Hamstring injuries: prevention and treatment
This article provides an update regarding the rehabilitation and ways to prevent recurrent hamstring injury. Although there is an increased knowledge of the hamstring muscle injuries, the incidence remains high. Exercise therapy is still the treatment of choice, with exercises in a lengthened position or using eccentric contraction mode being most effective.
It is important to understand that there are different types of injuries. The first one involves the biceps femoris' long head and occurs during high speed running. The other injury occurs during movements leading to extensive lengthening of the hamstrings and involves the free proximal tendon of the semitendinosus.The recurrence rate is higher when the biceps femoris is involved. There is increasing evidence that the eccentric hamstring strength remains reduced, even when the patient has returned to sports activities. This may be a factor associated with the high recurrence rate. Moreover, it has been suggested that, if the lesion is closer to the ischial tuberosity, a longer time to return to play is required.
Until today it is unknown what factors can most accurately predict hamstring injuries. Eccentric knee flexor weakness is an important factor when a hamstring injury re-occurs within 12 months. There is evidence that eccentric exercises or exercise in the end range can reduce the incidence of hamstring muscle injuries. When applying this in a rehabilitation program, it is important to understand which exercises are most effective and how they should be performed.