The hamstrings are the tendons that attach the large muscles at the back of the thigh to bone. The hamstring muscles actively bend (flex) the knee. They also act to straighten or (extend) the hip (as in the motion of moving the thigh backward). Surprisingly, these large muscles are not very active with normal walking or standing. However, they are extremely important in power activities such as running, jumping, and climbing. Thus, sedentary individuals can get by with quite weak or deconditioned hamstrings, whereas athletes and very physically active individuals absolutely depend on healthy, well-conditioned hamstrings.
Hamstring injuries usually occur with sudden lunging, running, or jumping, resulting in muscle injury. The sudden jerking pulls on the tissues of the hamstring muscle. Examination of the individual with a hamstring injury reveals spasm, tightness, and tenderness. With more severe injury, swelling and a black and blue or bruised appearance will follow. In some cases, a palpable defect (detectable by touching) will be present in the muscle.
Most hamstring injuries heal without surgery. The goal of treatment is to restore muscle function and prevent scar formation. Initially, treatment consists of rest, ice, compression, and elevation (RICE). As soon as pain permits, it is important to begin a program of stretching and range-of-motion exercises because prolonged immobilization and inactivity results in muscle shrinkage (atrophy) and scar tissue (fibrosis). After pain and swelling have been controlled and acceptable range of motion and flexibility has been attained, a gradual strengthening program should follow. Depending on the severity of injury, the entire rehabilitative process may take several months. Physical therapists can assist in guiding the exercise program.
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