A Speedster’s Nightmare: The Hamstring Strain

Watching ESPN this past weekend while in Charlotte getting ready for our big game against the Cam Newton Panthers, I heard an amazing statistic:  Five (5) starting NFL running backs were listed as “questionable” or “out” because of hamstring injuries.

If you’re a “speed guy” or you play a “skill position” in football such as a RB, QB, WR or DB, having an injured hamstring is a nightmare. With the key role of assisting with acceleration and changing of direction, the hamstring muscles become a significant hindrance if they are not firing on all cylinders.

Getting to Know Your Hammys

You rely on them every day to move from here to there so now it’s time for you to get to know your hamstrings.  If you think about it, you sit on your hammy’s every day yet they are probably as foreign to you as your refrigerator’s owner’s manual.

Your hamstrings are made up of three (3) muscles.  All three muscles originate or start at the ischial tuberosity on the back underside of the pelvis. Two of them, the semitendinosis and the semimembranosis muscles, form the inner-back of the thigh and insert or attach just below the knee on the inner side of the tibia or shin bone.

The lateral or outer-back of the thigh is made up of the third hamstring known as the biceps femoris.  This lone lateral hamstring attaches to the head of the smaller bone of the outer shin know as the fibula.

The Functions of the Hamstring Muscles

Keeping it simple, the hamstrings flex or bend the knee joint and, more importantly, they slow the lower leg as it rapidly extends at the knee joint while running and changing directions.

This is a key function of the hamstrings because this eccentric or lengthening muscle contraction, commonly referred to as the “negative direction”, is the most difficult phase of the recovery for a speed guy to master when returning from a hamstring strain.

The hammy also assists with additional functions such as hip extension and lower leg rotation.  The bottom line is that the hamstring muscles play a vital role in normal lower extremity function.

What You Need to Know About Hamstring Strains

Whether you’re a loyal fan of the NFL or a guy looking for a better way to understand fantasy football injuries, here are my sports medicine bullet points on hamstring strains:

High Hammys are Hell – A “high hammy” is a strain to the upper tendon of the hamstrings close to the attachment at the pelvis.  It’s not a location where an athletes wants an injury.  The proximal or upper tendon is very dense and slow to heal.

Grading a Muscle Strain

  • Grade 1:  Minor strain, minimal disruption of the muscle fibers, minimal time lost.
  • Grade 2:  Moderate strain, some muscle tissue damage with a palpable location of injury, bleeding into the muscle with pain and swelling, typically out 1-4 weeks.
  • Grade 3:  Severe strain, significant muscle tissue damage with a visual defect noted in the muscle belly or upper tendon, extensive bleeding, poor muscle strength, pain with walking, typically out 3-8 weeks.

Waiting on 5th Gear – I tell my coaches that a player returning from a hamstring strain needs to “stay out of 5th gear” for the first few days.  That 5th gear will come back but if they try to test it too early during their return, it won’t be there and, by doing so, they will set themselves back for at least 1 week.  If your fantasy football star wide receiver is coming back from a hamstring strain, you’ll be more likely to see him running more out-routes and short slants than you are long go-routes 50 yards down the field.  Any smart DB will know that and play that WR tight, forcing him to “open up” his stride to stress his hamstring.

Avoid Stretching Early On – When I tell a player who just strained his hamstring to avoid all hamstring stretching on the involved (I never call it “bad”) side for the first 72 hours, they look at me crazy.  An athlete will feel tightness in the hamstring and get a sense that they need to just stretch it out and they’ll be fine.  That’s a mistake and it only prolongs the muscle’s bleeding and protective spasms.

Apply the Pressure – Most acutely strained hamstring will benefit from compression such as a custom sleeve, girdle or elastic wrapping.  It keeps the muscle and surrounding tissue supported, it minimizes the accumulation of inflammation and it keeps the muscle warm.

Most Like it Hot – Coming back to play in cold weather with a hamstring strain makes it harder, especially for the speed guys.  Warmer weather is a chronic hamstring’s best friend.

Drown Your Hammys – Dehydration is the secret x-factor for all soft tissue injuries.  Staying well hydrated with fluids and Gatorade is a common tip I share with my players and anyone who will listen.  Hydration is a key step for smart athletes wanting to keep their muscle functioning well and significantly reducing their chance of injury.

Two Minute Warning

The hamstring muscles are vitally important for any running athlete, especially the fast ones.  An injured hamstring muscle or tendon can be slow to heal and frustrating for players and coaches alike. The quads may get the hype by being front stage center but any sprinter or football player will tell you that it’s the hamstrings that keep them in the game.

 

Author: Mike Ryan

After 26 seasons as a full-time certified athletic trainer and registered physical therapist in the National Football League, Mike Ryan has outstanding first-hand experience. His unique professional and athletic background has sharpened his skills in the arts of sports injury management, elite rehabilitation, performance enhancement and injury prevention. Mike is now taking his experience to mainstream America. His mission is simple: Sports Medicine advice that is easy to use and brings fast results. Learn more about Mike Ryan

5 thoughts on “A Speedster’s Nightmare: The Hamstring Strain”

  1. Well written article, simple and concise.
    I would go further on the avoidance of early stretching and argue that if you educate walking and running gait and include functional stepping and walking, slow jog routines in different directions you may be able to avoid stretching all together, but certainly for 2-3 weeks.
    Keep up the good work
    Andy

    1. Good points, Andy. Your functional approach is a wonderfully simple plan to get the athletes moving and to take the blinders off instead of thinking “stretch, stretch & stretch some more”. Depending upon the needs of their sport, your suggestions will help most athletes recover quickly and avoid a re-injury down the road. Does it get any better than that?! Thanks, Andy.

  2. It’s also interesting to note that there is evidence to suggest poor core activation in athletes with both chronic hamstring and adductor strains. This is something to consider as well when designing a treatment plan. There are a number of articles out that support the importance of core stability in relation to lower extremity injuries. Leetun D. is one of the best.

    1. I couldn’t agree more, Jeff. I go so far as to implement a core stability program for all hamstring, groin, quad, hip flexor and calf strains, both acute and chronic. It makes such a positive difference.

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