By Dr. Michael Harper, OSMS Interventional Sports Medicine/Physical Medicine & Rehabilitation Physician

Dr. Harper is board-certified in Sports Medicine and Physical Medicine & Rehabilitation. He sees patients at our OSMS Green Bay Location and treats non-operative orthopedic conditions such as knee pain, shoulder pain, hip pain, and neck and back pain. Additionally, he treats a variety of both acute and chronic conditions from ankle sprains to tendon disorders, to osteoarthritis.

Dr. Harper performs a variety of musculoskeletal procedures in which the majority are guided by ultrasound or fluoroscopy (x-ray). Some of these procedures he performs include joint injections, radiofrequency ablations, and Orthobiologics – also known as Regenerative Medicine.

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How is the Hamstring Structured?
The hamstring is made up of three muscles in the back of the thigh. These muscles are the semitendinosus, semimembranosus, and biceps femoris. Each of the hamstring muscles originate from the pelvis at the ischial tuberosity which is at the buttock and insert below the knee.

How does a Pulled Hamstring or Hamstring Strain Occur?
A pulled hamstring or a hamstring strain can be an injury to one or more of the muscles in the back of the thigh. Partial hamstring tears are the most common type of injury and typically managed without surgery. A grade 1 strain is considered mild and usually heals readily, while a grade 3 strain is a complete tear of the muscle or tendon that can take months to heal and may require surgery.  

The majority of the grade 1-2 injuries occur in the muscle belly or where the muscle fibers turn into the tendon fibers.  The most severe injuries occur to the tendon where it tears away from the bone and the buttock. It may also have pulled a piece of the bone away with it, which would classify this injury as an avulsion injury.

Who is at Risk of a Pulled Hamstring or Strained Hamstring?
Hamstring muscle injuries, often referred to as a “pulled hamstring”, occur frequently in athletes, particularly those who participate in sports that require sprinting and changing directions. Some of these sports include track, soccer, football, and basketball.

Most commonly the injury occurs when the muscle is being stretched beyond its capacity or challenged with the sudden load. Hamstring muscle injuries typically occur with an eccentric load or contraction which is where the muscle is contracting but lengthening at the same time. During sprinting the hamstring muscles contract eccentrically as the back leg is straightened and the toes are used to push off and move forward.

Risk Factors include:

• Muscle tightness
• Muscle imbalance
• Poor conditioning
• Muscle fatigue

What are the Symptoms of a Hamstring Injury?
Symptoms typically include sudden pain in the back of the thigh, when running, that will cause someone to quickly stop or hop on the good leg. Furthermore, the area may swell or have bruising and discoloration on the back of the leg. This bruising may travel down the leg into more severe injuries. Weakness in the hamstring may occur and can persist for weeks.

Treatment Options:
Non-surgical treatment for hamstring injuries starts with the basics for any musculoskeletal injury. This includes what is known as PRICE:

• Protect
• Rest
• Ice
• Compression
• Evaluation

Therapeutic exercises with a physical therapist or athletic trainer is also utilized to regain flexibility, strength and optimize the healing process to return to activities.

When this treatment fails, we can consider utilizing neurodevelopment and technology such as platelet rich plasma (PRP). Additionally, we can retake the patient’s own blood and concentrate the healing factors, including the platelets, and inject them directly into the site of injury under ultrasound guidance to promote healing response. More research is currently being done to fully understand the role of PRP and muscle injuries such as hamstring strains.

Prevention:
The ways to prevent hamstring injuries are to optimize flexibility and strength, including correcting any muscle imbalances. This is typically done by providers that specialize in sports performance such as personal trainers, like our friends at Synergy Sports Performance in Green Bay and Blaze Sports & Fitness in Appleton.

If you or someone you know is suffering from a Hamstring Injury, schedule an appointment with me, Dr. Michael Harper, or another one of my colleagues, by clicking here: Schedule an Appointment