Treatment and Prevention of Hamstring Injuries

By: Kenton H. Fibel, M.D.

Primary Care Sports Medicine
Anaheim Ducks Medical Director

Hamstring injuries are quite common among athletes across a broad spectrum of sports and at all levels – professional, amateur, and recreational. The good news is, that there are a variety of effective treatments for these types of muscle injuries that can help players get back in the game safely and without pain. Of course, the best hamstring injury is the one that never occurs in the first place, so an emphasis on ways to prevent them is also in order.

First, it may surprise you to know that “the hamstring” isn’t one singular muscle, but a group of three that extends along the back part of the thigh, from hip to knee. These muscles are the conduit by which your leg can bend at the knee. To say that the hamstring is crucial for any activity that requires running or jumping is an understatement. Your body cannot perform these movements without the work of the hamstring.

When a hamstring strain or tear occurs, one or more of the muscles/tendons involved has become overloaded. If the strain is severe enough, the pain involved can be significant and may even prevent the ability to walk or stand properly. When you’ve “pulled a hammy,” you’re likely to know it…and never forget it. The question is, what do you do when it happens? And, how are these injuries best treated and prevented in the future?

Of course, the first order of business to accurately diagnose a hamstring injury is to visit a sports medicine physician for an examination. If you are diagnosed with a hamstring injury, depending on the severity, there are different treatments that can help achieve quicker and more effective healing. It is also important to recognize though that these injuries can take time to properly heal. You can actively help the healing process by resting the leg and not engaging in sport or vigorous activity that stresses an already injured hamstring. I know that recommendation sounds like such simple, non-treatment advice, but it is not uncommon to see reaggravation of an injury from returning to activity too soon or not fully recovering from the initial injury because there was never an adequate period of rest. When a sport is your passion, being advised to avoid it or even just limit it can be extremely hard to do. As a result, some people return to play too soon with an injury that is at a much higher risk of getting worse. That is why it is important to see a doctor who is experienced in treating these types of injuries so that they can provide you with a roadmap of how to return to sport successfully.

Sometimes these injuries will initially feel better with RICE (Rest, Ice, Compress, and Elevate) treatment of the affected leg and giving it the time needed to fully heal. But starting physical therapy can also be very helpful to accelerate the healing process and improve your chances of returning to sport successfully and without reaggravation.

For hamstring injuries that don’t improve with these treatments or are too severe for those treatments to be effective alone, other treatment options are available. The Cedars-Sinai Kerlan-Jobe Institute provides platelet-rich plasma (PRP) injections for some hamstring injury types. This treatment involves drawing a small amount of blood and using a special machine to spin it down via centrifuge to concentrate the platelets and other important healing components. The PRP is then re-injected into the patient at the area of injury under ultrasound guidance to help stimulate the body’s healing response. The appropriate use of PRP is dependent on a patient’s injury and their unique set of circumstances. In some cases where there is a more significant tear of the hamstring tendon, surgery may be recommended to repair the damaged tendon and reattach it to the bone. While the need for surgery is less common, our physicians have a breadth of training and experience in the surgical treatment of hamstring injuries – from professional athletes to avid weekend warriors.

As anyone who has ever sustained a hamstring injury can attest, a bit of preventative effort is well worth it to keep the hamstring muscles in optimal shape. With muscle tightness, imbalance, fatigue, and poor conditioning as issues that significantly raise the risk of a hamstring injury, a focus on specific physical therapy exercises and an eccentric strengthening routine can play an important role in preventing these injuries. Though these strategies may seem like a nuisance, participating in them is ultimately far more effective and far less painful than sustaining a hamstring injury and can help keep you participating in the sport or activity that you love.

Sources:

https://www.webmd.com/fitness-exercise/hamstring-strain#1

https://orthoinfo.aaos.org/en/diseases–conditions/hamstring-muscle-injuries

https://www.drdavidgeier.com/ask-dr-geier-prp-hamstring-injuries/