Home' Trinidad and Tobago Guardian : June 21st 2013 Contents a variety of activities and exercises in a well-structured
programme. In many cases the runner may have to
be put through a corrective exercise programme to
retrain movement patterns and eliminate modifiable
risk factors that may have contributed to the initial
injury. The rehabilitation process is usually longer
than expected as the hamstrings take a long time to
heal and tend to develop significant scar tissue at
the injury site, which can become difficult to eliminate.
So if you experience a sudden onset of strong pain
in your hamstring while running, which soon bruises,
chances are that you have a true "pull" and should
seek medical and rehabilitative care. However, many
runners experience niggling pains, tightness and
spasms that may not necessarily prevent them from
running, but cause them to slow down and shorten
All is not right, and these athletes may benefit
from the services of a physical therapist who can
decipher the problem and correct it.
If you are a runner and have been lucky enough
not to have any hamstring issues, it is important to
keep the muscles strong and flexible. Occasionally,
massage may help release some uncomfortable knots.
But don t neglect these important muscles. While
they may not be as visible as the quadriceps, they
are equally as important and much more delicate!
Guardian www.guardian.co.tt Friday, June 21, 2013
Hamstring injuries must be every runner s worst
nightmare, not only for the debilitating effect they
have on the runner, but also for the length of time
they take to rehabilitate. I am sure Ato Boldon can
attest to this, as a hamstring injury prevented him
from competing in the World Championships in
Seville in 1999. This condition is the final topic in
this series on common running injuries.
The hamstrings are a group of three muscles that
run the length of the posterior thigh. They bend our
knees, help drive us up hills and power our explosive
kicks to the finish line. So when they are injured,
we certainly notice it!
They are especially predisposed to injury during
running, and particularly during sprinting. This is
because during the last phase of the leg swing, before
the foot touches the ground, the hamstrings are very
active as they lengthen and absorb energy in order
to slow the forward acceleration of the leg in prepa-
ration for foot contact.
This type of muscle activation is called an eccentric
contraction and places massive stress on the muscle.
The faster the sprint, the greater the effort of the
hamstrings. It is therefore vital to have flexible ham-
strings that are very strong. Other risk factors for
injury include muscle imbalances between the quadri-
ceps (muscles at the front of the thigh) and the ham-
strings, poor core control and extreme flexibility.
Hamstring injuries usually begin suddenly with
pain in the back of the thigh after or during running.
Some runners may even report pain in the location
of their "sit-bones" or ischial tuberosities, when sit-
ting. Because this injury has a high rate of recurrence,
many individuals may have battled prior pain in and
around the location of their current site of injury.
Hamstring strains are also characterized by
decreased strength and pain with contraction of the
muscle against resistance. Decreased hamstring length
is also common, with pain produced when the muscle
is stretched. There is usually also tenderness at the
site of injury in the muscle.
A hamstring strain needs to be differentiated from
other injuries that can display similar symptoms. A
qualified physical therapist or physician will be able
to rule out other conditions such as a back injury
that may refer pain to the back of the leg, and an
adductor strain (as these muscles are located in close
proximity to the hamstrings on the inside of the
Ultrasound imaging and MRIs may be of benefit
in helping to correctly diagnose the exact location
and severity of a hamstring injury, which will be
useful in determining the prognosis and length of
rehabilitation. MRIs, however, are usually reserved
for use in more severe cases.
Even with the slightest of strains, a proper reha-
bilitation programme is vital to the successful return
of the athlete to pain-free running. In fact, a high
rate of injury recurrence has been documented. One
third of all hamstring injuries will recur, with the
highest risk during the initial two weeks following
return to running.
The research has suggested that this is because
of an inadequate rehabilitation programme, or a pre-
mature return to sport, or both. It is, therefore, vital
that the runner seek the services of an up-to-date,
well-qualified physical therapist who can guide the
rehabilitation process accordingly.
The athlete must be systematically and gradually
exposed to the kinds of forces and contractions that
the hamstrings experience during running through
Hamstring strains are
also characterized by
and pain with
contraction of the
Carla Rauseo, DPT, CSCS is a Doctor of
Physical Therapy and Certified Strength and
Conditioning Specialist at Total
Rehabilitation Centre Limited in El Socorro.
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