How To Reduce Return To Sport Timeframes With Hamstring Strain Injuries

Reducing Return To Sport Timeframes Following Hamstring Strain

Hamstring Strain Common With Sprinting

Hamstring injuries are both an equally common and frustrating injury for athletes involved in sprinting sports to experience. Frustrating because following injury there is always a recovery period required but more so because a hamstring strain is an injury that tends to have high recurrence rates with some reports suggesting around a 16-30% hamstring injury recurrence rate. With the majority of hamstring injuries it is the long head of biceps femoris (which is the more lateral of the three hamstring muscles) that gets injured. Typically recovery time frames with hamstring injuries are suggested to be around an average of 20 days to return to play. Which is an amount of days meaning for your classic weekend warrior following a hamstring strain they ultimately end up missing at least two or three matches. This is the big scheme of things isn’t many but when a season is often only 18- 20 games long missing 3 of them is significant to the athlete.
Worse still is if injury involves the “common hamstring tendon” it is then suggested that the recovery time frames blow out significantly, with return to play timeframes somewhere around an estimated average of 72 days to return to play. Which obviously means in a 18 game season this could see the athlete miss around half a season of matches and this is why hamstring injuries can prove to be a very frustrating complaint for the keen athlete.

Predicting Recovery Time Frames With Hamstring Injuries

The majority of hamstring injuries result from fast running where some studies estimate around 80% of hamstring strains come from this activity alone. When it comes to recovery from injury there are a few predictors of outcomes and return to play delays and some of these simple injury severity predictors are listed below:
• Severity of pain felt at the time of injury.
• Palpable length of the hamstring that is painful to the touch.
• Specific location of the area that is painful to touch.
• Pain experienced with bending forward and trying to touch toes.
If the individual has pain bending to touch their toes, significant pain at the time of injury, with pain indicating a high hamstring strain where there is tenderness to touch starting high up near the fold of the buttocks that extends a distance into the posterior thigh then these are all predictors of a poor prognosis. With these factors indicating a potentially slow and drawn out recovery process for the athlete.

Start Hamstring Strain Treatment With Your Physio Early

Following a hamstring injury where possible it is important to start treatment early. Early management can help reduce the time taken to return to sport. Obtaining professional advice from a physiotherapist regarding the management of your hamstring strain and prescription of an appropriate rehabilitation program with strict guidelines on your checklist regarding return to sport is crucial for reducing both the time out of action and the likelihood of any injury recurrence. For the program to be successful, a rehabilitation strengthening program for hamstring injury recovery ideally would tie in around 3 sessions a week of targeted work into the athletes other training commitments (be they running, other cardio, weights…).

Nordic Hamstring Exercises As A Go To Hamstring Strengthening Exercise

An exercise that has some solid research backing regarding its use in both reducing the incidence of hamstring strains and the recurrence of hamstring strains in individuals suffering repeat episodes is what is called the “Nordic hamstring” exercise (as can be seen in the partner assisted Nordic hamstring exercise image above).
The Nordic hamstring exercise is a partner (or equipment) assisted eccentric strengthening exercise for hamstrings. It has been shown to decrease the incidence of hamstring strains by 60% and reduce recurrence by 80%. As a result Nordic hamstring curls are an exercise included in most hamstring rehabilitation programs as individual progress towards returning to play, as well as those looking to reduce the likelihood of re injury when already successfully back playing.

Returning To Play Following A Hamstring Strain

Not only is appropriate assessment and prescription of a sport specific rehabilitation program crucial when managing a hamstring strain (be it, acute, or recurrent), the importance of timing the return to sport moment can not be underestimated. Some research has suggested on return to play the athlete has a 30% increased risk of recurrence of their hamstring injury up until week 14 post-injury.

A T-Test for agility (involving sprinting, bending, turning, and backwards running) is a good checklist exercise for return to play. A successful T-Test performed pain free at 100% prior to any return to sport where fast running is involved would increase confidence in predicting a successful resumption of activity.

Also a basic rule to follow is if you can’t train at 100% you can not play, end of story! Actual game play typically encourages athletes to give the clichéd “110%” therefore any athlete holding back at training (however much) to protect their hamstring in my experience has little, to no chance of lasting the actual competitive match with out suffering a disappointing re-injury to their hamstring. So the rule is… Only can the idea of an actual match be entertained when training is unrestricted. The classic training at 90% on a Thursday night to test it out and then playing on the weekend, is fraught with risk and is not recommended. If an athlete is doing this then I would suggest they are not ready and should continue their rehab in the coming week and return once having successfully trained at 100%.

Disclaimer: This information is provided as an educational service and is not intended to serve as a substitute for personalized medical advice. Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned in this post. Anyone seeking specific advice, or assistance regarding “hamstring strain” should consult his, or her physiotherapist, orthopaedic surgeon, general practitioner, sports medicine specialist, or otherwise appropriately skilled medical practitioner.