Determining the reason for a hamstring tear is very often the most challenging. Apart from routine biomechanic, core stability and flexibilty assessment, muscle imbalance checks are important. Simple strength testing for hamstrings involves comparing the good side to the injured one. This is often a good enough test to determine loss of strength. However, clinically it is often found that people possess weak hamstrings on both sides. It seems that people dislike training their hamstrings for numerous reasons. Some excuses given include:
“hamstrings are weaker than the quadriceps hence more difficult to strengthen”
“it is more painful to do hamstring exercises”
“people only strengthen what they can see in the mirror”
Strengthening of hamstring muscles can be done in various ways. Most commonly are bridging exercises, dead lifts and Russian curls (which involves lowering of the body in a kneeling position). Traditional hamstring curls done whilst lying on your stomach are no longer deemed appropriate as they are not functional. It is not often we use our hamstring muscles in this fashion.
Chronic hamstring pain tends to be more complex as it often involves the hamstring tendon/s. Tendon injuries tend to take longer to heal with studies showing that tendons require 100 days for maximal healing. Pain in the region of the hamstring can also arise from:
- dysfunction in the lower back
- nerve entrapment or tightness around nerves (particularly the sciatic nerve)
- groin/adductor muscle pathology
Rest times for chronic injuries are usually longer with a much more gradual strengthening programme. The same principles apply as when treating acute injuries such as looking at one’s biomechanics, core stability, flexibility and overall strength.
As always, it is recommended that you consult the appropriate health professional who can make a full assessment and then direct your management/treatment.
