Hamstring complaints in runners .

Hamstring injuries are common among runners. Pain and loss of strength are common symptoms of hamstring injuries. A hamstring injury often occurs during a specific and explosive movement such as sprinting, lunging and bending the knee (against resistance). The muscles involved in a hamstring injury are the biceps femoris muscle, the semitendinosus muscle and the semimembranosus muscle. In some cases, we speak of a sprint or stretch type hamstring injury. A sprint type hamstring injury is the most common and usually occurs during an explosive rapid onset for a (for example) sprint movement (athletics). In this blog, we will explain to you further what type of acute hamstring injuries there are and how we treat them at Fysio Fitaal in Tilburg.

The hamstring is muscle that consists of several sections these are namely musculus semimembranosus, semitendinosus and the biceps femoris. Together they are called the ischiocrural muscle group. The hamstrings run from the sit bone (os ischii) to the calf region and attach well below the knee crease. The movements made by the hamstrings are bi-articular meaning they provide both movement and force that pass over the hip joint(extension) and over the knee joint(flexion). The hamstring group is innervated by the sciatic nerve (m. biceps femoris by the n. peroneus communis). The hamstrings are mainly active in hip extension, knee flexion and lower leg rotation (exorotation).

Risk factors:

• Building up too quickly in training (without using a warm up)
• Age group: 18-35 years old 
• Sprint-related sports (often explosive in nature); athletics, soccer, field hockey, high jump. 
• Stretch movements; gymnastics, crossfit, gymnastics-related movements 
• Degeneration of tendon tissue due to age
• Smoking, poor diet (lifestyle), obesity, cardiovascular disease 
• Already familiar with hamstring complaints 
• Past muscle tear (rupture)

Common hamstring diagnoses among runners; 

Sprint type hamstring injury

Related to sprint or heavy weight exercises. A sprint type hamstring (type 1) occurs during sprint, jump and or fast kick/step movements. And is also the most common type of hamstring injury when it comes to type 1 or 2. Often the moment of a hamstring tear occurs just before the foot hits the ground. During the swing phase or footstrike are the moments when the hamstring is most maximally activated in its maximum length, when also the knee and ankle movement is performed simultaneously in an eccentric manner. 

Stretch type hamstring injurye 

An acute hamstring injury (type 2) is stretch related which is often seen in dancers and gymnasts (gymnastics). During these movements, the muscles are at their longest due to hip flexion (flexion). This type of hamstring injury is less acute with respect to pain and often provides less restriction than a type 1 hamstring injury. Often the rehabilitation time of type 2 does take longer due to the location of the injury, often this is at the level of the muscle to the insertion. In fact, tendon tissue has a longer recovery time compared to a muscle injury. The most common muscle in which a stretch type injury occurs is the musculus semimembranosus. 

Gradations of hamstring tear  

1. Grade 1: Mild muscle tear. Minimal presence, no obvious loss of strength. 
2. Grade 2: Moderate muscle tear. Obvious tearing of muscle fibers and occurrence of loss of strength. 
3. Grade 3; Total rupture. least common. Possible indication for surgery if diagnosed promptly. 

At Fysio Fitaal in Tilburg, we use ultrasound to classify the severity of the injury. Should further diagnostic testing be necessary, we link this back to the general practitioner. 

Rehabilitating with a hamstring injury 

Rehabilitation from a hamstring injury takes time. The No. 1 risk factor for developing a hamstring injury is a past hamstring injury! That is, the region loses a lot in strength and coordination after a serious injury. So it is really important that you make a logical and responsible build-up until you resume your sports activities such as running. Specific strength training for the hamstring group is important. Here we build up from low load exercises such as isometric exercises to eccentrically loaded exercises where we mimic the sport specific situation as much as possible. At Fysio Fitaal in Tilburg we use an extensive test battery to minimize the risk of a new injury. 

Rehabilitating together

Hamstring injuries are often difficult injuries and often recur when not properly treated. Knowledge of training theory and a logical structure of training load are crucial. At Fysio Fitaal in Tilburg, we will help you get back on the track, field or in the gym as soon as possible! Together we work step by step towards a pain free and healthy situation to get back to sports with full enthusiasm. 

Are you looking for professional sports physical therapy? Then send an email to info@fysiofitaal.nl or contact us using and contact form.

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