| The accurate diagnosis of the injury and the | | | | hamstrings makes elevation impractical and it may |
| degree of its severity is the crucial factor to be | | | | be unnecessary. A reduction in the levels of pain |
| decided initially as this indicates how the injury is | | | | and inflammation allows the physiotherapist to |
| to be expected to improve and how long it will be | | | | start passive movements to the limb and to |
| until the patient has functionally recovered. The | | | | prescribe active assisted movements. Physios |
| mainstay of treatment is physiotherapy and the | | | | avoid stretching at this point as this may |
| physio has to decide the how to progress the | | | | aggravate the symptoms and damage the area. |
| treatment according to the level of tissue injury | | | | Minor hamstring injuries typically recover in a few |
| and the time which has elapsed since the event. | | | | days but should still be managed appropriately. |
| There is no effective scientific evidence for | | | | Soft tissue injuries take at least six weeks to |
| managing this kind of injury and the | | | | heal, even minor ones, so once feeling much |
| physiotherapist will design the rehabilitation | | | | better athletes should be encouraged to ease |
| programme individually to suit the particular and | | | | slowly into doing more stressful activities and |
| variable requirements. | | | | should pay attention to strengthening muscles, |
| There are three initial phases which hamstring | | | | stretching and balance to reduce the likelihood of |
| injuries can be classified into: the acute phase, the | | | | the injury recurring. In the sub acute phase, which |
| sub-acute phase and the remodelling phase. There | | | | lasts until about three weeks after injury, the pain |
| is a different treatment plan and strategy for | | | | and inflammation of the acute injury should be |
| each phase and the time elapsed since injury. The | | | | reducing and so the physiotherapist can progress |
| acute stage can last up to the end of the week | | | | the treatment on to active range of motion |
| since injury and the main aims are to reduce the | | | | exercises and then to muscle strengthening. |
| levels of inflammation, pain and swelling secondary | | | | To facilitate hamstring rehabilitation without a high |
| to the tissue damage. Treatment normally follows | | | | degree of weight bearing on the limb it can be |
| the PRICE system: protection; rest; ice; | | | | appropriate to use pool therapy and patients can |
| compression; elevation. Protection is aimed at | | | | continue with their aerobic training to maintain |
| eliminating any significantly harmful stresses to the | | | | their cardiovascular ability and arm training. The |
| damaged tissues, with the treatment options of | | | | injured area will be exercised with sub maximal |
| using crutches to limit the amount of weight on | | | | training effort. The phase of remodelling takes the |
| the leg or bracing the knee in flexion. | | | | injury towards the six week time after the injury |
| Rest is the second requirement to protect the | | | | and the physio will test to see if the patient can |
| damaged muscle tissue by eliminating force | | | | cope with a full strength contraction without any |
| through the area although athletes find this difficult | | | | pain. If successful the rehab can be progressed |
| to adhere to. Ice is a primary treatment for | | | | via through range exercises (isotonic) with light |
| acute injuries and reduces pain when applied for | | | | weights and high repetitions. |
| approximately 20 minutes, with a check after 10 | | | | The patient starts this process in prone with light |
| to ensure skin health. Cold inhibits inflammatory | | | | ankle weights, progressing to heavier and heavier |
| changes in the local area by reducing metabolism | | | | resistance provided the pain in the injured area is |
| and so the amount of circulation coming to the | | | | not provoked. The progression of weights should |
| area. Compression may be more useful than cold, | | | | be conservative as too rapid an increase may |
| which is typically used by physios, and controls | | | | lead to relapse and a more long term problem. |
| local swelling, with elasticated bandages applied to | | | | Once the patient has achieved good strengthening |
| the limb an effective strategy. | | | | with the muscle shortening (concentric |
| For acute injuries elevation of the affected parts | | | | contraction) they should be progresses to |
| is usually advised with the part lifted above heart | | | | strengthening with the muscle lengthening |
| level to give the best effect in providing build up | | | | (eccentric contraction). |
| of tissue fluid. The position of the injury to the | | | | |