How do the world's best manage their Hamstring Strains?


16 minutes gone of the third quarter of the second last game of the home and away season. Your team is up by 14 points against the top team. You know that you have got them by the scruff of the neck. A win here would do wonders for the confidence of your team. After an up and down season for your things have finally started to click into place. You are feeling great!

You run past a team-mate who has just taken a strong mark 60 meters out from goal. You know that he is a weak kick. You sprint past him like a man possessed willing the handball. He dishes it off to you. This is your chance to seal the game! You sprint 10 meters with the ball eyes set on the goals. You wind back the right foot ready to thump the ball over the goal umpires head.

"As your foot makes contact with the ball you feel an almighty POP at the back of your thigh. It feels like someone has shot you."

You instantly grab for the back of your leg as it collapses underneath you. As you lie there pounding the floor you know that your chance of winning a premiership is all but done.

That night you lie there in bed with ice strapped to the back of your leg and consult Dr. Google. You read multiple different management strategies. Some say stretch some say don’t! Should I move it, should I not? Should you book in for a massage? When can I run? 

"Sadly, the above scenario is all too common for the seasoned player. Unfortunately, most players still do not know how to best manage their muscle injuries"

The advice below is based on a consensus from international experts in sports medicine and using these principles you will be able manage your injury safely and effectively. 

TIP 1: Although the research is still scarce at this point of time, EARLY ICE AND COMPRESSION remain essential. By icing immediately, you can restrict blood flow to the injured area and prevent excessive inflammation. My recommended icing protocol is 15 minutes on and 45 minutes off 4-5 times per day. 

TIP 2: EARLY MOVEMENT and motion is important. This should not be to the point of pain so stay away from overloading the muscle or aggressive stretching. However gentle movements should be commenced even in the first 24 hours! 

TIP 3: Early SOFT TISSUE RELEASE and JOINT MOBILISATIONS of the lower back can make a large difference to recovery rates and this can be commenced 3 days after the initial injury.

TIP 4: MRI scans can be helpful and in some cases imperative however the DETAILED ASSESSMENT from an expert clinician will be your best guide to recovery times and rates. This is because we know that imaging doesn’t make a great predictor of return to sport timing. 

TIP 5: Return to sport timing should be based on the exact muscle affected, the position of the player and the quality and consistency of the player’s commitment to rehabilitation. We always try to keep our rehabilitation GOAL BASED rather than time based. Our Physiotherapists always give you a plan of action after assessing your personal situation. 

TIP 6: Your rehab plan must be specifically tailored to your individual injury and must include ECCENTRIC STRENGTHENING. This is the type of strengthening in which we are loading up a muscle whilst putting it on stretch. In the case of hamstring strains a single leg deadlift would be an example of an eccentric exercise. Your ability to progress to this phase of rehab needs to be determined by a Physiotherapist or you risk causing further damage! 

All soft tissue injuries are different require individual exercises, management strategies and rehabilitation plan’s. The best advice that we can give you is to consult with an expert Physiotherapist to help you map out a clear plan with achievable goals of rehabilitation. 

SIMPLY CONTACT THE CLINIC ON 5174 7250 or BOOK ONLINE with myself or one of our expert Physio's below. We can't wait to help get you back to your best!

AUTHOR: NITIN MADAN - Physiotherapist

1 Thorlund, J. B., Juhl, C. B., Ingelsrud, L. H., & Skou, S. T. (2018). Risk factors, diagnosis and non-surgical treatment for meniscal tears: evidence and recommendations: a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF). British Journal of Sports Medicine52(9), 557-565.

2  Siemieniuk, R. A., Harris, I. A., Agoritsas, T., Poolman, R. W., Brignardello-Petersen, R., Van de Velde, S., ... & Helsingen, L. (2018). Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline. British Journal of Sports Medicine52(5), 313-313.

3 Kise, N. J., Risberg, M. A., Stensrud, S., Ranstam, J., Engebretsen, L., & Roos, E. M. (2016). Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up. British Medical Journal354, i3740.