Melbourne Storm have been flying over the past few weeks! They may struggle with the loss of Ryan Papenhuyzen with a hamstring strain.

 

Injury of the week – Hamstring Strains

There were many injuries in the AFL/NRL over the weekend, a common injury sustained by athletes in sports that involve running, change of direction and kicking are soft tissue injuries, with the most common being hamstring strains. Hamstring injuries make up for 26% of all injuries in professional football (Lahti et al. 2020). Melbourne Storm’s Ryan Papenhuyzen is facing selection doubt for the infamous State of Origin after sustaining a sprinting mechanism hamstring strain while scoring a try. 

What is a Hamstring Strain?

The hamstring complex is made up of 3 muscles which include semimembranosus, semitendinosus and biceps femoris. The hamstring muscles are responsible for helping bend the knee and the hip move backwards. This muscle group is important for many aspects of sport such as sprinting, slowing down, kicking and changing direction. These muscles need to have adequate strength and be well-equipped to stretch especially for reaching down for ground balls in AFL and reaching down for a low ball in  NRL. Hamstring strains (as well as other muscle strains) are graded in terms of severity from Grade 1 (mildest) to Grade 3 (most severe). 

Causes of a Hamstring Strain

Hamstring muscle strains usually occur as a result of a single event where it exceeds the athlete’s muscle stretch and strength capabilities (Hickey et al. 2022). Essentially most hamstring strains occur in sports due to the load or stretch imposed on the muscle group is higher than its current threshold at the time of injury. 

Symptoms
  • Tightness 
  • Pain on stretching the hamstrings 
  • Bruising/Swelling/Tenderness at the back of the thigh
  • Pain when loading the hamstrings 
Prognosis

Time until return to sport after sustaining a hamstring injury can range anywhere from 2 – 8 weeks, depending on the severity of the muscle damage that occurred and the grading of injury (Erickson & Sherry, 2017): 

  • Grade 1 – mild muscle strain (up to 3 weeks)Symmetry-Physiotherapy-Hamstring

These have the quickest prognosis and are usually described as muscle ‘tightness’ and/or pain in the back of the thigh with no real loss in muscle strength and length.

  • Grade 2 – partial tear (4-8 weeks) 

This is when there is a little more damage to the muscle and there is moderate loss of muscle strength and length, as well as pain/swelling and tenderness to touch which may cause you to limp. 

  • Grade 3 – full tear (8+ weeks)

This is where there is a severe to complete rupture of the muscle causing a lot of pain to walk with likely bruising. Surgery may be required in some cases. 

Rehabilitation and Prevention 

Within the first 72 hours of a hamstring muscle strain the NO H.A.R.M protocol should be applied to reduce the amount of swelling and bleeding to the area, which is – No Heat, Alcohol, Running or Massage. It is also good to provide some compression to the area and ice if required in the first 48 – 72 hours to assist with pain management and reduce bleeding/swelling. 

The goal of rehabilitation is to promote tissue healing by gradually increasing load and flexibility to help gain full stretch and strength of the hamstring muscle(s) affected. Full strength and stretch should be achieved pain free prior to returning to sport. This will be guided by your physiotherapist to meet the demands of your particular sport. 

 

Take Home Message

It is important to recognise when you may have sustained a hamstring injury and to avoid returning to sport until you have been given clearance by your physiotherapist. Premature return to sport may result in risk of re-injury. Remember to keep the hamstrings strong!

 

The Team at Symmetry Physiotherapy. 

 

References:

Erickson, L. N., & Sherry, M. A. (2017). Rehabilitation and return to sport after hamstring strain injury. Journal of sport and health science, 6(3), 262–270. https://doi.org/10.1016/j.jshs.2017.04.001

Hickey, J. T., Opar, D. A., Weiss, L. J., & Heiderscheit, B. C. (2022). Hamstring Strain Injury Rehabilitation. Journal of athletic training, 57(2), 125–135. https://doi.org/10.4085/1062-6050-0707.20

Lahti J, Mendiguchia J, Ahtiainen J, et alMultifactorial individualised programme for hamstring muscle injury risk reduction in professional football: protocol for a prospective cohort studyBMJ Open Sport & Exercise Medicine 2020;6:e000758. doi: 10.1136/bmjsem-2020-000758