Hamstring tear, injury to fear

All sports physiotherapists fear the damn hamstring tear. is the most frequent injury in impact sports and the injury that, if it does not heal well, is the cause of continuous recurrences that can leave the runner in a dry dock for a long time and even prematurely "retire" the athlete.

This occurs not only because it is not a muscle tear like any other, but also because of the importance of the hamstrings in the dynamics of running in any sport that involves support and movement, as is the case of running. running and especially the trail running.

A hamstring tear is one of those injuries that must be feared and, therefore, everything must be done to prevent it. In the world of running and especially the trail running A hamstring injury or tear can be a tortuous and unpleasant path to recovery.

The dreaded hamstring tear. Don't go too far

We are going to break down all the functional biomechanics of the race by parts to understand in the case of the hamstring muscles its mechanism of injury and its prevention.

How do the hamstrings influence the biomechanics of movement? The extension of the hip to be able to move must be done by activating the gluteus maximus, the maximum responsible for the movement, but for this to happen the antagonist (muscle that performs the opposite function) must be relaxed.

Currently, running programs, sports training, functional recovery programs and sitting time at work cause the iliopsoas, the maximum hip flexor, to be overstressed, causing the gluteus maximus to become inhibited and this entails the appearance of of the famous “gluteal amnesia".

Why does a hamstring tear occur?

"Gluteal amnesia" forces you to ask for help from the hamstrings to perform the hip extension function or to throw your leg when running.

When this happens, the hamstrings become the main actor in the throwing movement when their function is to stop the race; We are, therefore, overloading a muscle that has to slow down and also launch at the same time. What we find is that the launch is concentric (shortening) and the braking is eccentric (stretching), but since the force is greater when braking, the hamstring is torn. And once broken, it already has a 50% chance of breaking again.

Depending on the load zone of the hamstring, the tear can mean one to three months of recovery time; However, if there is tearing of the tendon or a large fibrillar mass affected, it may even require surgical treatment.

The importance of the hamstring muscles

But why are the hamstring muscles so important? These are the fundamental reasons why the hamstrings are so important:

1. They slow down the march, so they are super important on descending terrain.
2. They cover the sciatic nerve on both sides and an increase in volume can injure the nerve by entrapment (this type of problem can be confused with sciatica).
3. They prevent the tibia from moving forward when changing direction, braking and receiving jumps.
4. They avoid the dreaded knee injuries.
5. They improve the quality of knee flexion.
6. They avoid ankle injuries by generating functional shortened legs.

What to do to prevent a hamstring tear

We are already clear about its importance, but then... how can we avoid hamstring tears?

As a physiotherapy professional with 20 years of experience, I consider it very important to follow the following tips to avoid injuries and/or hamstring tears and, above all, the famous relapses.

•  Be clear about the muscular timing of the gluteus-hamstring pattern in order to have activation-braking quality while walking.
•  Electromyographic assessment of the activation pattern or, failing that, physiotherapy tests of hip extension activation.
•  Objectively assess through biomechanical assessment of gait with objective applications such as VALOBANDO. (App for use in BOX55 SPORTS PHYSIOTHERAPY to objectify data on prevention and recovery in athletes).
•  Go to the physiotherapist to try to achieve gluteal and hamstring quality to perform the sport
•  Avoid standardized lower limb strength programs and above all avoid excessive work on the quadriceps (squats), which inhibit and weaken the work of the hamstrings.
•  Improve tissue elasticity with specific stretching plans for each runner guided by a physical therapist around the amount of elastina that is possessed

Recommendations to recover without recurrence of hamstring tears

•  Objectify the lesion with ultrasound and nuclear magnetic resonance to indicate muscle rupture, tissue involvement, location of the rupture and size of the lesion.
•  Go to the physiotherapist to control the structural lesion through treatments.
•  Go to the physiotherapist to control "muscular timing" and functional recovery to avoid relapses.
•  Objectiveize the improvement of the structure and the function by means of physiotherapeutic tests (eg VALOBANDO. Functional Biomechanical Analysis)
•  Avoid hard work with non-health professionals without control of the injured structure.
•  Control the process of readaptation to sport with career-oriented active physiotherapy work.
•  Monthly control for 3 months to prevent relapses and planning future tests in competition.

How to know if there is a risk of hamstring injury or tear?

1.  Feeling of tired legs.
2.  Lack of mobility in hip and knees.
3.  Episodes of intermittent sciatic pain.
4.  Sensation of 'bite' in the posterior area of ​​the leg.
5.  Ramps when generating force in knee flexion.
6.  Loss of elasticity in the back of the leg.

Hamstring tears are the most common injury in impact sports. In BOX55 SPORTS PHYSIOTHERAPY We have more than 20 years of experience in treating muscle injuries, and we have the technology through ultrasound, electromyography, physiotherapy, an assessment system through specific biomechanical studies (VALOBANDO) and sports rehabilitation to achieve, as we have indicated in several previous articles: prevent before what to cure

In previous articles I have talked about how prevent meniscus injuries or as prevent sprained ankle on trail running.

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David Valenzuela Diaz

Physiotherapist at BOX55

David Valenzuela Díaz has a degree in physiotherapy from the Cardenal Herrera CEU University and a Master's degree in assessment, physiotherapy and sports rehabilitation from the University of Valencia. He is CEO of BOX55 Fisioterapia y Academia SL, of BOX55 Academy and of Valobando SL Functional Biomechanical Analysis.
David Valenzuela, CEO of BOX55

Other entries by David Valenzuela Díaz

• Low back pain, the good weather injury
• How to prevent meniscus injuries
• 3 golden rules to prevent ankle sprains on the trail running