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Get back on your feet again after a hamstring injury with rehab

James Winger, MD Assistant Professor of Family Medicine Loyola University Chicago Stritch School of Medicine

The hamstrings are the muscles of the back of your thigh. They are commonly injured, usually when participating in running sports. They are challenging to rehabilitate, commonly recur and improper or incomplete rehabilitation leads to a higher risk of recurrence. Properly rehabilitating a hamstring injury will not only get you back to sport quicker, but decrease your risk of the hamstring being re-injured.


Do

Do recognize a hamstring injury

Hamstring injuries may happen suddenly, in which case the athlete may feel a sudden pop or snap coming from their back thigh, back knee or buttock. Sudden hamstring injuries happen most commonly when running at maximum speeds, as in sprinting. If the injury is extensive enough, walking may be difficult and bruising may be noted on the back of the thigh.

Some hamstring injuries occur over time. During these injuries, it is unlikely for the athlete to experience a sudden pop or snap. Usually, a dull, throbbing ache develops during the course of endurance activities like running. These may or may not be severe enough to limit one’s activity and rarely affect common daily activities like walking.

Do understand the need for treatment to achieve full recovery

Due to the high rate of occurrence and recurrence, all hamstring strains should be evaluated by a professional who routinely treats athletes with hamstring injuries. In most cases, this will be a physical therapist or a physician who specialize in sports medicine. You may be given a set of home exercises to complete by yourself, or you may attend physical therapy appointments up to several times weekly.

Do start range of motion exercises early in treatment

Pain is common, especially after the initial injury. It is important to discuss with your healthcare provider how much pain is acceptable during rehabilitation. While certain types of exercises may be uncomfortable, especially for rehabilitating long-injured tendons, pain is acceptable only up to a certain point and should be monitored.

Do find ways to keep up other strength and endurance during rehabilitation

When we stop exercising or parts of our body are immobilized, muscle fibers that are responsible for endurance wither before those responsible for strength. This means that if you wait until the end of rehabilitation to restart endurance-type activities, you will have a significant deficit of endurance. Try to introduce endurance activities that do not bother your hamstring earlier, rather than later, in the process.


Don't

Do not wait for treatment

Starting rehabilitation promptly will maximize the likelihood of full recovery. As the body heals torn tissue, the healing tissue may be molded with the correct type of exercise therapy. Prolonging treatment may make the process more difficult and delay recovery.

Do not assume it will get better by itself

Many injuries will heal with simply rest and time. Certain muscles or groups of muscles, such as the groin muscles and hamstrings are notorious for demanding structured recovery. Following a rehabilitation protocol will decrease the significant risk of recurrence.

Do not skip rehabilitation sessions

Rehabilitation of muscle injuries should be viewed the same as medicine treatment for medical illnesses. One wouldn’t expect to improve a medical condition if a prescribed medicine wasn’t taken, and performing prescribed rehabilitation exercises is similar. Adherence to rehabilitation regimens will decrease pain and increase function.

Do not continue aggravating activity

Relative rest is an important concept in rehabilitation. In non-traumatic injuries (such as chronic hamstring strain) the hamstring is overused which prolongs a cycle of poor healing. Resting the injured hamstring from aggravating activity is important, as is using other activities to maintain strength in the injured extremity.

Do not become discouraged

Rehabilitation can be a long process; typically 6-12 weeks of daily or twice-daily exercises. Setbacks can be common, but with persistence and good communication with your healthcare provider, you can overcome your hamstring injury and return to exercise.


Summary
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Hamstring injuries are common in running sports. Formal rehabilitation is important to return to patient to pre-injury levels of function as soon as possible. Adherence to prescribed regimens of therapeutic exercise will decrease pain in shorten the time that you are away from your preferred activity.


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James Winger, MDAssistant Professor of Family Medicine

Family Medicine and Primary Care Sports Medicine specialist. ...

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