Hamstring strains. What is a hamstring strain? How do hamstring strains occur? what you ll find in this brochure

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1 what you find in this brochure What is a hamstring strain? How do hamstring strains occur? What you shoud do if a hamstring strain occurs. What rehabiitation you shoud do. Exampe of a return to pay strategy. How you can reduce the risk of re-injury. What is a hamstring strain? The hamstrings are a group of musces at the back of the thigh A hamstring strain is caused by an over-stretch resuting in a tear or compete rupture of one or more of the three hamstring musces (e.g. when sprinting from either a jog or a standsti position) Hamstring strains are common in sports that require exposive stop-start running motions (e.g. rugby, netba and athetic sprinting events) How do hamstring strains occur? Hamstring strains frequenty occur at the beginning of a game/training session due to inadequate warm-up, or near the end of the game/training session when fatigue is a contributing factor Poor rehabiitation can eave infexibe scar tissue making it prone to re-injury Hamstring injuries often recur and can become ong-term injuries if rehabiitation is inadequate or the progression of rehabiitation is too fast Common Injuries HAMSTRING STRAINS Page 1 /5 Te Kaporeihana Awhina Hunga Whara

2 What shoud you do if a hamstring strains occur? Appy the RICED procedure... RICED procedure rest Rest reduces further damage - stop activity as soon as the injury occurs. Avoid as much movement of the injured part as possibe to imit further injury. Don't put any weight on the injured part of the body. ice Ice coos the tissue and reduces pain, sweing and beeding. Pace ice wrapped in a damp towe onto the injured area - don't put ice directy onto bare skin. Hod the ice pack firmy in pace with a bandage. Keep ice on the injury for 20 minutes every two hours for the first 48 hours. compression Firm bandaging heps to reduce beeding and sweing. Ensure that bandaging is not so tight that it cuts of circuation or causes tinging or pain past the bandage. Bandage the injury between ice treatments. eevation Eevation heps to stop beeding and reduce sweing. Raise the injured area on a piow for comfort and support. Keep the injured area raised as much as possibe. diagnosis Consut a medica professiona (such as a doctor or physiotherapist) especiay if you are worried about the injury, or if the pain or sweing gets worse. If the pain or sweing has not gone down significanty within 48 hours, aso seek treatment. An accurate diagnosis is essentia for proper rehabiitation of moderate to severe injuries. Common Injuries HAMSTRING STRAINS Page 2 /5 Te Kaporeihana Awhina Hunga Whara

3 What rehabiitation shoud foow a hamstring strain? The foowing recommendations serve as a guideine ony. Aways seek the advice of a medica professiona for a rehabiitation programme specific to you and your injury. Range of motion Restoring norma range of motion is essentia to aow fu functiona recovery of the injured musce Stretching the hamstrings wi hep to restore the ength of the musces. This wi reduce the risk of further injury and assist performance Initia stretching shoud be imited by pain. Longer stretches (10 to 20 seconds) hed at positions of greater stretch shoud be performed as comfort permits A eve of fexibiity equa to or greater than the opposite eg is desirabe before return to competition Continued stretching during the season wi hep to maintain fexibiity Cardiovascuar fitness Keeping fit wi ensure a more comfortabe return to training and competition Over-exertion or continued activity whie fatigued coud ead to further injury n-weight-bearing activities such as swimming, cycing and arm ergometry (grinding) are good options at the beginning of rehabiitation Strength Strengthening the hamstrings and other ower imb musces is essentia to restore proper function in the ower imb Pay particuar attention to deveoping a good strength baance between the quadriceps (front thigh musces) and the hamstrings Strengthening of the guteus maximus (buttocks) and gastrocnemius (ong caf musce) is aso important Gente strengthening exercises shoud be started eary on in the rehabiitation process to minimise musce wasting and increase the speed of recovery Strength can be measured by contracting against resistance provided by another person. Ask them to make a comparison of strength between egs As improvements aow, strengthening shoud be progressed and functiona exercises incuded Advice on appropriate strengthening exercies can be provided by a heath professiona such as a physiotherapist Psychoogica status Reduced confidence foowing a hamstring injury may impair an athetes abiity to regain fu functiona capacity (e.g. striding at fu speed or acceerating rapidy whie running) Graduay attempting more difficut agiity tasks and setting reaistic goas and time frames may hep to rebuid sporting confidence Return to competition is not advised unti an individua has 100% confidence in their paying abiity Sport-specific rehabiitation Speed training is the most important part of sport-specific hamstring rehabiitation as hamstring injuries usuay occur during sudden exposive acceerations Backwards running shoud be introduced between jogging and speed training Graduay increasing straight ine (forward) running speed (e.g. from 1/2 to 3/4 to fu pace) and then introducing curves and bends work wi hep the scar tissue become accustomed to rapid and muti-directiona stresses Adding rapid acceerations and deceerations, changes of direction (cutting at 45 and 90 ) and jumping as appropriate wi aso make the training more specific to sporting activity Ensure you are competey rehabiitated before returning to competition to minimise the risk of re-injury. Common Injuries HAMSTRING STRAINS Page 3 /5 Te Kaporeihana Awhina Hunga Whara

4 Exampe of a return to pay strategy after a hamstring strain > NOTE: This is a guide ony. Timeframes for rehabiitation and return to pay vary depending on the nature and severity of the injury. Aways seek the advice of a medica professiona for a rehabiitation programme specific to you and your injury. days 1-4 post injury Have sweing and pain setted? Is stretching pain free? Begin range of motion exercises Continue RICED treatment Graduay increase stretching If sweing and pain persist, consut a Weight-bear as comfort permits medica professiona for further assessment Begin gente and treatment strengthening exercises Isometric contractions weeks 1-2 can you: Contract hamstrings against resistance without pain? Progression Continue to improve Maintain stretching strength and Graduay progress strengthening movement Basic baance exercises Maintain Fitness Pain-free stationary cycing, swimming, poo running Fu weight-bearing weeks 2-3 can you: Contract hamstrings against resistance without pain? Achieve a fu stretch? Baance on injured foot for an equa amount of time as the other foot? Demonstrate reasonabe strength? Begin functiona exercises Continue to improve Jogging when pain-free agiity and sportspecific Acceeration / dris deceeration dris Jumping, hopping, twisting, figure of eight running Maintain Fitness Jogging when pain-free, stationary cycing, swimming, poo running Fu weight-bearing weeks 4 can you: Run forwards and backwards? Sow down and stop suddeny? Jump and hop? Run up and down his? Cut to the eft and right at speed? Compete a exercises with 100% confidence? Return to training Continue to improve Maintain stretching agiity and sportspecific dris Maintain Fitness, range of motion, strength, proprioception Common Injuries HAMSTRING STRAINS Page 4 /5 Te Kaporeihana Awhina Hunga Whara

5 How can you reduce the risk of re-injury? ALWAYS seek the advice of a medica professiona before returning to sport. Inadequate rehabiitation and a premature return to sport wi increase the risk of re-injury. Continue stretching and strengthening exercises as part of a norma training routine If there is pain during activity, stop and appy the principes of acute care (i.e. RICED) A neoprene seeve can be worn to support the hamstrings and keep them warm during activity A thorough genera body warm-up shoud be foowed by stretching and a sport-specific warm-up. Stretching shoud aso be performed after exercise Fatigue is a major contributing factor for hamstring strains. Maintaining high eves of cardiovascuar fitness and muscuar endurance can hep to prevent premature fatigue If hamstring strains continue to occur or if pain is persistent, consut a medica professiona for advice on other possibe contributing factors. Common Injuries HAMSTRING STRAINS Page 5 /5 Te Kaporeihana Awhina Hunga Whara