury or enhance performance.

The Journal of Science and Medicine in Sport analyzed several studies looking at pre-workout warmup. Five high-quality studies were evaluated. Three studies showed some benefit to warming up and two showed no benefit at all.

Sports Medicine published an abstract that evaluated whether stretching before exercise was beneficial or not. It concluded that it might depend on the type of sport involved. For example, for high-intensity sports like running sprints and soccer, stretching may provide more benefit. For low-intensity activities like jogging and cycling, stretching may not be as important.

Should I Warm Up and Stretch Before Exercise?

No matter what activity you choose, it’s a good idea to warm up and stretch. This gets the blood flowing into your muscles and makes them more compliant. When it comes to hamstring injury prevention, this could be critical. Be careful not to overstretch. If you feel significant pain, you’re probably overdoing it.

Stretching by bending over at the waist may not be the best idea. This puts extra strain on the hamstring. Instead, try lying on your back and bring your knee up to your chest. This can also be done from a standing position. You can also try a straight leg raise stretch with your knee slightly bent.

Muscle Training to Prevent Hamstring Strain

As we discussed earlier, muscle imbalance may increase your risk for a hamstring injury. The way to prevent this is to have proper all-around muscle conditioning. The first step is to focus on hamstring muscle strength. This can be accomplished with leg curl weightlifting and cycling.

Your glutes and hips strength should be optimized as well. If these muscles are weak, they could cause your hamstring to overwork. Straight leg raises, squats and leg presses are great for building up these areas. Also, standing leg raises to the side and rear can help establish overall glute, hip and hamstring fitness.

Cross Training

Another effective method for solid hip and leg muscles is to vary your workouts. If you mostly run, try adding in swimming or cycling once a week. Different activities use different muscles and variation helps even out muscle imbalances. This method — in addition to the targeted strengthening of the hamstrings, glutes and hips — minimizes your chances of a hamstring injury.

Conclusion

Nothing can prevent hamstring injuries 100 percent of the time. Still, if you take the proper precautions and train smart, you’ll have more confidence in your performance. Balanced fitness, proper warmup and stretching are all methods to stay on top of your game.