Tuesday, September 27, 2011

The Troublesome Hamstring

We’ve all seen our favorite player pull up as she breaks away a layup or runs down a drop shot.  The player grabs the back of the thigh and limps off to the side to receive “treatment” for the dreaded hamstring strain.  You know it will hobble her for the rest of the match and it’ll be a constant annoyance for the rest of the tournament.

Recently, in American pro football, Arian Foster and Miles Austin are the latest big name hamstring tears to hit the mainstream media.  Foster’s decision to even tweet a picture from his MRI scan speaks to the annoyance of this injury.  But how bad could it be?  There’s no talk of surgery on these tears, right?

So what are the hamstring muscle and how to prevent such an annoying injury?  What are the potential treatments?


Unfortunately, hamstring injuries occur in all age groups and are quite common.  They strike athletes of all sorts, from tennis players to track sprinters to footballers (the beautiful game- soccer, Australian-rules, and American).  This group of three muscles in the back of the thigh bends your knee.  They function quite a bit with any locomotion.  The strain/pull/tear occurs when the muscles are suddenly stretched when sprinting and lunging as the knee straightens and hip flexes.


In an injury to this area, there can be an intramuscular tear or a tear of the tendon attachment to the pelvis at the lower buttock.  It’s a bad one when you look at the back of your thigh that night and you see a dark blue bruise!

Prevention revolves around proper warm up, consistently stretching the hamstring (not right before you start exercising, but after you warm up and after you cool down), keeping your hamstring strong to balance against the powerful quadriceps on the front side of the thigh, and being gradual in increasing your exercise regimen.  Staying warm during workouts/exercise by wearing bicycle shorts may be helpful.

Treatment is rarely surgical and generally performed only for severe tears of the tendon off of its attachment to the pelvis in high-level athletes.

Initial treatment includes ice, elevation and compression.  After 1-2 weeks, as the injured area is scarring in, stretching and careful progression of strengthening exercises occurs. 

Re-injury after a hamstring strain is generally more severe and has a longer recovery time.  Sorry, Adrian Foster and Miles Austin fans (both re-tears from training camp injuries)!  I wouldn’t be surprised if the team doc tries some new invasive measures like platelet-rich plasma (PRP) injections (injecting the player’s own platelets and growth factors to the area of tear) to help stimulate quicker healing.  That’s a topic for another time.

Until the next injury…


  1. Water skiing in July was a bad idea for this 53 year old. I knew it was bad when I felt my hamstring pop as I crashed. Had trouble getting in the boat an to the hospital the next morning. Before the injury I was running 3-5 miles a day and biking 10-15 miles. Well it's been 4 months now and I'm trying to run again. Well not quite since I only ran 1 mile and it feels weird. Now I have pain again. Both on the outer and inner side of my hamstring. What is going on--will I ever run again and begin shedding those new pounds? Please make a recommendation and write back to cernuda1@comcast.net

    1. Hi Lee, thanks for posting. I would see an Orthopaedic surgeon to see what part of the hamstring is torn. If it's near the buttock, then an X-ray should be done to check for an avulsion fracture, where the tendon pulls a small fleck of bone off of the pelvis. If that occurs and it's badly displaced (possible pushing on sciatic nerve) then surgery may be needed.

      Sometimes all you need is physical therapy to break down the scar tissue and strengthen the muscle. That helps most people. If it doesn't, then an MRI may be in order.

      I hope that works out for you!