Hamstring Tear

One of the most common injuries in sport is a hamstring strain. Hamstring strains are especially prevalent in sports that require speed, agility and power, for example rugby, soccer, netball.

Our hamstring is made up of three muscles, the biceps femoris, semitendinosus and semimembranosus. Their main action is to flex (bend) the knee and extend (straighten) the hip. When we are running, our hamstring muscle is working to create and control this motion.

What causes a hamstring tear?

A hamstring will usually tear in an acceleration or deceleration motion during running, as the hamstring has to contract to perform these motions. This causes the fibres of the muscle to tear.

There has been a link shown between increasing age, lack of strength of the quadriceps and hamstring and previous hamstring injuries to increasing the likelihood of a hamstring tear.

Signs and symptoms

Grade 1 - A grade 1 tear can sometimes be played through, however pain will be worse once the activity has stopped. You will have a loss of strength and flexibility, pain with running and minimal swelling. Grade 1 hamstring injuries will usually return to sport within 2-4 weeks.

Grade 2 - Grade 2 tears are partial tears of the muscle. A noticeable reduction in strength and flexibility will be present, pain will be immediate and more severe and it is likely you will walk with a limp. Occasionally, a bruise will appear around the site of the tear. Return to sport is usually around

the 4-6 week mark.

Grade 3 - Grade 3 tears are ruptures or complete tears of the muscle or tendon of the hamstring. Symptoms will include sudden, sharp pain in the back of the thigh, severe pain, a large bruise and occasionally an audible tear or pop at the time of the injury. Recovery is usually 8-12 weeks if able to be managed conservatively. If surgical management is elected, this is usually due to a rupture of the tendon and recovery can take 6-9 months.

Rehabilitation of hamstring tears

Hamstring rehabilitation can be broken into three categories:

• Strength/power
• Flexibility
• Return to sport

1. Strength - Hamstring rehabilitation strengthening has a large focus on balancing quadriceps and hamstring strength ratio, as well as eccentric strengthening of the hamstring as this is usually the motion that will cause the injury.

An example of exercise progressions could be:

Phase 1

- Isometric hamstring

- Isometric quadricep

Phase 2

- Bodyweight squat

- Slider hamstring curl

Phase 3

- Single leg hamstring slider

- Lunge

Phase 4

- Razor curls or nordic curls

- Single leg deadlift

- Single leg squat