The precise diagnosis of the injury and the degree of its severity is the crucial factor to be decided initially, as it indicates how the injury is expected to improve and how long it will be until the patient recovers functionally. The mainstay of treatment is physiotherapy and the physio must decide how to progress the treatment according to the level of tissue injury and the time since the event. There is no effective scientific evidence for the management of this type of injury and the physiotherapist will design the rehabilitation program individually to adapt to the particular and variable requirements.
There are three initial phases that hamstring injuries can be classified into: the acute phase, the subacute phase, and the remodeling phase. There is a different treatment plan and strategy for each phase and time since injury. The acute stage can last up to the end of the week from the injury and the main objectives are to reduce the levels of inflammation, pain and swelling secondary to tissue damage. Treatment normally follows the PRICE system: protection; break; ice; compression; elevation. Protection aims to remove any significantly damaging stress to damaged tissue, with treatment options of using crutches to limit the amount of weight on the leg or to reinforce the knee in flexion.
Rest is the second requirement to protect damaged muscle tissue by removing force through the area, although athletes find this difficult to accomplish. Ice is a primary treatment for acute injuries and reduces pain when applied for approximately 20 minutes, with a check-up after 10 to ensure skin health. Cold inhibits inflammatory changes in the local area by reducing metabolism and thus the amount of circulation reaching the area. Compression can be more than cold, which is normally used by physiotherapists, and controls local swelling, with elastic bandages applied to the limb as an effective strategy.
For acute injuries, elevation of the affected parts with the raised part above the level of the heart is generally recommended to achieve the best effect on tissue fluid accumulation. The position of the hamstring injury makes lifting impractical and may be unnecessary. A reduction in pain and inflammation levels allows the physiotherapist to initiate passive movements in the limb and prescribe assisted active movements. Physiotherapists avoid stretching at this point as this can aggravate symptoms and damage the area. Minor hamstring injuries usually recover within a few days, but they still need to be managed properly.
Soft tissue injuries take at least six weeks to heal, even minor ones, so once feeling much better, athletes should be encouraged to slowly wind down for more stressful activities and attention should be paid. to muscle strengthening, stretching, and balance to reduce the chance of injury. Newspaper. In the subacute phase, which lasts up to approximately three weeks post-injury, the pain and swelling of the acute injury should be reduced and therefore the physiotherapist can progress treatment to active range of motion exercises and then to muscle strengthening.
To facilitate hamstring rehabilitation without a high degree of weight bearing on the extremity, pool therapy may be appropriate and patients may continue their aerobic training to maintain their cardiovascular and arm training capacity. The injured area will be exercised with a submaximal training effort. The remodeling phase brings the injury up to six weeks post-injury and the physio will test to see if the patient can handle a full force contraction without any pain. If successful, rehabilitation can progress through range (isotonic) exercises with light weights and high repetitions.
The patient begins this process in the prone position with light ankle weights, progressing to heavy weights and resistance as long as pain is not caused in the injured area. The progression of the weights should be conservative, as too rapid an increase can lead to relapse and a longer term problem. Once the patient has achieved good strengthening by shortening the muscle (concentric contraction) they should progress to strengthening by lengthening the muscle (eccentric contraction).