Hamstring Strain Buttock Pain Physiotherapy Treatment

Hamstring injuries are common in athletes and become a troublesome chronic condition. The hamstring muscles are the muscles on the back of thighs which consist of 3 muscles: the semimembranosus, semitendinosus and the biceps femoris. The biceps femoris has a long head and a short head. The hamstring group is a two-joint muscle that means it crosses two joints, the hips and knees which makes it susceptible to strain. These muscles help in bending your knees and moving your leg backwards from your hip. When you walk these muscles will help in propulsion of your leg and also control momentum of your leg. They are more active during activities that involve bending the knees, such as running, jumping and climbing.

Causes

Strain is caused when the muscle or tendon is stretched beyond their limit. They often occur in sudden, explosive movements such as sprinting, lunging or jumping. They can also occur during slower movements that over stretch your hamstrings. There are some contributing factors such as lack of flexibility in the muscle, inadequate warm up and muscle fatigue or weakness. Addressing these factors are important in the prevention of injuries.

Risk factors Tight hamstrings

Previous knee injury and  hamstring or calf injury
Older age
Tightness in the muscles at the front of your hip joint
Poor core stability

Symptoms

Muscle stains are classified in to 3 grades

Grade 1-The muscle is over stretched to cause a minor damage few muscle fibers or a “pulled muscle”

You will have a sudden pain and tenderness in the back of your thigh. It may be painful to move your leg, but the strength of the muscle is not affected.

Grade 2-a partial muscle tear or approximately half of the muscle fibres are torn

More painful and tender than grade 1. There may be some swelling and bruising at the back of your thigh and you may have lost some strength in your leg and experience difficulty in walking.

Grade3–  more than half of the fibres to a complete muscle tear

This kind of injuries will be very painful, tender, swollen and bruised. There may have been a popping sensation at the time of injury and you will be unable to walk or use your affected leg to continue the activity.

There are two types of strains, Type 1 occurs in high speed running, kicking, twisting, jumping and hurdling and type II occurs with maximal stretching during high kicking, sliding tackling and forward split. Type I injuries happen at the muscle tendon junction where as type II injuries happen close origin of the muscle on your pelvic bone. An injury closer to the pelvic bone has been reported to have longer period of rehabilitation.

Signs and symptoms

Sudden onset of severe pain in the back of your thigh after the injury

Difficulty in walking and unable to run

Local bruising, swelling and tenderness.

Physiotherapy management

Your Physiotherapist will be able to diagnose the muscle strain by asking you questions about how the injury happened, your symptoms and a detailed examination. After completing a detailed assessment of your Injury, the treatment is planned based on you extend of injury and the goals. You will be referred to your family Physician if the injury is severe and need further investigations.

Initial management focusses on reducing the pain and swelling, promote healing and minimize scar tissue formation by using ice, compression, elevation electrotherapy modalities like Ultrasound therapy, laser acupuncture, taping and controlled muscle activation as tolerated after the rest period.

 When you are able to walk without any pain and able to maintain a resisted muscle contraction without pain, active rehabilitation phase starts which includes stretching program, soft tissue techniques/ manual therapy and progressive strengthening. The next stages are functional Phase or return to full training and return to play. The time frame of each stage depends on the type of Injury, extend of Injury and the tasks involved for return to function. Your Physiotherapist will assess you in each stage and progress through these stages to help with return to sports or other activities.

You will be given a progressive strengthening and stretching programme to regain the muscle function and flexibility. Core stability exercises and balance training helps to reduce the chances of re injury.    Eccentric strength training, balance or proprioception exercises and sports specific training is necessary to reduce or prevent re injuries. These exercises will help you to recover from the injury and to regain highest function possible to return to the sports or normal activities.

Complete rupture is rare in hamstring injuries so surgical intervention is an extremely rare procedure after hamstring strain. Recovery can take weeks or months depending on the severity of the injury. You have high chances of re injury because of inadequate rehabilitation and premature return to competition before complete recovery takes place.

You are less likely to develop muscle strain if you  warm up your muscles before the exercise or sport and cool down afterwards, do adequate stretching and strengthening of your muscles, give enough time to recover between training and rest for overused or tired muscles, use the right sports gear and proper training to avoid poor techniques in sports and use  correct lifting techniques if you are in a job where you need to lift heavy weights.

How to book an appointment with a Physiotherapist at Physio now?

We have four Physiotherapy clinics of which three are located in Mississauga and one is in Etobicoke. You can call in any of these clinics to book for a same day appointment with a Physiotherapist. Most of the time we can arrange your initial visit on the same day in a location which is near to you. Your initial appointment will be a one to one 40 minutes session with a Physiotherapist which includes initial assessment, education and treatment. You will have 30 to 40 minutes of follow up, which will be usually 2 to 3 sessions a week depending on the factors identified on initial assessment, treatment plan and your goals.