BY ALISHA JOHNSON

Physical Therapy Exercises for Hamstring Muscle Strain

Common Muscles Strained of the Hip

Hip AdductorsGracilisPectineusAdductor LongusAdductor BrevisAdductor Magnus

Hip FlexorsIliopsoasQuadriceps group –

More common of the group is Rectus Femoris

Hip ExtensorsHamstrings group –

Most common

General Info

The most commonly sprained muscles of the hip is the Hamstring group

The Hamstring muscle group consists of the Biceps Femoris, Semitendinosus and Semimembranosus

Running sports poses an increased risk for a sprain A strain results from a rapid contraction of the muscle

during an explosive actionAfter a Hamstring, there is an increased risk of reinjuryInjury disrupts normal gait mechanics because of pain

and weaknessFull recovery is necessary before continuing on with

sport activity and even normal mobility

Hamstring Muscle Group

Causes of Injury

Prior hamstring injury

Lumbar DJD

Biomechanical

inadequacies such as:

anterior pelvic tilt, leg

length discrepancies,

anatomical arrangement

Poor posture

Muscle imbalance

Decreased flexibility

Hamstring strength

Fatigue

Cause of Injury

Prior Hamstring StrainDue to loss of

extensibility and eccentric strength

Lumbar DJDDecreased ROM and

hamstring extensibility. LBP has been shown to decrease proprioception & neuromuscular control of the LE’s

FatigueFrom overtraining or

overexertion is easily damaged

PostureAdaptive shortening of

hip flexors place hamstrings in a lengthened position

Decreased FlexibilityPrimary cause of injury

Cause of Injury

Biomechanical Inadequacies Anterior pelvic tilt:

innonimate bone in injured side increases tension on hamstrings and cause lengthened position of O&I

Leg Length Inequality: The shorter leg develops overly tight hamstrings

Anatomical: The hamstrings are a biarticular muscle (cross two joints) group which are more susceptible to shortening

Muscle ImbalanceAgonist/Antagonist

muscle groups The hamstrings are antagonistic to the quadriceps group

Eccentric to concentric rations

Hamstring to trunk stabilizer ratios

Conservative Treatment

Phase I (Acute)RICE—Rest, Ice,

Compression, ElevationModalities such as

Ultrasound, Cryotherapy and Electric Stimulation

AROM-Knee flexion and extension

Manual therapy such as massage

Aquatic therapy

Phase II (Subacute)When patient has full

ROM w/o pain, mild concentric strengthening such as hamstring sets and curls, heel slides, hip extension can be introduced

For cardiovascular fitness: stationary bike or swimming can be initiated

Treatment cont.

Phase III (Remodeling)Begin Hamstring

stretchingEccentric

Strengthening can be initiated

Concentric strengthening is introduced first because eccentric causes a greater force than concentric

Phase IV (Functional)Prepare patient’s to

return to sportContinue and progress

strengthening and flexibility

Introduce running activities: a light jog increasing to a sprint

Phase V (Return to Sport)

Goal is to avoid re-injury

Hip Strengthening Program

Quadruped Hip Extension Knee Bent Bring knee in toward chest, while keepingyour knee bent extend hip and reach foottoward the ceiling. Keep buttocks tight. Donot arch back.

Quadruped Crossover While keeping knee bent, extend hip andreach foot toward the ceiling while keepingbuttocks tight. Lower knee over opposite

leg.Touch knee to the floor and reach foot

towardthe ceiling and repeat.

 

Bridges with Ball Squeeze

 Lift hips up while squeezing the ball

between legs. Keep buttocks tight.

*Progress by lifting one leg, hold for 5

seconds and switch legs.

Bridges with Hamstring Ball Curl

 With legs and feet on the exercise ball,

lift hips up while squeezing your

buttocks. Roll ball toward you then

underneath buttocks while maintaining

a bridge.

Hip Strengthening Program

Sidelying Adductor StrengtheningLie on your side, bend the knee of your top

leg,set the foot flat on the floor behind your

oppositeleg. Keep bottom leg straight. Lift & lower in

a straight plane then clockwise/counter

clockwisecircles.

Hip IR/ER with BallSitting with band around ankles and ball between ankles. Squeeze ball and hold 5 sec.Push out into band and hold 5 sec. Keep

knees close together throughout exercise.

Supine Straight Leg RaiseLie on your back with band around ankles.

Hold oneleg on the floor while slowly lifting opposite

leg off floor while keeping the band tight. Repeat

with other leg. Keep your back flat on the floor.

Clamshells with Band Lie on your side with both knees bent with

bandaround knees. Keep ankles together. Lift &

lower topknee slowly while keeping pelvis still and

back straight.

Hip Strengthening Program

Butt BustersUse support surface to keep balance if

necessary.Take side steps by lifting one foot, then the

other.Keep toes pointed forward & upper body

vertical.

Monster Walks Walk forward, stepping as far as possible.

Keep feet18'' apart. Return to starting point by walking Backward with the above instructions. Keep

toes fwd

5 Way Hip 

Place band around ankles. Stand on one leg

with the other leg pushing forward 3x, pushing to the side 3x, pushing back 3x, clockwise circles 3x and counterclockwise circles 3x. Repeat with other leg. Use

support surface to maintain balance if necessary.

Works Cited

Opar D, Williams M, Shield A. Hamstring Strain Injuries: Factors that Lead to Injury and Re-Injury. Sports Medicine [serial online]. March 2012;42(3):209-226. Available from: Academic Search Premier, Ipswich, MA. Accessed November 20, 2012.

Proske U, Morgan D, Brockett C, Percival P. IDENTIFYING ATHLETES AT RISK OF HAMSTRING STRAINS AND HOW TO PROTECT THEM. Clinical & Experimental Pharmacology & Physiology [serial online]. August 2004;31(8):546-550. Available from: Academic Search Premier, Ipswich, MA. Accessed November 20, 2012.

Gokaraju K, Garikipati S, Ashwood N. Hamstring injuries. Trauma [serial online]. October 2008;10(4):271-279. Available from: Academic Search Premier, Ipswich, MA. Accessed November 20, 2012.

Petersen J, Hölmich P. Evidence based prevention of hamstring injuries in sport. British Journal Of Sports Medicine [serial online]. June 2005;39(6):319-323. Available from: Academic Search Premier, Ipswich, MA. Accessed November 20, 2012.

Questions?