Member Case Study: Hamstring Pain

author : AMSSM

comments : 0

I strained my left hamstring over two years ago and thought I had gotten past it. Yesterday, it hampered me quite a bit and it felt like it was on the edge of giving out again.

Member question from nickster
Last May I started triathlon training, being a runner up until then. I strained my left hamstring over two years ago and thought I had gotten past it. Last June as I started training harder, I hurt the same hamstring again and was not able to do any "fast" running - fast being 7:30 miles or faster.

Last week I hit 7:08 for the last mile in a 9 mile run and now the hamstring is sore again. Yesterday, it hampered me quite a bit and it felt like it was on the edge of giving out again. I think I need to take a few days off running at least. What can I do to help this heal and prevent recurrence?

Answer from Ken Bielak MD

Member AMSSM

It sounds like you are “overusing” the hamstring in that once injured the pain recurs when you push it beyond its normal limitation. It may be that as you are increasing your speed you are extending your leg to cover more ground quicker and in doing so, you are pushing the hamstring beyond its limit. You have already suggested one solution: resting it. To keep it from recurring in the future will take some time and diligence on your part. Allow it some time to heal itself with adequate rest - at this juncture a week or two should suffice. This would be an excellent time to cross train – bike or swim as long as it does not aggravate the hamstring. Then you need to get into the habit of stretching it every day, mild, gentle progressive stretching keeping it under the pain threshold. This may take several weeks so be patient.

Once adequately stretched with your range of motion being equal to the other leg, eccentric training is next. That is, stretching the muscle while under a load. The so called 'Russian Lean' is a good example of this. Start in a kneeling position with someone or something securing the back of your legs at the ankles. While keeping your legs, hip and spine straight, lean forward as far as you can go without using your arms to rescue you and then return to upright kneeling position. You may only get to 20 to 30 degrees off vertical initially but see if you can progress even further. The really good elite athletes, say professional soccer players, can get their nose to the ground and return upright without using their hands! Over time you will want to stress the hamstring even more and you may want to use your hands to catch you as you go horizontal but the key is to progressively stretch the hamstring while under load so do this in a careful, perhaps even supervised, progressive manner.

If this doesn’t work, then you should see a sports oriented physician or physical therapist to ensure that it is nothing more than a strain. Occasionally there can be avulsion fractures at the hamstring insertion, bony deposits in previously injured muscles or even a stress fracture.

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date: May 25, 2009