Hamstring Strains
Zachary Anders
What are the Hamstrings
Term derived from
butchers
Muscles of the
posterior thigh
Consist of the
semitendinosus,
semimembranosus
and the biceps
femoris www.injuryupdate.com
More About Hamstrings
Two joint muscle
Fast Type II muscles
Strains mostly in
sports with sudden
acceleration
www.bjsportmed.com
Semimembranosus
Forms the bulk of the
muscle mass
Innervated by tibial
portion of sciatic
nerve
www.waynesburg.edu
Semitendinosus
Goes along the
medial side of the
posterior thigh with
the
semimembranosus
Innervated by the
tibial side of the
sciatic nerve
www.waynesburg.edu
Biceps Femoris
Most commonly
strained
Two heads
Duel Innervation
LH – Tibial division of
sciatic nerve
SH – Common
Peroneal division of
sciatic nerve
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Grades
Strains are tears or ruptures in muscles
due to overstretching. Strains are divided
into three grades
Grade I - mild strain with minimal fibers
torn
Grade II – obvious loss in strength and
moderate strain
Grade III – Absolute rupture
Why are hamstring strains
detrimental for athlete?
Time Consuming
High Recurrence
Premature Return
Mental Hold
Common Causes
Imbalance of muscle strength
Muscle fatigue
Poor warm-up
Poor flexibility
Inadequate rehabilitation
Poor technique
Diagnosing
Simple history and physical examination
usually suffices
X-Rays are primarily used to rule out
avulsions
MRI proves useful in predicting recovery
time
Case Study On Sprinters
This study was done on sprinters who suffered
from hamstring strains
Every sprinter claimed the injury to happen
during or near maximal speed
Most pain was discovered on the lateral part of
the rear thigh upon palpation
The more superior the injury site, the longer
recovery time
Information on predicting recovery time may be
achieved through careful palpation within three
weeks and an MRI within six weeks
Sprinter VS Dancers
Hamstring strains can either occur during maximal
speed running or overstretching
Maximal speed is when the sprinters got injured, while
the dancers suffered injury through slow training
Hamstring strains due to max speed showed acute
decline in function, but a faster recovery time than the
dancers that were put in extreme stretching positions
MRI revealed that hamstrings among sprinters tear
primarily at the muscle tissue, where as the hamstrings
of the dancers tear at the proximal tendon tissue
Pain location for the dancers appears to be more
proximal when compared to the sprinters
Risk Factors
Age
Aboriginal descent
Muscle Fiber Composition
Common History
Sudden onset of pain after explosive
movement
Audible pops Posterior thigh pain noticed
toward or near the end of activity
Pain during sitting, uphill walking or ascending
stairs may be reported
With more severe injuries, swelling and
ecchymosis may occur
Pain upon muscle activity
Palpable mass
Problems on the
Homestretch?
Most strains occur at
end of play
This supports the
idea of muscle
fatigue
This graph
represents hamstring
strain injuries related
to time of soccer
game www.bjsportsmed.com
Works Cited
Askling C, Saartok T, Thorstenson A Type of acute hamstring strain affects
flexibility, strength, and time to return to pre-injury level. Br J Sports Med
2006;40:40-44
Askling CM, Tengvar M, Saartok T, Thorstensson A Acute First-Time Hamstring
Strains During High-Speed Running. Am J Sports Med 2007;35:197-206
Best TM, and Garret WE Hamstring Strains: Expediting Return to Play. The
physician and sportsmedicine 1996;24 No 8
Crosier J, Forthomme B, Namurois M, et al Hamstring Muscle Strain Recurrance
and Strength Performant Disorder. Am J Sports Med 2002;30:199-203
Dadebo B, White J, George KP A survey of flexibility training protocols and
hamstring strains in professional football clubs in England. Br J Sports Med
2004;38:388-394
Heftler, Jeffrey e-medicine: Hamstring Strain: Article by Jeffrey M Heftler, MD
www.emedicine.com/pmr/topic49.htm
Ruiz, Herman e-medicine: Hamstring Injury: Article by Herman Brad Ruiz
www.emedicine.com/sports/topic45.htm
Verrall GM, Slavotinek JP, Barnes PG, Fon GT, Spriggins AJ Clinical risk factors
for hamstring muscle strain injury: a prospective study with correlation of injury by
magnetic imaging. Br J Sports Med 2001;35:435-440