Incidence of all muscle strains in the body:

• Hamstrings     25%

• Calf         19%

• Quadriceps    17%

• Lumbar    9%

• Adductor     8%

 

Variety of hamstring injuries, such as contusion, strain, laceration or even complete rupture.

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Pathophysiology of injury:

• Biceps most active during take off and support phase

• Medial hamstrings most active during late swing phase

• Both usually injured with ballistic eccentric contraction with knee extended & hip flexed (Kicking, hurdling, jumping etc)

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History:

• Acute pain on activity

• felt (or heard) a sudden “pop”

• Unable to run

Examination:

• Prone with knee flexed

• Point tenderness worse on stretching

• Occasionally palpable defect (fills with haematoma after a day or two)

 

Graded by severity:

• Grade I: mild pain, minimal spasm, loss of 20 degrees extension, no defect

• Grade II: Moderate pain & spasm, bruising & swelling, loss of 20 to 45 degrees of extension

• Grade III: Complete rupture, palpable defect early on, inability to tense muscle, severe pain, swelling & bruising

 

Investigations:

• Ultrasound for grade II & III

 

Treatment:

• More bleeding = delayed healing, more scar tissue &possible myositis ossificans

• Rest, ice, NSAIDs in acute phase

• Rehabilitation after 5 to 7 days stretching, strengthening, muscle balance

• Avoid early return 

• Endurance training & good warm up