Hamstring injuries are one of the most challenging injuries to treat as a Physical Therapy due to the high rate of re-injury.
Over the years, the medical field has tried to accelerate the recovery, and even though good progress has been made, we are not quite there yet: hamstring injury number remain high in the soccer population.
Learn about the Types of HSI and the common symptoms of this condition.
Types of HSI
We have four hamstring muscles: semimembranosus and semitendinosus (medially) and biceps femoris - short and long heads (laterally).
As most of the Muscle Injuries, Hamstrings Strain Injuries (HSI) are graded 1, 2 or 3 depending on severity.
Ultrasound scan and MRI are able to identify the location and extent of your hamstring tear but usually the physical exam can reveal what time of muscle injury you have and accurately determine the best treatment options.
On examination, we as Physical Therapist will look for signs of pain on hamstring contraction, reduced hamstring flexibility, tenderness or a palpable lump or gap within the hamstring muscle bulk.
Grade 1 Hamstring Strain
With a grade 1 , the mildest of the hamstring strain, you may have tightness in the back of the thigh but will be able to walk normally. You will be aware of some hamstring discomfort and unable to run at full speed. There will be mild swelling and spasm. Bending your knee against resistance is unlikely to reproduce much pain but stretching or eccentric contraction most like will reproduce your pain
Grade 2 Hamstring Strain
With a grade 2 hamstring strain, you will have to stop playing because of the pain, and you will have problems walking and you will most likely be limping. Almost any activity will be painful. You may notice some hamstring muscle swelling and your hamstring will be tender to palpate. It will also be painful for you to bend your knee against resistance. Still with these Grade 2 strains a simple Xray is usually enough to rule out an avulsion. Expensive MRIs are not necessary in my experience for this type of Hamstring Strain
Grade 3 Hamstring Strain
A grade 3 hamstring strain is a severe injury involving a tear to half or all of the hamstring muscle. A grade 3 injury is a serious condition and most likely you will not be able to leave the field on you own. You may need crutches to walk and will feel severe pain and weakness in the muscle. Swelling will be noticed immediately and bruising will usually appear within 24 hours.
Diagnostic MRI may also be used to specifically identify the grade of hamstring tear and its exact location.
What are the Symptoms of a Hamstring Strain?
Hamstring Injuries (HSI) are the second most common muscular injury in soccer players (quadriceps is #1)
Grade I injuries recover quick, while Grade II and III will take long time to recover and have an unfortunate high risk of re-injury and becoming chronic ( Proximal Hamstring Tendinopathy)
Most of these injuries does not require expensive MRIs or Test. The clinical examination by a professional specialized in HSI is usually enough to make the diagnosis and treatment
Do you want to find out more about what you can do to get better from your Hamstring Strain?
Click the link below to get access to our PDF E-Book
where you'll find valuable information about Muscle Injuries in general
and Hamstring Injuries in Particular
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