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Pulled Hamstring: A Pain Real Pain in the Leg!

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editors: Melissa Conrad Stöppler, MD

One moment the runner is gliding down the track; the next he is collapsed in a heap clutching his thigh, writhing in pain. Another dream lost because of a pulled hamstring. While a pulled "hammy" is often thought of as an athlete's injury, it can happen to even the most unfit of us. While professional athletes suffer injuries in front of huge crowds, and millions more see the pain in slow motion on television, few people are there to watch you trip on a step.

The hamstrings are a group of muscles located in the back of the thigh. The function of these muscles are to flex the knee and extend the hip. The quadriceps muscles on the front of the thigh extend the knee and flex the hip. When we walk or run, the knee extends, and the leg stretches to reach the ground. When the foot reaches the ground, the knee flexes and pushes the body forward. The quadriceps and the hamstrings need to be coordinated for walking to take place. As the foot is stroking the ground, the hamstrings have to extend the hip to allow the other leg room to begin moving. At this point in the stride, the hamstrings are full stretch and can tear. A pull, strain, or tear, means the same thing: fibers in the muscle are stretched apart - causing pain, swelling, and bleeding.

Pulled hamstrings often happen on the playing field because the athlete is trying to push the body to perform to its maximum capacity while sprinting or jumping. For the rest of us, a pulled hamstring happens because we don't prepare for the routine activities of the day like walking or climbing steps. As we age (one risk factor), we lose flexibility (another risk factor), and we tend to lose general muscle strength and fitness, and are more susceptible to fatigue (adding even more risks).

If a muscle is cold and tight, there is a greater chance it can be injured if it is required to stretch quickly. If the muscle is warm and has been loosened, the risk of injury decreases. The hamstring can tear near the knee, toward the hip, or anywhere in-between. Often you feel a "pop" when the injury occurs, and walking becomes extremely painful. It's no wonder that the athlete collapses to ground when the hamstring is damaged while sprinting. As the foot hits the ground, the pain can be intolerable.

The initial treatment of a pulled hamstring is RICE (rest, ice, compression, and elevation). Compression is especially important to try to minimize swelling and bleeding into the muscle. By initially resting the muscle, the amount of spasm and scarring can be minimized. Ultimately, the leg needs to move, and walking has to be accomplished. The job of the health care practitioner, physical therapist, or chiropractor, is to balance muscle healing with range of motion and flexibility to heal the injury. A variety of treatment options can be used to help heal the muscle such as stretching, massage, therapeutic ultrasound, and electrical stimulation.

As with most injuries, a pulled hamstring muscle can be prevented; it takes time and effort to keep the body in shape, even to do routine daily activities. Stretching and flexibility programs along with a little strength training will help prevent muscle tears and will promote strong bones and joints.

When we watch athletes run, dancers jump, and acrobats move, we can imagine ourselves doing those exact motions. We also need to imagine ourselves warming up gracefully in the gym or in the dance studio, because none of us want to imagine ourselves in the doctor's office getting treated for a pulled hamstring.


Last Editorial Review: 1/30/2009




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