Hamstring strains are one of the most common injuries experienced by those who participate in sports that involve high power and acceleration, such as football, soccer, and athletics. These strains occur when the hamstring muscles are overloaded; either by being overstretched or contracting too hard.

The hamstring structure is made up of three main muscles:

  • Biceps femoris
  • Semitendinosus
  • Semimembranosus

Hamstring strains occur when the muscle fibres cannot cope with the load placed upon them and subsequently tear. Hamstring strains usually only involve tears to the muscle fibres. However, intramuscular tendon tears can occur when the load placed upon the hamstring is very high. Intramuscular tendon tears often take longer to heal so identifying patients with this type of injury is vital for ensuring accurate prognostic information is communicated.

Hamstring strains are generally divided into three grades:

  • Grade I: small number of fibres torn, local pain, no loss of strength. Mainly affects biceps femoris, and occurs in the belly of the muscle.
  • Grade II: significant number of fibres torn, pain, swelling, reduced strength and mobility. Mainly affects semimembranosus, and occurs at proximal tendon.
  • Grade III: complete tear of the muscle

How Can Physiotherapy Help?

To ensure a timely and safe return to sport, patients with hamstring strains are encouraged to seek treatment from a physiotherapist. Physiotherapists can assess the extent of the injury through a range of assessment and diagnostic skills and accurately inform the patient when they could be expected to return to their sport or activity.

Physiotherapists can prescribe rehabilitation exercises that are tailored to the stage of healing of the hamstring and the patients fitness level. Prescribing the right exercises at the right time will help patients with hamstring strains return to sport as soon as possible while reducing their risk of re-injury. Physiotherapists also play a key role in educating patients about the balance between training too hard – and increasing injury risk – and strengthening the hamstring to reduce injury risk.

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