Skip to main content

Hamstring Injuries

Proposed Aetiological Factors, Prevention, and Treatment

Summary

Injuries to the hamstring muscles can be devastating to the athlete because these injuries frequently heal slowly and have a tendency to recur. It is thought that many of the recurrent injuries to the hamstring musculotendinous unit are the result of inadequate rehabilitation following the initial injury. The severity of hamstring injuries is usually of first or second degree, but occasionally third-degree injuries (complete rupture of the musculotendinous unit) do occur.

Most hamstring strain injuries occur while running or sprinting. Several aetiological factors have been proposed as being related to injury of the hamstring musculotendinous unit. They include: poor flexibility, inadequate muscle strength and/or endurance, dyssynergic muscle contraction during running, insufficient warm-up and stretching prior to exercise, awkward running style, and a return to activity before complete rehabilitation following injury.

Treatment for hamstring injuries includes rest and immobilisation immediately following injury and then a gradually increasing programme of mobilisation, strengthening, and activity. Permission to return to athletic competition should be withheld until full rehabilitation has been achieved (complete return of muscle strength, endurance, and flexibility in addition to a return of co-ordination and athletic agility). Failure to achieve full rehabilitation will only predispose the athlete to recurrent injury. The best treatment for hamstring injuries is prevention, which should include training to maintain and/or improve strength, flexibility, endurance, co-ordination, and agility.

This is a preview of subscription content, access via your institution.

References

  • Agre, J.C. and Baxter, T.L.: Strength and flexibility characteristics of collegiate soccer players. Archives of Physical Medicine and Rehabilitation 62: 539 (1981).

    Google Scholar 

  • Arner, O.; Lindholm, A. and Orell, S.R.: Histologic changes in subcutaneous rupture of the Achilles tendon. Acta Chirurgica Scandinavica 116: 484–490 (1958).

    Google Scholar 

  • Baker, B.E.: Current concepts in the diagnosis and treatment of musculotendinous injuries. Medicine and Science in Sports and Exercise 16: 323–327 (1984).

    PubMed  CAS  Google Scholar 

  • Basmajian, J.V.: Muscles Alive: Their Functions Revealed by Electromyography, pp. 156–164 and 235–280 (Williams and Wilkins Company, Baltimore 1978).

    Google Scholar 

  • Brewer, B.J.: Mechanism of injury to the musculotendinous unit. Instructional Course Lectures, American Academy of Orthopedic Surgeons 17: 354–358 (1960).

    Google Scholar 

  • Brewer, B.J.: Athletic injuries; musculotendinous unit. Clinical Orthopedics 23: 30–37 (1962).

    CAS  Google Scholar 

  • Brubaker, C.E. and James, S.L.: Injuries to runners. Journal of Sports Medicine 2: 189–198 (1974).

    PubMed  Article  CAS  Google Scholar 

  • Burkett, L.N.: Causative factors in hamstring strains. Medicine and Science in Sports and Exercise 2: 39–42 (1970).

    CAS  Google Scholar 

  • Cailliet, R.: Low Back Pain Syndrome, 2nd ed, pp.44–46 (F.A. Davis Company, Philadelphia, 1968).

    Google Scholar 

  • Casal, D.C.; Agre, J.C.; Leon, A.S.; McNally, M.C.; Baxter, T.L.; and Serfass, R.: Pre-season cardiorespiratory, anthropometric, and musculoskeletal characteristics of professional ice hockey players. Submitted for publication (1985).

    Google Scholar 

  • Christensen, C.S.: Strength, the common variable in hamstring strain. Athletic Trainer 7: 36–40 (1972).

    Google Scholar 

  • Cooper, D.L. and Fair, J.: Trainer’s corner: Hamstring strains. Physician and Sportsmedicine 6: 104 (1978).

    Google Scholar 

  • Craig, T.T. (Ed.): American Medical Association Comments in Sports Medicine, pp.25–27 (American Medical Association, Chicago, 1973).

    Google Scholar 

  • Dornan, P.: A report on 140 hamstring injuries. Australian Journal of Sports Medicine 4: 30–36 (1971).

    Google Scholar 

  • Ekstrand, J. and Gillquist, J.: Soccer injuries and their mechanisms: A prospective study. Medicine and Science in Sports and Exercise 15: 267–270 (1983).

    PubMed  Article  CAS  Google Scholar 

  • Garrett, W.E.: Strains and sprains in athletes. Postgraduate Medicine 73 (3): 200–209 (1983).

    PubMed  Google Scholar 

  • Gilliam, T.B.; Sady, S.P.; Freedson, P.S.; and Villanacci, J.: Isokinetic torque levels for high school football players. Archives of Physical Medicine and Rehabilitation 60: 110–114 (1979).

    PubMed  CAS  Google Scholar 

  • Glick, J.M.: Muscle strains: Prevention and treatment. Physician and Sportsmedicine 8: 73–77 (1980).

    Google Scholar 

  • Inman, V.T.; Ralston, H.J.; and Todd, F.: Human Walking, pp.l–154 (Williams and Wilkins, Baltimore 1981).

    Google Scholar 

  • Kennedy, J.C. and Willis, R.B.: The effects of local steroid injections on tendons: A biomechanical and microscopic correlative study. American Journal of Sports Medicine 4: 11–21 (1976).

    PubMed  Article  CAS  Google Scholar 

  • Kirby, R.L.; Simms, F.C.; Symington, V.J. and Garner, J.B.: Flexibility and musculoskeletal symptomatology in female gymnasts and age-matched controls. American Journal of Sports Medicine 9: 160–164 (1981).

    PubMed  Article  CAS  Google Scholar 

  • Kottke, F.J.: Therapeutic exercise to maintain mobility and therapeutic exercise to develop meuromuscular coordination; in Kottke et al. (Eds) Krusen’s Handbook of Physical Medicine and Rehabilitation, 3rd ed. pp.389–402 and 403–426 (W.B. Saunders Company, Philadelphia 1982).

    Google Scholar 

  • Kraus, H: Evaluation and treatment of muscle function of the athletic injury. American Journal of Surgery 98: 353–362 (1959).

    PubMed  Article  CAS  Google Scholar 

  • Kulund, D.N. (Ed.): The Injured Athlete, pp.358–359 (J.B. Lippincott Company, Philadelphia 1982).

    Google Scholar 

  • Leach, R.: Running injuries of the knee; in D’Ambrosia and Drez Jr (Eds) Prevention and Treatment of Running Injuries, pp. 57–76 (Charles B. Slack, Inc., Thorofare, NJ 1982).

    Google Scholar 

  • Mann, R.A.: Biomechanics of running: in D’Ambrosia and Drez Jr (Eds) Prevention and Treatment of Running Injuries, pp.l–14 (Charles B. Slack Inc., Thorofare, NJ 1982a).

    Google Scholar 

  • Mann, R.A.: Biomechanics of running; in Mack (Ed.) American Academy of Orthopedic Surgeons’ Symposium on The Foot and Leg in Running Sports, pp. 1–29 (C.V. Mosby Company, St Louis 1982b).

    Google Scholar 

  • Mann, R.A. and Hagy, J.L.: Running, jogging, and walking: A comparative electromyographic and biomechanical study; in Bateman and Trott (Eds) The Foot and Ankle (Thieme-Stratton, Inc, New York 1980).

    Google Scholar 

  • Mannis, C.I.: Individualized preseason evaluation of high school football players. Medicine and Science in Sports and Exercise 12: 135 (1980).

    Google Scholar 

  • Morris, A.F.: Sports Medicine: Prevention of Athletic Injuries, pp. 162–163 (Wm C. Brown Publishers, Dubuque, Iowa 1984).

    Google Scholar 

  • Mueller, E.A.: Influence of training and inactivity on muscle strength. Archives of Physical Medicine and Rehabilitation 51: 449–462 (1970).

    Google Scholar 

  • Roy, S. and Irvin, R.: Sportsmedicine: Prevention, Evaluation, Management and Rehabilitation, pp.298–305 (Prentice-Hall, Inc., Englewood Cliffs, NJ 1983). ai]Scudder, G.N.: Torque curve produced at the knee during isometric and isokinetic exercise. Archives of Physical Medicine and Rehabilitation 61: 68–73 (1980).

    Google Scholar 

  • Tipton, C.M.; Matthes, R.D.; Maynard, J.A.; and Carey, R.A.: The influence of physical activity on ligaments and tendons. Medicine and Science in Sports 7: 165–175 (1975).

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Agre, J.C. Hamstring Injuries. Sports Medicine 2, 21–33 (1985). https://doi.org/10.2165/00007256-198502010-00003

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-198502010-00003

Keywords

  • Stance Phase
  • Gait Cycle
  • Swing Phase
  • Hamstring Muscle
  • Hamstring Injury