The feared hamstring tear usually strikes at the most inconvenient moment. Personally, I’ve lost track of the times my hamstrings have informed me, “Not today.” Not so long ago, I tore my hamstring while jumping into a pool with my sons. It can occur at any moment, and for me, to my embarrassment, it happened in front of my children—who found my painful mishap quite amusing.
But when you’re pushing the boundaries of your performance, hamstring tears can and do happen. The best thing you can do is prevent hamstring tears from occurring, but when it’s too late or becomes chronic, it’s time for Physical Therapy. Fortunately, if your hamstrings are causing you trouble, we’re here to bring the PT to you.
Here, Dr Bo Babenko, PT, DPT, and Dan Swinscoe, MPT, C.S.C.S., who has over 30 years of PT experience, delve into how to identify and address the hamstring tear. But first, a little background on the hamstring muscle.
Hamstring Structure and Roles
The hamstrings are a group of three muscles on the back thigh: biceps femoris (long and short head), semitendinosus, and semimembranosus. They originate on the rear lower pelvis and are inserted medially and laterally below the knee on the fibula and tibia.
Except for the biceps femoris short head, which originates from the lower femur.
The main roles of the hamstrings include:
- Hip Extension: squats, deadlifts, and hip thrusts.
- Hip Hyperextension: Glute kickbacks.
- Knee Flexion: Hamstring curl variations.
How can You Determine If You Have a Hamstring Tear?
You will be aware if you’re like me and have torn it several times. But if not, Dr. Bo will enlighten you.
“ The most direct clinical test I use is isolating the hamstring by sitting the client up or face down, bending the knee to 90 degrees, and asking them to hold it strong – if there is pain and or weakness felt in the hamstring that is highly indicative of a hamstring tear.
It is possible to have a slight tear and compensate with other aspects of the surrounding muscles, especially since the hamstring has three main portions. It is possible to tear one, and the other two can do much of the work. Pain should be a primary guide, but an assessment from a Doctor of Physical Therapy should guide your next steps to be more specific.
Often, one knows from feeling an unusual tearing sensation during exertion, and they will likely continue to have pain even with simple hamstring tasks like using one leg to kick off your shoes.” explains Babenko.
Approaches to Address Hamstring Tear and Prevent It From Recurring
“If there is a tear, the main focus should be to rest and allow healing. Respect the body’s healing times. A grade one tear takes up to six weeks to get back to about 90% of healing. Some will be faster and others slower based on many variables, including age and diet. Getting an accurate diagnosis is crucial to ensure any exercises you introduce are safe and won’t do more harm.
When I work with these clients, I constantly communicate and introduce new exercises very gradually to ensure we are not further tearing any fibers.
We can strengthen around the hamstring with training the Adductors and Abductors. Another primary rule I give is to avoid “stretching,” aka lengthening, as this will likely create further damage and slow down or reverse some of the healing.” says Babenko.
Above is a late-stage stretch Dr. Bo uses with his clients to halt hamstring tears.
Swinscoe explains that when a hamstring tear keeps occurring, there is usually something more to it.
“When a simple hamstring tear becomes chronic, or the tightness of your hamstring is chronic, it usually means the issue isn’t your hamstring. That’s just where you feel it. The issue is going to be higher up the pelvis.
For instance, if we’re engaging in sporting activities like sprinting, there will be an arch in the back, which is normal. What stabilizes against that is your abdominal wall, or it should.
However, something will have to substitute when it doesn’t, and that something can be the hamstring. The hamstring can tilt your pelvis the same way your abdominal wall can, so if this issue is perpetuated, chances are your abdominal wall needs education, not necessarily strength but motor control.” explains Swimscoe.
The two exercises in the video above will provide you with all the ‘education’ you need.
So, there you have it, straight from the horse’s mouth. If your hamstring issues persist, don’t hesitate to seek a Physical Therapist’s help. They do more than inflict pain for fun, you know.