Hamstring Injuries - What Can Cause Them
Andrew O'Neill - Chartered Physiotherapist
Are you constantly ‘pulling’ your hamstrings ? do they constantly feel tight? Hamstring injuries are probably the most common sports-related injuries we see in the clinic especially in GAA players and runners. So why is this? Several reasons are playing, sometimes the issue is not the hamstring muscle or tissue itself, it’s what’s happening around it.
The hip capsule and knee capsule.
Its important people can first of all fully flex the knee and hip, To simplify - the ability to bring heel to bum lying on your front and bring knee to chest lying on your back. An inability to do this may mean you may have some knee capsule tightness and quad length issues (if quad muscles cannot lengthen, hamstrings cannot shorten) or hip capsule tightness. Generally, people you have this on their hip will feel a pinch in their groin when they go to do this movement. If you cannot do both of these movements properly your hamstring cannot function effectively when you are running and as the leg swings forward and backward.
How the hamstrings and calf muscle work together.
When our feet hit ground a lot of forces go through the leg and up through the the body. It is important that we can control these effectively. This obviously starts with the foot and ankle but one of the most important junctions to absorb these forces is the posterior knee or back of the knee. At this point the calf muscles and hamstring muscles have to interact together. We find in most people who have recurrent hamstring injuries that these muscles do not work well together and they are quite weak here also. So, what tends to happen is the the calf does a lot more work than the hamstring and an imbalance forms where the hamstring doesn’t activate properly and basically it cannot create enough of tension required to contract the muscles in a few different ways that need to run, jump, slow, twist and turn.
The position of the pelvis.
We often see in clinic that people have really long hamstrings. They can lie on their back keeping the leg straight and raise it to 90 degrees and beyond. This is not good. This generally means they have LONG hamstrings. So why do they say they still feel tight though they can lengthen them so far? This is important so stick with me !
The reason people still feel they have tight hamstrings even though they are long is because the hamstring muscles are in a constantly lengthened position. Think of an elastic band - if you stretch it, it is not loose is it ? If you flick the band when it stretched there is tension on it, you hamstring is the very same but your brain cannot distinguish if this tension is in a lengthen position or in a shortened position - it will just feel tension ! So unfortunately people feel this tension and presume they are tight and then they stretch them even further creating a vicious circle ! Next, let’s think of what’s happening when your running with long hamstrings. Well remember if they are in a constant lengthened and toned state, so they cannot full contract fully or act like a spring. Hence they only work through a short range of motion and then become tired and give up, causing pain or worse, a tear. To adjust this we need to posteriorly tilt our pelvis and try not to run is such an extend position especially when we are tired and caught for air ! We can do this by working on our diaphragm and rib cage. We have several exercises online to show you how to do this.
Pic demonstrates anterior pelvic tilt - note lengthened hamstrings on right hand side
So as you can see hamstring issues, isn’t down to tight hamstrings it’s multifactorial issue. For more information visit our website and facebook and instagram pages, or do not hesitate to contact us.