Are you experiencing hamstring pain while running?
A hamstring strain can occur due to direct trauma to an area or, like most running injuries, when your training demands exceed your body’s training tolerance.
The severity of a hamstring strain can range from a mild strain with minimal discomfort to a complete tear of the muscle with significant pain and loss of function. Ignoring a hamstring strain can end up leaving us completely sidelined. Alongside a high risk of reoccurrence if not properly treated.
In this article, we will look to provide up-to-date science regarding hamstring strains and how to effectively treat this problematic injury.
More specifically, we will cover the following:
- What Is A Hamstring Strain?
- Hamstring Muscle Anatomy
- Hamstring Strain Symptoms & Diagnosis
- Causes Of Hamstring Pain Running
- Can I Run With A Hamstring Strain?
- How To Effectively Treat A Hamstring Strain
what is a hamstring strain?
Hamstring strains can occur when the hamstring muscles in the back of the leg are stretched beyond their capacity, subjected to a sudden force, or engaged in prolonged activities without adequate rest, resulting in microtrauma or small tears in the muscle fibers.
This damage can cause inflammation and significant discomfort and may leave you unable to run or walk for a period of time.
This injury is common in activities involving sprinting, jumping, or sudden changes or direction changes, such as sports like football or track and field. They commonly happen during the late swing phase of your running gait whilst your hamstring takes on the force.Acute hamstring strain injuries can also be classified by the severity of pain, weakness, and loss of range of motion.
There are three classifications for a hamstring strain, these are:
- Grade I Injury: considered minor and typically involves no loss of strength or function, minor damage to the structural integrity of the muscle fibers, and low-level inflammation. The long head of the biceps femoris is most commonly involved in Grade I hamstring strains, typically at the proximal muscle-tendon junction.
- Grade II Injury: typically involves a partial or incomplete tear of the affected muscle or tendon. This type of injury is characterized by moderate loss of strength and may be accompanied by muscular edema and hematoma. Grade II hamstring strains commonly involve the proximal free tendon of the semimembranosus, close to the ischial tuberosity.
- Grade III Injury: the most severe and involves a complete tear or rupture of the affected muscle or tendon. This type of injury results in significant loss of function and may require surgery or other intensive treatment.
Hamstring muscle anatomy
The hamstring muscles play an important part in running, jumping, and other athletic activities that require lower body strength and flexibility.
The hamstring muscle group is located at the back of the thigh and is composed of three muscles: the biceps femoris, the semitendinosus, and the semimembranosus.
The biceps femoris is the most lateral of the three muscles and has two heads: the long head and the short head.
The long head originates from the ischial tuberosity (the bony prominence at the base of the pelvis), and the short head originates from the femur (the thigh bone). Both heads of the biceps femoris insert into the fibula (one of the two bones in the lower leg) and the lateral condyle of the tibia (the shinbone).
The semitendinosus is located medial to the biceps femoris and originates from the ischial tuberosity. It inserts into the medial surface of the upper tibia.
The semimembranosus is the most medial of the three muscles and also originates from the ischial tuberosity. It inserts into the posterior surface of the medial condyle of the tibia.
The hamstring muscles are responsible for knee flexion (bending the knee), hip extension (moving the thigh backward), and aiding in hip rotation.
Hamstring Strain Symptoms & Diagnosis
The symptoms of a hamstring strain will vary depending on the severity of the injury.
Mild strains may cause minimal discomfort, while more severe strains can result in significant pain and loss of function.
Some common symptoms of a hamstring strain include:
- Pain or tenderness in the back of the thigh
- Swelling or bruising in the affected area
- Stiffness or limited range of motion in the hip or knee
- Difficulty walking or running, especially when trying to extend the leg
- Weakness in the affected leg
- Muscle spasms or cramping
In some cases, the symptoms of a hamstring strain may not appear immediately and may take a few hours or days to develop.
To diagnose a hamstring strain correctly, it is important to get your injury looked at by a healthcare professional.
They will perform a physical examination, which may include the following:
- Medical history: The healthcare provider will ask questions about the nature of the injury, including when it occurred and what activities were being performed at the time.
- Physical examination: The provider will examine the affected area, checking for signs of swelling, tenderness, or bruising.
- Range of motion tests: The provider may ask the patient to move their leg in different directions to assess their range of motion and identify any limitations.
- Strength tests: The provider may test the strength of the affected leg compared to the unaffected leg.
- Imaging tests: In some cases, imaging tests such as an MRI or X-ray may be ordered to rule out other injuries or confirm the severity of the hamstring strain.
causes of hamstring Pain Running
A hamstring strain can develop for a number of reasons. The most common causes are overuse, direct trauma, and muscle weakness.
Studies have concluded that a staggering 80% of running injuries were overuse-based. Overuse occurs when the body is subjected to excessive amounts of force without adequate time to repair or adapt to the new load volume.
Check for recent inconsistencies in your training. Have you recently increased your running volume? Have you recently introduced HIIT or sprints? If so, be sure to allow your body to rest and adapt.
When it comes to hamstring strains, high-speed running is a large risk factor, so be sure to introduce or increase sprint training slowly.
#2: Direct Trauma
A sudden forceful impact or blow to the muscle can cause it to tear or rupture. This is especially common if the injury occurs during sports that involve sudden turning, sprinting, or physical contact.
Direct trauma is a less likely cause for us long-distance runners, although it is still possible to awkwardly slip on a trail!
#3: Running Gait
There is no one size fits all solution regarding running technique. We all have different bodies, and “correct” forms will vary slightly as a result. That said, there is better and worse form and a few mistakes to avoid.
Hamstring strains often occur when you overstride, as this causes your hamstrings to stretch beyond their capacity.
Overstriding means that the foot lands too far ahead of the body’s center of mass rather than underneath it. This puts extra strain on the hamstring and increases the force it has to contend with.
Runners’ feet should land softly under their center of gravity, as taking shorter, faster steps make you a more efficient runner and reduce the impact on your joints.
If you have someone local to you, I would recommend contacting a professional who can offer a running gait analysis. They can accurately identify if you will benefit from modifying your running technique.
Can I run with a hamstring strain?
Running with a hamstring strain can make your injury worse. Whether or not you can run with a hamstring strain depends on the severity of the strain itself.
If you are suffering from a Grade II/III strain, then no, you should not run. It will prolong and aggravate your injury.
If you are suffering from a Grade I strain, then a reduced volume of running may be possible. Even in this scenario, it is worth resting for a short period of time whilst you analyze how bad your injury is.
If you go for a run and the pain is getting progressively worse as you go, stop. If the pain is severe afterward, you will likely need to take a break from running.
If, however, you feel fine after a short run, you may be able to continue running. Keep the run steady state and on flat ground if possible. Let your running volume be conservative, with a larger focus on a progressive plan of rehabilitation.
How to effectively treat a hamstring strain
As mentioned earlier, hamstring strains have a high injury re-occurrence. Be serious about your recovery; you will thank yourself later.
Being active and involved in your recovery can help prevent the injury from becoming more severe and improve recovery time.
Rehabilitation is usually done in phases; as your injury heals, the phases progress. Rather than running with a hamstring strain, focus on progressively strengthening your injury.
Focus on the eccentric phase (as the muscle lengthens) of the exercises.
Here is an example of what recovery from a hamstring strain may look like:
In the early stages of injury, you want to protect the damaged tissue, minimize muscle loss and keep as mobile as possible.
If any of the exercises excessively hurt, stop. Try and make them easier.
- Begin practicing with RICE: rest, ice, compress and elevate, although in this case, rest/ice are the most effective.
- Go to see a qualified Sports Massage Therapist.
- Avoid activities that aggravate the injury.
- After a period of rest, try incorporating activities such as low-resistance cycling, walking, single-leg balancing, and sciatic nerve flossing.
When you are able to walk pain-free and perform a standing hamstring curl without pain, you can likely progress to phase 2.
During this phase, you want to start rebuilding strength in the hamstring muscle alongside regaining muscular proprioception in anticipation of returning to running.
- Continue to avoid aggravating activities.
- Begin to incorporate harder exercises, such as medium resistance cycling, moderate intensity walking, single-legged windmill, supine hamstring curl, and bodyweight single-legged deadlift.
Once you can perform these activities without pain, you may be able to progress to phase 3.
By this point, you can start re-introducing running into your routine! If you feel hamstring pain while running, stop.
- Continue to perform hamstring exercises, adding more time under tension or resistance as you get stronger. You can do this by increasing the strength of the resistance band, increasing the number of repetitions, increasing the amount of time it takes to perform one repetition, or increasing the weight used.
- Start with short, slow runs to allow your body to adjust to the physical demands of running again. Gradually increase the distance and speed over time.
- Pay attention to your body: Listen to your body and be aware of any pain or discomfort. If you experience pain, reduce the intensity or stop running until you fully recover.
It is important to follow this step-by-step process for the most efficient recovery possible.
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