Hamstring Injuries

By Mark Jenkins, MD

Editor's Note: Because hamstring injuries are so common in karate, kung fu and other martial arts we have posted this article from the SportsMedWeb.

The hamstring muscles are located in the back of the thigh and injuries can be acute or chronic. Sprinting subjects these muscles to high tension loads and sudden tears can occur. The recent Olympic games in Atlanta saw several sprinters go down in agony with acute hamstring injuries. Conditions that predispose to acute injury are,

• inadequate warm-up/stretching,
• poor lower back flexibility, and
• abnormal biomechanics (e.g., anterior pelvic tilt).

Chronic hamstring injuries usually arise from an improperly rehabilitated acute injury, but may occur as the result of small amounts of trauma repeated over a long period (i.e., distance running). Poor hamstring flexibility increases the likelihood of small tears, which in turn cause the muscle to shorten and get tighter. A vicious circle can become established. Prompt and appropriate initial treatment can break this spiral. The initial care of an acute hamstring injury involves the R.I.C.E. regimen. This acronym stands for,

• rest,
• ice,
• compression (e.g., an ace bandage), and
• elevation.

After 1 – 2 days, the athlete can stop the intermittent application of ice and begin a gentle stretching routine. It is important not to overstretch into the pain range , since this will contribute to muscle damage. As recovery progresses, rehabilitation exercises are added and gradually increased. Soft tissue therapy is useful to promote full range of motion and to break down areas of "scar" formation. Return to full functional activity should proceed slowly and be carefully monitored. Treat the injured muscle with respect. Too quick a return may cause a quick recurrence.

The final phases of treatment, as well as prevention, involve correcting any existing biomechanical problems and a hamstring strengthening program. A good running coach can help uncover any abnormal motion in running and video analysis can help show the athlete what is happening. Weak abdominal muscles are often the cause of an anterior (forward) pelvic tilt. Finally, eccentric exercises are vital for the prevention of hamstring injuries.

Eccentric – the muscle lengthens as it exerts force (e.g. lowering a weight). This can be done with the hamstring by using ankle weights, or using specific exercise equipment. One method to perform eccentric exercises with hamstring curl equipment is to raise the weight with two legs, and then slowly lower with one.

This article is posted with permission of Dr. Mark Jenkins and SportsMedWeb.

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Mark Jenkins, MD
Dr. Jenkins is Director of SportsMedWeb. He is a Board Certified medical practitioner, Director of the Student Health Service at Rice University and Associate Team physician for Rice University (N.C.A.A. sports).