Hamstring injuries are one of the most common, poorly rehabbed muscle injuries. They have a tendency to re-tear, just when you think you are in the clear.
But why does this happen?
This is the million dollar question that the elite sports teams to the weekend warrior are asking.
It is complex – and that is why to date there is still a lot of money and time being devoted to research in this area. The three main reasons that your hamstring will ‘go’ again are:
- The shape of the muscle
- Not addressing all aspects of return to play
- The cause from the original injury still exists!
So let’s address these one at a time…
The design of the muscle – not so simple!
The hamstrings are a group of four muscles which attach to your hip and to the knee. The issue with this is that the muscle is often stretched from both ends when running, bending over, kicking – placing a great deal of load to the hammy muscles and tendons.
This is often overloaded to a point which the hammys are not used to… and so a tear is created. Insufficient strength and control when performing these movements predisposes the athlete or everyday person to getting injured. Unfortunately not much can be done about the shape and location of the muscle to reduce your injury risk!
Not addressing all aspects of rehab
It is one thing to complete a bunch of standing hamstring curls and glute bridging for hamstring rehab – but to do this without covering the different aspects that the hamstring muscle group needs to adequately delve into the ‘outside world’ safely is the most common mistake.
The fitness industry loves to use the buzz word ‘functional’ training, and when it comes to rehab we need to consider function with a whole bunch of questions for how you plan to use your hamstring once you’re back to your best.
Considerations after hammy rehab
- Has the hamstring been sufficiently lengthened throughout rehab?
- Has the hamstring developed the eccentric under length (halting forces) phase to cope with heavy eccentric loads when running?
- Has the hamstring established rotational stability? – think running around the bend of an athletics track in a 400m race.
- Has the hamstring been worked at fatigue?
- Has the hamstring been worked as part of a cog in the machine with it’s surrounding muscles?
The cause from the original injury still exists!
Great! The hamstring no longer hurts and you can run like you did pre-injury. How good is that! But wait.. this has happened previously and resulted in you being back in rehab way too soon.
Has the ‘real’ reason your hamstring injury keeps recurring been addressed?
These area known as ‘causative factors’ – which can be an internal factor such as poor lumbopelvic control or issues around your hip and ankles which cause your hamstring to do more than its fair share of the work.
External factors such as high training loads and exercise technique. This area in the #1 most missed area when returning to sport post injury.
Injuries don’t just happen because of luck of the draw – there is always a reason.
Written by
Pete Colagiuri
Sports Physiotherapist
Pete has over 20 years experience as a Physiotherapist and specialises in running biomechanics and complex injuries. He believes that you must identify and fix the underlying cause of an injury, to recover faster, prevent recurrences and improve performance.
