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JAG Physical Therapy Tip

Hamstring Strain Injuries in Hockey

A pulled (or strained) hamstring is common among athletes who rely on explosive speed; it is very painful, hard to heal and can be preventable. The injury is a strain or tear in the muscles and tendons that run along the back part of your upper leg. Three muscles, working in conjunction with the quadriceps on the front of your thigh, allow your legs to straighten out at the hip joint and bend at the knees. When the hamstrings contract, the quadriceps relax and when the quads contract, the hamstrings relax. When they are out of sync, bad things can happen that extend beyond the muscle groups themselves.

How it happens:
Several factors, often in play at the same time, can cause a strained hamstring. As mentioned, an imbalance between the relative strength of the hamstrings and the quadriceps—the quads are naturally stronger than the hamstrings—and the amount of work they are able to perform at any moment could cause a strain. Not warming up properly may add to the risk factor. “A cold, un-stretched muscle that is required to contract at maximum intensity is at highest risk. If one or both sets of muscles are fatigued from training or the demand of the sport, they are even more vulnerable. If you suddenly need an extra burst of speed, tremendous force is required of both the hamstrings and the quadriceps. Put all four factors together at the same time — muscle imbalance, inadequate warm-up, fatigue, and a sudden need for speed—and you’ve created your own perfect storm for a pulled hamstring. Running in cold weather could make it even worse and poor running technique can also contribute to an overload of the muscle and a strain.

Any athlete who relies on explosive leg action is most at risk. At the top of the list are runners (especially sprinters), jumpers and skaters, followed closely by football, basketball, baseball and soccer players. Regardless of the sport, older athletes are more susceptible than younger ones.

Symptoms:

  • Severe pain behind the upper leg and/or buttock at the moment of the injury
  • Muscle spasms behind the leg after the injury has occurred
  • Bruising
  • Tenderness
  • Swelling
  • Possible popping or snapping sensation
  • A complete (Grade 3) tear
  • You may feel a “ball” of muscle on the back of the leg

Treatment:

  • Rest
  • Don’t put weight on the affected leg. Use crutches, if necessary
  • Apply ice packs for 15-20 minutes, 3-4 times a day, for at least the first 72 hours
  • Elevate your leg (using a pillow) when sitting or lying down
  • Use an elastic wrap around your upper leg for compression (to control swelling)
  • Aspirin, ibuprofen, and naproxen may relieve pain and reduce inflammation (consult a physician before taking medications)
  • If the pain is significant or if the symptoms don’t subside within two weeks, see a doctor

Return to play:
Hamstring strains can be difficult because the muscles are extremely strong and they contract every time an athlete tries to accelerate. It is not unusual for athletes, especially those who try to return to a sport too quickly, to experience pain with these powerful contractions on recently injured tissues. Minor hamstring pulls may heal on their own with time. Give your legs a rest and gradually return to training based on the absence of symptoms, not the number of days or weeks since sustaining the injury. Remember: Athletes recover at different rates. Severe hamstring pulls may take weeks or months to heal.

How to prevent it:

  • Do not increase exercise intensity, frequency or duration more than 10-15 percent a week
  • Stop exercising if you feel tightness in the back of your legs. Tightness may develop before an actual tear occurs
  • Allow extra warm-up time in cold weather
  • Incorporate flexibility exercises into your training program.

For more information on JAG Physical Therapy or any of our other fine products visit jagpt.com

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