Hamstrings are a group posterior thigh muscles that are located at the rear of the upper leg. The muscles are biceps femoris, semitendinosus, and semi-membranous.
They are used in walking, running, hiking, and every other physical activity that requires the use of the legs. The hamstrings are muscles that are necessary for movements. Therefore, the overuse of them can cause discomfort over time. These discomforts manifest as pain in the hamstrings and obstruct movement because of fear of pain when the hamstrings are moved.
Causes of hamstring pain
1. Hamstring injury (strain)
Hamstring injury (strain) is stretching or tearing of the hamstring muscles or the tendons connecting the hamstring to the bones. It affects athletes of all sports: runners, soccer players, basketball players, and skaters. There are three grades of hamstring injury:
- Grade 1: This is a mild muscle pull or strain that takes about 3 to 7days to heal.
- Grade 2: it is a partial tear of the muscle that takes a few weeks to heal.
- Grade 3: is full/complete muscle tear that takes months to heal and require the cancellation of all training or sports activities for a while.
The stretching/tearing of the hamstring cause:
- Sudden and severe pain during exercise
- Snapping or popping feeling during activities
- Pain in the back of the thigh and lower buttock when walking, straightening the leg, or bending over.
- Tenderness in the area of the hamstring
- Muscle spasm.
- Limited ability to move the muscle
How do you heal a strained hamstring?
The best way to manage the hamstring strain is to use the RICE method:
- Rest the legs from all physical activities.
- Ice the sore muscles to reduce pain and any swelling.
- Wrap an elastic bandage around the leg to reduce swelling (Compression).
- Elevate the leg with a pillow.
- Visit a physiotherapist: he or she will teach you stretching exercises to help move a muscle properly and strengthening exercises to keep the muscle strength and prevent atrophy of muscles when it is not in use.
- NSAIDs: anti-inflammatory medications will reduce any inflammation going on and reduce the pain that you feel.
2. Hamstring Tendonitis
Hamstring Tendonitis is inflammation of the tendons that connect the hamstring to the pelvis, knee, and lower legs. It is usually caused by overuse.
What does hamstring tendonitis feel like?
- Sudden sharp pain that is severe and intense in the first few hours of the injury
- Pain that decreases with rest and gets worse with activities.
- Pain that radiates to the knee, buttock, and lowers back
- Muscle weakness
- Swelling and redness around the legs
How do you treat hamstring tendonitis?
The management of hamstring tendonitis is using the RICE method:
- Anti-inflammatory medications: naproxen and ibuprofen
It takes a couple of weeks or even months for a full recovery of the inflamed tendons.
3. Femoral stress fracture
A femoral stress fracture is a fracture of the femur that mainly occurs at the femoral neck. It can occur on the shaft and the condyles as well. Stress fracture usually happens from overuse and any disease that weakens the bone. Also, it rarely occurs from trauma.
What does femoral stress fracture feel like?
It is characterized by pain that is located deep into the thigh and groin and gets worse during exercise and intense physical activities and also, muscle weakness.
How do you treat a femoral stress fracture?
A femoral stress fracture can be managed with:
- The RICE method.
- Anti-inflammatory and analgesics.
- Use of protective footwear to reduce stress on the leg
- A cast or a fracture boot to prevent any movement of leg, the aim is to keep the leg in a fixed position.
- Clutches: can be used for the main time to keep weight off the feet until the leg heals.
- Surgical procedures: Screws, pins, or plates can be surgically used to hold the bone together in severe cases of a stress fracture. This method is called internal fixation.
4. Meralgia paresthetica
Meralgia paresthetica is a thigh nerve disorder that causes the upper thigh region to become tingly, painful, or numb. It is caused by compression of the lateral cutaneous nerve of the thigh by excess weight, tight clothing, pregnancy, trauma from a seatbelt during a car crash, diabetes mellitus, and build up pressure when standing or walking long distances.
How do you treat Meralgia Paresthetica?
It can be managed with:
- Heat or ice compression
- Wearing loose-fitting clothing
- Weight loss.
- Use of corticosteroids to reduce swelling
- Surgery: to release pressure placed on nerves
5. Compartment syndrome
Compartment syndrome is the increased pressure within a close muscle compartment. It is as a result of a traumatic injury, usually from a cast placed to align bone, tractions or on burns.
Muscles are wrapped together by a strong white sheet of connective tissue called fascia. A bundle of muscles wrapped together is called compartments. Compartment syndrome occurs when something interferes with free flow of blood, the blood gets trapped within the compartment, this caused pressure within the compartment to rise and since fascia is a tough tissue that does not expand, this lead to serious leg damaging manifestations known as the 6Ps:
- Pain that increases with movements
- Paresthesia (sensation of pins and needles)
- Pallor (pale skin tone)
- Paralysis (weakness with movements)
- Poikilothermia (change of temperature in the affected leg in comparison to the healthy leg)
- Pulselessness (absent of leg pulses)
How do you fix compartment syndrome?
Management of compartment syndrome includes:
- Cutting through the cast to release pressure.
- If it is traction: weight is reduced.
- Fasciotomy: the fascia is surgical cut into to release the pressure.
- Shoe inserts to release stress on the legs
- Nonsteroidal Anti-inflammatory Drugs.
How do you diagnose hamstring pain?
- Puranen–Orava test: is actively stretching the hamstring muscles in standing position with the hip flexed at 90° angle, the knee fully extended and foot on a solid surface.
- X-ray of the leg to check for fractures
- Ultrasound: it shows the location and degree of the hamstring tear.
- Magnetic Resonance Imaging: reveals muscle tear.
Lastly, while you’re here, take a look at 6 types of foot pain