Download Hamstring Tear

Physical Therapy Exercises for
Hamstring Muscle Strain
BY ALISHA JOHNSON
Common Muscles Strained of the Hip
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Hip Adductors
Gracilis
Pectineus
Adductor Longus
Adductor Brevis
Adductor Magnus
Hip Flexors
 Iliopsoas
 Quadriceps group –More
common of the group is
Rectus Femoris
Hip Extensors
 Hamstrings group –Most
common
General Info
 The most commonly sprained muscles of the hip is the
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Hamstring group
The Hamstring muscle group consists of the Biceps
Femoris, Semitendinosus and Semimembranosus
Running sports poses an increased risk for a sprain
A strain results from a rapid contraction of the muscle
during an explosive action
After a Hamstring, there is an increased risk of reinjury
Injury disrupts normal gait mechanics because of pain
and weakness
Full recovery is necessary before continuing on with
sport activity and even normal mobility
Hamstring Muscle Group
Causes of Injury
 Prior hamstring injury
 Poor posture
 Lumbar DJD
 Muscle imbalance
 Biomechanical
 Decreased flexibility
inadequacies such as:
anterior pelvic tilt, leg
length discrepancies,
anatomical arrangement
 Hamstring strength
 Fatigue
Cause of Injury
Prior Hamstring Strain
 Due to loss of extensibility
and eccentric strength
Lumbar DJD
 Decreased ROM and
hamstring extensibility.
LBP has been shown to
decrease proprioception &
neuromuscular control of
the LE’s
Fatigue
 From overtraining or
overexertion is easily
damaged
Posture
 Adaptive shortening of hip
flexors place hamstrings in
a lengthened position
Decreased Flexibility
 Primary cause of injury
Cause of Injury
Biomechanical Inadequacies
 Anterior pelvic tilt:
innonimate bone in injured
side increases tension on
hamstrings and cause
lengthened position of O&I
 Leg Length Inequality: The
shorter leg develops overly
tight hamstrings
 Anatomical: The hamstrings
are a biarticular muscle (cross
two joints) group which are
more susceptible to
shortening
Muscle Imbalance
 Agonist/Antagonist
muscle groups  The
hamstrings are
antagonistic to the
quadriceps group
 Eccentric to concentric
rations
 Hamstring to trunk
stabilizer ratios
Conservative Treatment
Phase I (Acute)
 RICE—Rest, Ice,
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Compression, Elevation
Modalities such as
Ultrasound, Cryotherapy
and Electric Stimulation
AROM-Knee flexion and
extension
Manual therapy such as
massage
Aquatic therapy
Phase II (Subacute)
 When patient has full
ROM w/o pain, mild
concentric strengthening
such as hamstring sets
and curls, heel slides, hip
extension can be
introduced
 For cardiovascular fitness:
stationary bike or
swimming can be initiated
Treatment cont.
Phase III (Remodeling)
Phase IV (Functional)
 Begin Hamstring
 Prepare patient’s to return
stretching
 Eccentric Strengthening
can be initiated
 Concentric strengthening
is introduced first because
eccentric causes a greater
force than concentric
to sport
 Continue and progress
strengthening and
flexibility
 Introduce running
activities: a light jog
increasing to a sprint
Phase V (Return to Sport)
 Goal is to avoid re-injury
Hip Strengthening Program
Quadruped Hip Extension Knee Bent
Bring knee in toward chest, while keeping
your knee bent extend hip and reach foot
toward the ceiling. Keep buttocks tight. Do
not arch back.
Quadruped Crossover
While keeping knee bent, extend hip and
reach foot toward the ceiling while keeping
buttocks tight. Lower knee over opposite leg.
Touch knee to the floor and reach foot toward
the ceiling and repeat.
Bridges with Ball Squeeze
Lift hips up while squeezing the ball
between legs. Keep buttocks tight.
*Progress by lifting one leg, hold for 5
seconds and switch legs.
Bridges with Hamstring Ball Curl
With legs and feet on the exercise ball,
lift hips up while squeezing your
buttocks. Roll ball toward you then
underneath buttocks while maintaining
a bridge.
Hip Strengthening Program
Sidelying Adductor Strengthening
Lie on your side, bend the knee of your top leg,
set the foot flat on the floor behind your opposite
leg. Keep bottom leg straight. Lift & lower in a
straight plane then clockwise/counter clockwise
circles.
Hip IR/ER with Ball
Sitting with band around ankles and ball
between ankles. Squeeze ball and hold 5 sec.
Push out into band and hold 5 sec. Keep knees
close together throughout exercise.
Supine Straight Leg Raise
Lie on your back with band around ankles. Hold one
leg on the floor while slowly lifting opposite leg off
floor while keeping the band tight. Repeat with other
leg. Keep your back flat on the floor.
Clamshells with Band
Lie on your side with both knees bent with band
around knees. Keep ankles together. Lift & lower top
knee slowly while keeping pelvis still and back
straight.
Hip Strengthening Program
Butt Busters
Use support surface to keep balance if necessary.
Take side steps by lifting one foot, then the other.
Keep toes pointed forward & upper body vertical.
Monster Walks
Walk forward, stepping as far as possible. Keep feet
18'' apart. Return to starting point by walking
Backward with the above instructions. Keep toes fwd
5 Way Hip
Place band around ankles. Stand on one leg
with the other leg pushing forward 3x,
pushing to the side 3x, pushing back 3x,
clockwise circles 3x and counterclockwise
circles 3x. Repeat with other leg. Use support
surface to maintain balance if necessary.
Works Cited
 Opar D, Williams M, Shield A. Hamstring Strain Injuries: Factors that Lead
to Injury and Re-Injury. Sports Medicine [serial online]. March
2012;42(3):209-226. Available from: Academic Search Premier, Ipswich,
MA. Accessed November 20, 2012.
 Proske U, Morgan D, Brockett C, Percival P. IDENTIFYING ATHLETES AT
RISK OF HAMSTRING STRAINS AND HOW TO PROTECT THEM.
Clinical & Experimental Pharmacology & Physiology [serial online].
August 2004;31(8):546-550. Available from: Academic Search Premier,
Ipswich, MA. Accessed November 20, 2012.
 Gokaraju K, Garikipati S, Ashwood N. Hamstring injuries. Trauma [serial
online]. October 2008;10(4):271-279. Available from: Academic Search
Premier, Ipswich, MA. Accessed November 20, 2012.
 Petersen J, Hölmich P. Evidence based prevention of hamstring injuries in
sport. British Journal Of Sports Medicine [serial online]. June
2005;39(6):319-323. Available from: Academic Search Premier, Ipswich,
MA. Accessed November 20, 2012.
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