Wednesday, March 2, 2011

Ham on a String?

As a result of my hamstring strain on my half marathon, I did some research on the hamstring.  Some of the information seemed outdated, like ice for 30 minutes (recent studies show 10 min on/10 off.) or to prevent a hamstring injury don’t run or jump.  Obviously a non-runner wrote that.  The question is with a hamstring strain, what can be done to get running as quick but as safely as possible. But also, how can it be prevented?  This comes down to doing the non-running things we tend to ignore... exercises and stretching. 

What is the hamstring?
There are three hamstring muscles that run along the back of the thigh.  A strain is when one or more of these muscles gets so tight that it's stretched too far.  This is when small tears occur and cause cause bleeding which results in bruising. The three muscles semitendinosus, semimembranosus and biceps femoris form the hamstring group. 

Three grades of hamstring strain

Grade 1: What does it feel like?
·         May have tightness in the posterior thigh.
·         Probably able to walk normally however will be aware of some discomfort
·         Minimal swelling.
·         Lying on front and trying to bend the knee against resistance probably won't produce much pain.
Grade 2: What does it feel like?
·         Gait will be affected-limp may be present .
·         May be associated with occasional sudden twinges of pain during activity.
·         May notice swelling.
·         Pressure increases pain.
·         Flexing the knee against resistance causes pain.
·         Might be unable to fully straighten the knee.
Grade 3: What does it feel like?
·         Walking severely affected- may need walking aids such as crutches
·         Severe pain- particularly during activity such as knee flexion.
·         Noticeable swelling visible immediately.

Many different things can cause a hamstring strain and many of the websites said the same thing, inadequate stretching.  One website goes as far to say there is little know about prevention, causes and best methods of rehabilitation due to lack of quality studies. Here are some possible causes (I think eventually if you list enough items anyone can pick some and say that is an indicator)
  • Inadequate flexibility of the hamstrings
  • No or a poor stretching routine
  • Inadequate strength or endurance of the hamstrings with either a side-to-side weakness or an imbalance between the hamstrings and the knee extensors can lead to injury
  • Muscle fatigue can lead to dyssynergia of muscle contraction
  • Insufficient warm-up time.
  • Poor running technique
  •  Return to activity before complete healing has occurred can lead to recurrence.
  • Weak lower back and core muscle strength and mobility
  •  Quadriceps inflexibility
  •  Ankle inflexibility
  • Greater quadriceps versus hamstring strength
  • Age -- older equals more susceptible
  • Fatigue
  • Different pace than previous paces
  • Change in training plan/paces/surfaces/cross training
Stretching -not only the hamstring but the calves and quad muscles also
Icing –ice for 10 minutes on/10 minutes off three times and three times a day
IBU Profin
Physical therapy
Strenghtening exercises
ASTYM - done by a PT certified in the process.  

Recovery time
This depends on the nature and severity of the injury. Don’t rush things and wait until it’s healed and don’t try to return to your old level of physical activity until you can move your leg as easily as your uninjured leg. Until your leg feels as strong as your uninjured leg and you feel no pain when you walk, job, spring or jump. When you get back into exercising listen to what your body is telling you. Stop before you push it that one extra step over the edge. Finish a run/workout on a positive note even if you did less than hoped. If the hours after the pain increases, you worked too hard. If the discomfort stays the same or decreases then you are on the right track.

While a hamstring strain may have been caused by a number of things, including the sun and moon being in alignment while it was raining out, I tend to believe it is due to an imbalance of muscles and they need strengthening.

Strengthening exercises
If you have a gym, you could try dead lift exercises, leg curl or barbell good morn

If you don't belong to a gym, try these options:
Walking lunges  use front leg to pull you up not back leg to push off.. 20 meters at a time.
Lunge matrix – step forward, back in place.  Step to the side and lean into it, step back in place.  Step backward and sideways and lean into it.
Chair pull – in a rolling chair, walk while seated pulling yourself along
Squats and one legged squats
Resistance Band -Attach a resistance band to furniture that won’t move, face the furniture and with the band on one foot, curl the leg behind you.  Turn to face away from the furniture and repeat.
Hamstring curls with an exercise ball.  Place both heels on the top of the ball and pull the ball towards you.  Do 10. Repeat with left leg only.  Repeat with right leg only.
Ball squats – stand with your back to the wall with exercise ball in the small of your back. Lower your body keeping your knees behind your toes. Then raise your body back up pressing off with your heels.
Kickbacks – On all fours, kick one leg back at a 90 degree position and lower it back down.  Use your butt muscles to push your leg up.  Do 10 then switch to the other leg.

NOTE: My hamstring injury is back and I've done a follow-up post here



Amanda@runninghood said...

Ahhh, the hammy. I wish I would have taken better care of my hamstring tear when it first happened. I was right in the middle of marathon training in August and I was in denial that it was hurt badly. I don't think it was a complete tear initially but I think that complete tear came from me being stupid and not resting, icing, compressing, etc. etc. Such a precious precious muscle to a runner! A powerhouse! The powerhouse perhaps for me. Can't believe I was trying to run on it when I could barely walk on it. stupid. :) Ha! Live and learn. Take care and thank you for such great info!! Nice to learn. I need to write more informative posts and less "fluff". ;)

Ewa said...

Lots of good info here. Thanks. I am noticing that my training with a heavy backpack makes my hamstrings even tighter than running, if that is possible. Yoga has been my salvation here.
Gosh, I don't want to get injured now. I don't heal as fast as I used to. ;(

Johann said...

Very interesting. My hammies usually behave well but sometimes take strain after heavy trail running. I've never had to stop running because of my hamstrings. Take it easy!

LookingUpAgain said...

Wow. Lots of information :) Thanks! I now know how to take care of those guys.

J said...

Great post! I have been having weird hamstring pain - don't know why! Guess I got to do more research!

The Green Girl said...

Great post, thanks so much for sharing your research with all of us.

Black Knight said...

Thanks for all the useful information. I have printed your post. Have a good week end.

joyRuN said...

I hate squats/lunges/etc. I've been doing most of my hamstring strengthening on the bike - focusing on pulling up at the back of the pedal stroke. Also, yoga's helped quite a bit with the tightness.

Good luck.

Anonymous said...

Great info! I hope you have healed up nicely.

Anonymous said...

Thanks! This was really helpful. Wish I didn't need it! Ironically, my achilles tendon, which has caused me trouble for years, was doing better, but now the hamstring seems strained (painful to step down on the leg), which is arguably worse and harder to run through (and now it's clear I shouldn't have tried!). I'm pretty sure the improvement on the achilles must have caused the tightness and early strain in the hamstring, which I then made worse by introducing new strengthening too vigorously. A reminder how interconnected all those tendons, muscles, etc. are, and, unfortunately, that age changes the body's adaptability.