The Anatomy of Hamstrings

Athletes of any kind are often plagued by hamstring injuries. However, since the hamstring controls walking, running and most general movement, it is possible for anyone to suffer from this condition. Often referred to as either a hamstring pull or tear, this injury can mean weeks of recovery or surgery to repair. Prevention of this type of injury involves not only strengthening and stretching exercises, but understanding exactly where it is located and what actually makes up the "hamstring."

Definition

• The first step in learning about the hamstring is to understand the meaning of the actual word. Originally, the word "ham" referred to fat and muscle, in this case located behind the knee. The word "string" is used to reference tendons in the body, again in this case those located on either side behind the knee. Therefore, the word "hamstring" can correctly be interpreted to mean those tendons of the semitendinosus, semimembranosus and biceps femoris muscles that exist behind the knee.

Function

• A hamstring works between two joints on the human body, the hip and the knee helping the knee to bend and the hip to straighten. To understand the function of the hamstring, one must understand first what the muscles control.
  The semimembranosus and the semitendinosus, located on the inside of the back of the knee, work to extend and straight the hip as well as cause the knee to flex and allow the lower leg to rotate inward when the knee is bent.
  The long head of the biceps femoris, located on the outside of the back of the knee, causes the hip to extend when walking or running begins. It also helps to flex the knee and allows the lower leg to rotate outwardly when the knee is bent. The short head of the biceps femoris does not assist in extending the hip and is therefore not considered a part of the "hamstring."

Injury

• A pulled or strained hamstring is in actual fact a tear in one or more of the muscles in the back of the upper leg. This can occur when the muscle is used suddenly, as in sprinter taking off at the sound of the gun, or then a sudden movement occurs that can twist or strain the muscle, for example when a person suddenly turns or lunges to catch something or avoid an accident. When the muscle is strained, the muscle fibers tear. The more fibers that are stretched or torn, the more severe the injury. A popping or burning will be felt in the muscle and pain while walking or bending the knee are common symptoms. Should any of these be occurring, please consult a doctor or orthopedic specialist as soon as possible.
  Factors that could increase the risk of an injury may include:
  * Age: The older the individual the more the risk of injury while exercising or during normal activity.
  * Previously injured area: If the hamstring has been injured in the past, there is a higher probability that an injury may re-occur.
  * Fatigue: A person who is tired tends to lose coordination leading to a higher possibility of muscle injury.

Treatment

• The faster treatment is started after injury, the shorter the recovery time may be.
  Treatment options (depending upon severity of the muscle injury) may include:
  * Ice pack application to limit swelling according to the physician recommendations, usually for 15 minutes every 2 to 3 hours.
  * Elevation of the leg with a pillow.
  * Compression by wrapping an elastic bandage around the area to prevent the swelling from worsening and to lend additional support to the injured area.
  * anti-inflammatory medication as prescribed by a doctor.
  * Walking with crutches to prevent unnecessary strain to the injured area while healing.
  * Surgery to repair a severe tear in the muscles.

  Once again, consult a physician or orthopedic specialist before beginning any treatment.

Recovery

• Recovery from a hamstring injury will depend largely on the severity of the muscle tear. Treatment times ranging anywhere from 2 to 6 weeks, not including any surgical options, are not unusual. Remember, the hamstring assists in just about all general movement that is supported or influenced by leg/knee/hip movement. The goal of any recovery program is to return the patient to normal day-to-day activity as soon as safely possible. Recovery times will be determined by your doctor, orthopedic specialist and/or your physical therapist. They will be evaluating recovery progress through some simple guidelines. These can include:
  * Comparison in the range of motion between the injured leg and the non-injured leg.
  * Comparison in the strength between the two legs.
  * Ability to walk/jog/run straight without limping.
  * Ability to turn sharply in a 45 or 90 angle and to accomplish figure 8 diagrams at various speeds.
  * Ability to perform simple acts of walking, jumping and general movement.

Prevention

• The best way to prevent a hamstring injury is to stretch and warm up properly before doing any form of exercise. This is not limited to athletic type of exercises, but should also include before long walks or hikes, excessive gardening, dancing and any activity that is not a normal part of your lifestyle. Basically any activity that will involve a length of time where walking, bending your knees or bending over from the hip is common place.
  Stretching should begin slowly to allow the muscles and tendons to become flexible. Some stretching exercises include:
  * Standing hamstring stretch: This is the first exercise to begin with. Stand with one heel on a stool (about 15 inches tall), keeping your knee straight. Slowly lean forward from the hip, keeping your shoulders in line with your upper body, until you feel a slight stretch in the back of your leg. Begin by holding for 30 seconds before relaxing to original position. Repeat 3 times on each leg. Gradually increase the time spent stretched once you have become comfortable at the various levels.
  * Hamstring stretch on a wall.
  * Standing calf stretch.
  Strengthening exercises for your hamstring can include prone knee flexion (bends), heel raises, wall slides, lunges, leg curls and various exercises that can be accomplished with leg curl or hamstring machines located in most health or exercise clubs.
  Please note once again - before beginning any stretching or strengthening exercise, please consult with your doctor, orthopedic specialist, physical therapist or exercise trainer to guarantee that the exercises will not injure you in any way.