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Pulled Hamstring (cont.)

Pulled Hamstring Treatment

Strains are initially treated with rest, ice, compression, and elevation (known as RICE). A pulled hamstring is also treated this way.

Since the hamstring is stretched with each step as the knee extends or straightens, walking may be difficult. It may be necessary to rest and even avoid weight-bearing activities for a period of time. Crutches may be used temporarily to help get around.

Icing should be done frequently for 15-20 minutes at a time. The ice is placed on the area of injury and pain. It is important that the skin is protected from direct contact with the ice to prevent frostbite.

An Ace wrap may be used for compression. Often one or two 6-inch wraps are applied beginning at the knee and circling the thigh until the wrap ends at the hip and groin. The compression should feel firm but not too tight to cause pain.

Athletes are often taped to provide the same compression and support to allow them to return to practice and competition more quickly.

Elevation is helpful to decrease swelling. Fluid caused by inflammation can drain back toward the center of the body if the leg is elevated above the level of the heart.

Medications to reduce inflammation, such as ibuprofen (Advil, Motrin, Nuprin), may be helpful in controlling the pain of inflammation.

Grade 1 or 2 injuries may require no further therapy and over a few weeks the pulled hamstring should gradually improve and return to normal function.

It may take a few weeks to recover from a hamstring strain, but if symptoms persist, physical therapy may be recommended. Uncommonly, surgery may be required to repair grade 3 strains that have damaged significant amounts of muscle and tendon.

Rehabilitation can be thought of in three phases. The first is to decrease the inflammation of the pulled muscle, the second is to return normal blood supply, and the third is to begin remodeling the muscle and allow it to return to full function.

Anytime a muscle is torn, the body repairs itself by forming scar tissue. It may take four to six weeks for the area to completely heal. Aside from return to activity, it will be important to consider rehabilitation at home or with a therapist to return full range of motion and power to the hamstring muscles. If the hamstrings do not return to full function, they are at risk for recurrent injury and developing chronic pain and weakness.

After RICE treatment lasting five to seven days, physical therapy may be considered to increase range of motion and begin gentle stretching and return to activity of the pulled muscle. Electrical stimulation therapy and muscle ultrasound may be used to increase blood circulation and begin the healing phase. This may take two to three weeks and may be followed by muscle strengthening and further stretching.

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