Is it a hamstring strain or referred pain (from the back, gluteals or hip) in the back of the thigh?
If unsure please consult one our experienced Richmond Physiotherapy Clinic physios for an expert clinical assessment. For physiotherapy guidelines in assessing hamstring strains a more specific estimation of severity may be seen in hamstring strains assessment of severity and grading of hamstring strains.
The following guidelines result from many years of treating hundreds of elite athletes, AFL funded research of AFL hamstring injured athletes and liaison with AFL and elite sports physiotherapists and physicians;
How many weeks until it is safe to return to play after a hamstring strain?
A previous strain in the prior 12 months or so almost always dictates that 3 weeks of rehabilitation is required before it is “safe to return to play”.
An inability to walk at normal pace on level ground within 24 hours almost always means that a 3 week period of training is required before it is “safe to return to play”.
A combination of both these parameters strengthens the requirement of a 3 week of rehab interval.
The consensus among AFL clubs is that a full week of 100% pace training should be undertaken prior to return to play.
What are the indicators of risk for potential recurrence for a hamstring strain?
Previous hamstring injury is primary predictor of recurrence. In addition taking anti-inflammatory medication and having a painful active knee extension stretch test of greater than 10 degrees are factors also associated with being at risk of suffering a recurrence of the hamstring strain.
Clinical predictors of time to return to competition and of recurrence following hamstring strain in elite Australian footballers (Published in the British Journal of Sports Medicine, 2008).
Is a hamstring MRI or ultrasound necessary for a hamstring strain?
An MRI or Ultrasound is not required for diagnosis or estimating the duration of rehabilitation of an acute minor or moderate hamstring injury – the physiotherapy examination is more accurate than MRI or US.
Does the rehabilitation influence the risk of recurrence in hamstring strains?
Training consisting of running drills and specific hamstring strengthening should be engaged in every second day, particularly in players thought to be at risk of re-injury. Players should stretch two to three times per day and engage in three full training sessions before returning to play. Not taking NSAID’s in the post-acute period following a hamstring strain may be associated with a greater chance of successful return to competition.
Hamstring injury prevention
Every full pace running or acceleration sport participant should engage in full pace running and acceleration during the preseason period and, in addition, perform 2 sessions of hamstring strengthening, including one eccentric emphasis hamstring exercise, as part of preseason training.
Eccentric emphasis hamstring exercise should include the only scientifically proven (2013) beneficial exercise; Nordic lowers.
Full attention to detail should be applied to rehab if you are at risk of recurrence. See our hamstring rehabilitation page for the indicators of risk and detailed rehabilitation programs.
Several new and previously unquantified parameters should be included in a clinical assessment to aid in prognosis; time to walk pain-free and previous hamstring injury are predictors of time to return to competition and recurrence, respectively. See our hamstring strain assessment and prevention research
The information contained in this site is not intended as a substitute for advice from a qualified health care professional. Always obtain advice from a qualified health care professional before starting any exercise, stretching or health care program. The author and everyone involved in the production of this site disclaim any liability for any adverse effects resulting from the use of the information presented.