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Hamstring Strain: Rehab For Rapid Recovery

A strained hamstring is worse than it sounds.  It means that your hamstring muscle is torn.  A first degree strain is a tear on a microscopic level, while a third degree strain is a muscle torn in half that collects in a ball above the knee.  A second degree strain is a partial tear accompanied by bruising and a palpable notch in the tissue.

How do you know if you pulled/ strained/ or tore your hammy?  You’ll know.  A good sign that you are about to tear your hammy is that your age to strength ratio is out of balance and you are about to play flag football. 

Prognosis:
A grade one strain is the most common and is what is usually referred to as a “pulled hammy.”  These should still be taken seriously in the first 3-5 days as it doesn’t take much to turn a grade one strain into a grade two, or a grade two strain into a grade three. As a general rule, grade one hamstring strains should be rested from competitive sporting activity for about 3 weeks and grade two injuries for about 4 to 6 weeks. In the case of a complete rupture, the muscle will have to be repaired surgically and the rehabilitation afterwards will take about 3 months. 

If you know any athletes you know that these general rules are almost impossible to enforce when there is a game to be played.  For that reason let’s explore some techniques to accelerate this lengthy and tedious healing curve.

1)  Avoid the Injury:

  • Build up to full speed over time when preparing for a max effort sprint particularly when recovering from a hamstring pull.  You’ll need 10 minutes of general warm-up before getting serious.  An example of escelating intensity post warm-up could look like:  100m @ about 85%, 200m@ 85%, 300m @90% before going 100% on subsequent 400m, 300m 200m and 100m.  This scheme would have been a good idea for me a week ago.



Here’s an image of my right hamstring at the time of this posting.  I’m 7 days into a grade II and feeling pretty solid.  I’m on pace to return to balistic movements next week.  The following is the approach I’m using to get those results:



2)  Rehab the Injury:

  • Control inflammation in the first 3-5 days
    • RICE (Rest, Ice, Compression, Elevation)  I iced 5-7x/day for 10-20 minute spells
    • Anti-Inflammatories- I do not recommend NSAIDs, but I have had success with the topical anti-inflammatory Traumeel.  It is better than tiger balm.  I know this to be blasphemous among many of my mentholated friends but traumeel is a blend of topical anti-inflammatory herbs supported by research and found to be equally effective at combating inflammation as NSAIDs but with a different mechanism without NSAID’s well documented side effects.
    • Avoid inflammatory foods by going paleo for the initial 3-5 days at a minimum.
    • High-end your fish oil intake.  I went to 4 tbs./day for the first 5 days.
  • Reduce muscle spasm–  Muscle spasm is a common and painful symptom of a hamstring injury. Because of the trauma to the muscle, signals of contraction are confused, and the muscle may be stimulated. 
    • Keep the muscle lengthened but not stretched.  
    • Avoid the seated position as much as possible.
    • General soft tissue work can help with both the inflammation and the spasm of an acute strain.  We’re not talking deep tissue massage here.  I used Graston on mine on days 2-5 by day six I was feeling pretty good.  Rather than breaking up adhesions, the goal was to facilitate healing by combing the broken edges back together. 
    • Other useful techniques are foam rolling and pin and stretch. 
  • Increase growth hormone and healing factors to your leg by continuing to train vigorously–  The hamstring is off limits for a while so hit everything else like it owes you money.  This is your chance to break away from those righteous  functional movements and indulge in a Jersey Shore-esque upper body jackage fest.  Baby oil, while lacking any medicinal or anti-inflammatory properties, is often liberally applied to the arms during and after these workouts.  Go ahead and hit those bench presses, those bicep curls and don’t forget the shrugs.  For cardio, you can remove all of the sleeves from your t-shirts for time.  Enjoy yourself.  You’ve popped your hamstring and you deserve it.

Fist Pump’n Like a Champ.
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Dr. Skylar Pond is a sports medicine chiropractor in Seattle, Washington. sportsmednw.com