Strong Hamstrings May Prevent Injury
Hamstrings are an important muscle group in the thigh, making your knees and hips function properly. They are heavily used in sports that involve running, jumping, squatting, kicking, and other strenuous movements. Thus, hamstring injuries occur frequently and in a wide variety of sports. In fact, a survey by NCAA found that this was the most common injury in collegiate athletes.1 Most hamstring injuries are sprains or partial tears and occur either in the muscle or at the muscle-tendon junction, typically during an activity that involves sprinting. An athlete may report sudden sharp pain in the thigh during sports activity, and may even recall hearing or feeling a “pop.” Symptoms include pain and stiffness in the back of the thigh. The injured athlete will typically walk with a stiff-leg, keeping the hip fully extended. Physical examination by a trained sports medicine professional should be performed as soon as possible, and additional assessment, such as ultrasound or MRI, may be ordered to help evaluate the exact location and severity of the injury.
A number of risk factors for hamstring injuries have been proposed, including inadequate warm-up, strength imbalance, lack of flexibility, weak core, as well as lower extremity muscle weakness and fatigue. The most significant risk factor for hamstring injury in sports is a previous history of such injury. The risk of recurrence after a hamstring strain or tear has been shown to be as high as 31%. Consequently, a number of prevention programs have been designed, which focus on improving hamstring strength and endurance.2 When properly implemented, these programs have been shown to be effective on both professionals and amateurs, with a decreased risk of first-time injuries and recurrences. These programs are considered most beneficial when started during the pre-season.
In summary, hamstring injuries are common in athletes, and need to be assessed early and with careful physical examination, as well as proper and timely imaging. Prompt initiation of conservative management allows most hamstring injuries to recover well, and enables athletes to return to sports participation within days to weeks, depending on injury severity. In addition, initiation of pre-season prevention programs focusing on hamstring strengthening may decrease the risks of injury during sports participation. More severe injuries, although rare, tend to occur at areas near the hip or the knee, and often require surgical repair.
References 1. Dalton SL, Kerr ZY, Dompier TP. Epidemiology of hamstring strains in 25 NCAA sports in the 2009–2010 to 2013–2014 academic years. Am J Sports Med. 2015. 43(11): p. 2671-9. 2. van der Horst N, Smits DW, Petersen J, Goedhart EA, Backx FJ. The preventive effect of the nordic hamstring exercise on hamstring injuries in amateur soccer players: a randomized controlled trial. Am J Sports Med. 2015. 43(6): p. 1316-23.