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Managing High Hamstring Strains

Managing High Hamstring Strains
Managing High Hamstring Strains

How Do I Treat A High Hamstring Strain?

Similar to the patellar and Achilles tendons, the tendon at the origin of the hamstrings is thick and fibrous with poor blood supply, making healing difficult with high hamstring strains. With the issue generally being more a degenerative process than an inflammatory one meaning that parts of the tendon have become frayed, damaged, and disordered again similar the majority of Achilles tendinopathies. Following making the diagnosis of a high hamstring strain and gauging severity through questioning, physical examination and/or a MRI scan treatment can begin.

Loading For High Hamstring Strains

Patellar and Achilles tendon complaints have for many years been treated quite effectively with eccentric strength exercises. Similar loading patterns make up a core part of high hamstring strain rehabilitation. Frequently loading begins with more sustained holds (isometric) style exercises and progressing as tolerated towards more eccentric (lengthening loading) exercises.
A strong and stable core including hip musculature such as the deep gluteal muscles can help stabilize the pelvis potentially taking strain off the hamstrings so it is not uncommon for exercises addressing trunk and hip stability to be included in any high hamstring rehabilitation program.
While some risk factors such as age cannot be changed, others, such as muscle imbalances and lack of flexibility, can be addressed through physiotherapy. Patients should work with their physio to strengthen weak muscles, increase mobility in tight areas as well as optimize alignment, form and biomechanics where applicable.

Maintaining Fitness Whilst Rehabilitating High Hamstrings Strains

It is important whilst undergoing rehabilitation for high hamstring strains that fitness is maintained to help a smooth transition with return to play or full training not to mention maintaining mental well being as chronic injuries can obviously be very frustrating for the athlete. Personally I don’t have an issue with people cross training during their rehab and in fact encourage it, however any training should not stress the area during training or be felt after training either when cooled down or the following day. Your physiotherapist can help guide you on what would be considered appropriate cross training in your individual situation following assessment of the severity of the injury and specific demands of the sports and activities you wish to return to.

Tips For Avoiding Day To Day Aggravation With High Hamstring Strains

  • High Hamstring strains are frequently uncomfortable or even painful when sitting or pressing down on the ischial tuberosity (sit bone). Generally try to avoid sitting on hard surfaces to minimize aggravating the condition.
  • Bending the hip up (fully flexing the hip bring your knee towards your hip) can cause pain at ischial tuberosity as it puts the tendon under stretch. Try to find ways to dress and wash yourself without using this bending movement to avoid irritation to the tendon. Also look at using loose slip on style or open shoes rather than ones with laces you have to bend to tie up or require pulling firmly when getting them on and off with difficulty over your foot.

Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Managing High Hamstring Strains should consult his or her physiotherapist or otherwise appropriately skilled practitioner.

Hayden Latimer is the founder of and principle physiotherapist at Sydney Physio Clinic. Since graduating from Otago University, Dunedin, New Zealand he’s gained wide experience practicing across the globe for over 15 years and is now extremely knowledgeable in helping people reduce discomfort and restore function and mobility.


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