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If you have had the unfortunate luck of experiencing a hamstring tweak, you know how uncomfortable and frustrating it can be. I am using the more lay term of hamstring "tweak," but I do think it may be worth all our time to share some of the medical terminology to help make sure we are all on the same page.
What is a Muscle Strain?
A hamstring tweak is referring to a hamstring muscle STRAIN. Other common names you will often hear in place of strain include: "tweak," "tear," or "pull." A muscle strain involves the muscle and/or tendon and occurs when the fibers are overstretched or torn. The muscle is the structure that actually lengthens and shortens ("contraction"), while the tendon attaches the muscle to the bone to allow for the transfer of the force and for movements as we know them to occur. Generally most tears occur where the muscle transitions into the tendon, which is called the "myotendinous junction."
Are "Strains" and "Sprains" the Same Thing?
Strains and sprains are NOT referring to the same thing. As mentioned above, strains involve muscles and/or tendons. Sprains, on the other hand, are concerned with ligaments. Ligaments are what connect bones to bones, which provides stability and support around our joints (e.g. when you "sprain your ankle", you have torn a ligament in your ankle, which causes a loss of stability around your ankle.)
Are there Different Levels of Hamstring Strains?
Yes. Generally they are broken up into 3 categories or "grades."
Grade 1: the muscle fibers are "overstretched" but not torn
Grade 2: some of the muscle fibers are torn, but not the entire muscle
Grade 3: rupture of the entire muscle belly
Is a Hamstring Tendinitis or Tendinopathy the Same as a Hamstring Strain?
Again, no. These things are different. With a hamstring tendinopathy there is an issue with the structure of only the hamstring tendon that occurs due to failure of the tendon to properly repair its structure. Generally tendinopathies occur with a gradual and slow onset. Often times there isn't a specific event or moment that you remember as the beginning of the pain. Whereas with a hamstring strain, you almost always can point to a single moment when the pain started (e.g. a single rep, a single sprint, etc...). There also is often an audible, or at least the sensation of a, "pop" with a hamstring strain.
Okay, Enough with the Nerdy Details....
I know that info probably all seemed rather nerdy and unnecessary, however, it is so important to differentiate between a muscle strain, a tendinopathy, or a sprain, as all of these will need to be addressed differently. So, now knowing the details, if you are quite certain you are dealing with a hamstring strain, then the upcoming suggestions are meant for you! If you are unsure, I would encourage you to schedule an appointment with us at Thrive, or with an orthopedic healthcare provider who can help you make the correct diagnosis.
#1 Thing to Do after a Hamstring Strain: "Give it Time to Heal"
Likely the most important thing you can do after a hamstring strain is to not continue to re-irritate and injure the muscle. It is imperative to "give it time" for the hamstring to repair. Just like if you get a cut on your skin, it takes days to weeks (assuming you are healthy) for the skin to repair back to its normal state. But what happens when you scratch the scab...? The clock resets and it takes longer to heal. Our muscles are no different in the sense that it simply takes time for muscles to repair themselves after being damaged. Unfortunately, we have two things working against us when working with a muscle strain
They take longer to heal than skin (but not as long as tendons or ligaments!)
We can't visually see if they are "healed" like we can with a cut. (okay, you could with ultrasound, MRI, or other high end imaging...)
How long it will take for the muscle to repair also depends heavily on the grade of your strain. Expect 3 weeks on the short end (grade 1) to several months on the long end (grade 3).
#2 Thing to Do after a Hamstring Strain: Compression and Graded Movement
This suggestion should not be done independently from the first suggestion, but rather should be occurring simultaneously. Compression refers to creating pressure around the leg to help push any swelling away from the site of the hamstring strain. Swelling is going to be your enemy from the get go. Swelling reduces your range of motion, causes pain, and inhibits your muscle function. This is why getting going with a regular and consistent compression program is essential. At Thrive, we utilize the Therabody Compression Boots to provide a graded compression throughout your entire lower extremity that pushes all the swelling up to be emptied into the collection of lymph nodes by your groin.
In addition to compression, graded movement from the onset of the hamstring strain is of utmost importance. Laying in your bed on the Netflix binge is not the prescription for success here... However, this suggestion seem at odds with our first suggestion of "giving it time to heal." This is where having a protocol with checks and balances often comes in incredibly handy. At Thrive we are "guided" by a protocol for hamstring strains that helps us conservatively help you return to your activity or sport. I put that we are "guided" in quotations, as there will be deviations necessary for almost everyone given their unique situation and goals. By following the protocol, you are able to see a stepwise progression from gentle ROM to progressive overload; from isometric strengthening to explosive plyometrics; from retraining your walking pattern to sprinting with changes of direction; from hip hinges to performing the olympic lifts.
#3 Thing to do after a Hamstring Strain: "Listen" to your Body
In our final suggestion, we want to emphasize the importance of listening to your body as you go through your rehab progression. We use a system called the "Green-Yellow-Red Light" that we encourage our members to employ. If at any point they feel a sharp/stabbing pain, that is a "red light" movement/exercise, and you should not be doing it RIGHT NOW. Save it for down the road in your recovery.
If a movement/exercise causes a mild to moderate sensation of "discomfort," "achiness," "soreness," "awkwardness," etc... then there is a good chance that you would benefit from pushing through this. If that sensation lasts for the rest of the day but calms down as you warm-up, then consider that a "yellow light." You can continue to do this movement/exercise, but don't increase the intensity/difficulty at all.
Finally, if you experience the same mild to moderate sensation of "discomfort," "achiness," "soreness," "awkwardness," etc., but the symptoms go away after you finish the exercise, then you have a "green light." You can challenge yourself a little more at this time if you'd like.
Summary:
In summary, 3 of our favorite suggestions for you to follow after a hamstring strain include:
"Give it time to heal"
Compression and Graded Movement
Listen to your body
Of course there are many other things that can help or hinder your rehab following a hamstring strain, but these are certainly a good foundation to build off of.
Need Guidance with Your Hamstring Strain?
We'd love to help guide you along the way back to your activities and your goals following a hamstring strain. Give us a call/text to get setup for a free 15 minute consult to help get get moving in the right direction of your recovery!
Call/Text: 651-383-2626
Email: matt@thrive-mn.com
Keep Thriving,
Dr. Matt