Before we get into a few tips and measures for return to training and return to sport following hamstring strain, I just wanted to give you a bit of personal experience with hamstring strain.
Prior to becoming a physiotherapist I was playing high level baseball in my late teens and suffered from my first hamstring strain whilst sprinting between bases. I did all the things we are told in the early stages such as ice, compression, elevation, protection and then sort treatment from a physio. Now I was diligent with the program for about 3 weeks and then started to fall away exercise wise and ended up on holidays and didn’t do much of my rehab. At this point as well I was being pressured by the coaching staff to get back out and play as the ‘needed me’. Needless to say I then went back too early and before I was ready and ended up with re-injuring the same hamstring and spending another month on the sidelines.
The second time I strained my hamstring (now the other leg) I was a qualified physio and had a lot more motivation and knowledge to get back as quick and safe as possible. This time round I followed a full progressive strength and endurance program with an integrated return to running and plyometrics and safely returned to playing a lot faster and without re-injury this time round. It definitely helped that I had experienced this before and knew what would happen if I didn’t put in the full effort into my rehab, it also helped that I had the knowledge and training of a physiotherapy degree behind me.
The moral of the story here is that you need to be sure that both your mind and your body are ready to get back into training and playing before you actually get back on the field and I have listed a few tips and measures below as a guide.
1. You are mentally ready to return to sport
This I believe is the most important component of the rehab program. If you are not mentally ready to get back on the field, court or pitch and run as fast as you can, make those agile cuts and quick stops required for you to play the sport to the best of your ability then you are simply not ready to get back out there. Going out and playing before you are ready to give 100%is a recipe for disaster and is another injury waiting to happen.
2. You have successfully completed your step by step rehab program
Don’t make the same mistake that I made when I got sloppy with my rehab program. The only way to get back to playing in the fastest and safest way possible is to listen to your health professional and make a genuine effort to complete all the steps in the rehab program. This will get you back as quick as possible and reduces the chance of further injury.
3. You have no pain in your hamstring when you are being assessed
This is where you need to be honest with both yourself and your health professional. If you have any pain at all through stretching your leg or you have pain when trying to complete an exercise, be honest about it.Trying to be tough and ignoring the pain is not the answer here. If you are still in pain then you are still at risk.
4. You have at least 90% strength in your injured leg as you do in your uninjured leg and have the ability to stretch both legs equally
This is something that you can estimate for yourself, simply take some of the exercises you have been provided with and complete them with your good leg as well. If you feel as through your bad leg is at, or very close to, the same level of stretch and strength as your good leg then this is a good indication that you are well on the way to returning to sport. Your therapist will be able to provide you with dynamometer testing measures to get numbers on this as well.
5. You are able to sprint as fast now as you could before the injury
Ideally you would have tested your running speed or have some idea of how fast you could run, say, 40m for this to be really accurate. But if you do not have something to go off before you got injured then then it is even more important to complete your graded return to running program building up to100% efforts. If you are not confident in this however, run against a friend you know you were close to the same speed as before you had your injury. Ask them if they think you are pushing them as much as your were previously.
6. You are able to hop as far on left leg as you are on your right
This is very easy to do yourself. Simply get 2 markers and hop as far as you can on your good leg and then place a marker where you start and land and then repeat with your bad leg and if they are the same then you are good to go in this area.
I hope you have found my general tips to be helpful, but please do remember that every injury is unique and there is no recipe for rehabilitation programs. This blog was meant as a general guide for those worried about how their injury is progressing and any questions about your program should be discussed directly with your Physiotherapist or book in and see one of the team at Asquith and Mount Kuring-Gai Health and we can assess you more thoroughly.
Adam van der Wielen