Category Archives: Hamstring strain

Hamstring Strain

Treating Tennis Injuries and Tendinopathy: Advice From an Expert

By:  Lisa Chase, PT, OMPT

Tennis elbow, plantar fasciitis and rotator cuff tendinopathy are common injuries that can plague a tennis player. The last thing an athlete wants to hear is, “You must rest and stop playing tennis.”  Soft tissue injuries can be painful, limiting conditions that are slow to heal, which is particularly challenging to a tennis player who wants to get back in the game.

Many athletes seek advice from primary care and sports medicine physicians when they have tendon pain and then are often offered anti-inflammatories, injections, and told to rest.  Typically, this common regimen only offers temporary relief and may not be the best method to heal a tendinopathy. Continue reading Treating Tennis Injuries and Tendinopathy: Advice From an Expert

Relief from Muscle Tightness and Pain

I’m a 33-year-old woman diagnosed from birth with cerebral palsy.
Because of this, I have had to deal with a lot of issues concerning my body. But my biggest complaint that I have is very tight hamstrings and leg muscles.
Through the years of dealing with tightness along with spasms and pain I have done physical therapy and still do, I have tried surgeries,
medications such as Baclofen, I have tried Botox injections and serial castings.
Some of these I no longer do because the treatment was very painful and not worth the short-term relief or the treatment was extremely inconvenient.
So I have continued to stretch as much as I can daily, but the discomfort is such that the attempt to do a stretch is very painful. But several months ago my physical therapist
Susan S. Ducote suggested that I try a new treatment called Astym therapy. She had just returned from taking a course on this and thought that it might possibly help me. I agreed to try it; on the day of the first treatment, my hamstrings were very tight. The back of my legs all the way down to my ankles felt like boards. The treatment itself I found to be very comfortable, and soon after my session ended I could already feel a big difference. The muscle down the back of my legs felt very soft. Later that evening in my home I was able to do hamstring stretches without pain. I was able to get my foot flat to the floor. I have not done that in forever. My walking was much more comfortable, which was a new sensation for me since I have always walked with tight hamstrings and muscles.
This is definitely a treatment that I would recommend. The results have been amazing.

Lacey Wells

Treating Clinic:
 NeuroTherapy Specialists, Inc.
Baton Rouge, Louisiana, 70816

What is Astym treatment?

Astym treatment is a physical therapy treatment that regenerates healthy soft tissues (muscles, tendons, etc.), and eliminates or reduces unwanted scar tissue that may be causing pain or movement restrictions.

Astym treatment is highly effective for restoring movement and reducing pain from soft tissue injury/dysfunction, and Astym even works when other approaches routinely fail.  One of the main reasons for this is Continue reading What is Astym treatment?

What is Astym treatment?: Astym Definition, Part II

Astym treatment is effective in resolving many soft tissue problems, including chronic tendinopathies, tendon pain, tendon injury, stiffness, restricted movement, limited function and other conditions associated with adhesions or scar tissue that can occur after trauma or surgical intervention. It is also quite effective on sprains, strains, and other acute and sub-acute soft tissue injuries.  Continue reading What is Astym treatment?: Astym Definition, Part II

A Miracle: chronic hamstring problem cured with Astym therapy

I had a chronic hamstring pull for over 25 years. As a runner, it was extremely difficult to run with any regularity. I visited a sports medicine physician and he recommended Astym therapy. I had six treatments and my chronic hamstring problem disappeared. This was three years ago and I’ve had no recurrence of any hamstring problem.

Henry Runner, Boca Raton Florida
Clinic: Center for Physical Therapy and Exercise, Poway, California,  Website:  Arch Health Partners

Hamstring Strain and Injury: Advice From The Experts, Part I

Hamstring Strain and Injury:  Advice From The Experts, Part I

Those of you who suffer from chronic hamstring strains know how frustrating this recurrent injury can be.  Hamstring strains and injuries typically occur with high-speed activities such as sprinting, soccer, or tennis.  As physical therapists, we treat an increased number of hamstring strains as recreational league softball gets into full swing.  Many “weekend warrior” athletes are not adequately conditioned or prepared for the quick starts and change of directions required for these sports.  Minor muscle strains may resolve with rest, gentle pain-free movement, and ice over a couple weeks.  More serious hamstring strains may cause swelling or bruising and can take several weeks to months to resolve.  Strains that occur where the hamstring muscle attaches at the “sit bone” tend to take longer to resolve than strains that occur in the muscle belly.

If a muscle strain is not treated appropriately there is greater chance for another strain to occur leading to a chronic injury.  The hamstring may not be painful with typical everyday activities, but can be aggravated as the athlete returns to running or sports requiring quick movements.  Residual scar tissue at the injury site and persistent muscle weakness are two common reasons for the increased re-injury rate.  As the muscle remodels itself following a strain, scar tissue forms at the injury site.  Early, pain free movement can help reduce the formation of scar tissue.  However, excessive hamstring stretching should be avoided as it can result in dense scar tissue formation.  As the muscle continues to heal and pain decreases, specific strengthening exercises called eccentric exercises should be included in the rehabilitation program.  Eccentric exercise involves slowly straightening your knee against resistance (working your hamstring muscles) so that the muscle is engaged while it is lengthening. Your physical therapist can show you how to perform these exercises.  Part II of this entry will provide more detail on rehabilitation exercises following a hamstring strain and tips for preventing hamstring injuries.

Even if you have suffered from a chronic hamstring strain for years, there are pulled hamstring treatments that can reduce the residual scar tissue, improve your strength, and get you back to full activity pain-free.   The scar tissue that forms around the injured muscle can create a knot in the muscle known as a trigger point.  While massage can effectively release these trigger points, a technique called trigger point dry needling can be more effective because the muscle can be directly treated at a deeper level by penetrating the skin with a fine needle.  Trigger point dry needling uses fine filament type needles to release the trigger points in the muscle.

The scar tissue can be effectively treated with Astym treatment.  With Astym your therapist will use instruments instead of her hands to engage the scar tissue and induce its resorption by the body.  Also, Astym will help regenerate any degenerated soft tissues in the area and stimulate the muscle and/or tendon to remodel itself.  A key part of the remodeling process is to apply controlled stress to the healing tissue with specific stretching and strengthening exercises.  Astym and controlled stress will help the muscle remodel and become stronger, and help prevent scar tissue from forming.  Your physical therapist can help you determine the appropriate exercise to stress the muscle enough to make it stronger while not causing damage.  So remember the good news if you continue to be plagued by a chronic hamstring injury…you can get back to the activities you love pain-free!

Dr. Tim Flynn and Dr. Terry Gebhardt are physical therapists and owners of Colorado Physical Therapy Specialists in Fort Collins, Colorado, the website of their practice is


Meet today’s guest bloggers:

Dr. Timothy W. Flynn, PT, PhD

Dr. Timothy W. Flynn, PT, PhD
Dr. Flynn is board certified in Orthopaedic Physical Therapy (OCS), a Fellow of the American Academy of Orthopaedic Manual Physical Therapists (FAAOMPT), and a frequent research presenter at state, national, and international meetings. Dr. Flynn is widely published including 5 textbooks, 6 book chapters, over 50 peer-reviewed manuscripts on orthopaedics, biomechanics, and manual therapy issues. He was the editor and author of The Thoracic Spine and Ribcage – Musculoskeletal Evaluation & Treatment and The Users’ Guides to the Musculoskeletal Examination, and the author of 3 educational CD-ROMs on Orthopaedic Manual Physical Therapy. Dr. Flynn has received numerous research grants. Awards include the James A. Gould Excellence in Teaching Orthopaedic Physical Therapy, the Steven J. Rose Excellence in Research (twice), the AAOMPT Outstanding Research Award (twice), and the Distinguished Alumnus- Marquette University Program in Physical Therapy. Dr. Flynn continues to maintain an active research agenda in the areas of spinal and extremity manipulation, low back disorders, characterization of spinal instability, and the development of clinical prediction rules. Continue reading Hamstring Strain and Injury: Advice From The Experts, Part I

Hamstring Strain and Injury: Advice From The Experts, Part II

Hamstring Strain and Injury:  Advice From The Experts, Part II

In Part I of this entry, we discussed some of the most effective treatments for chronic hamstring strains and injuries.  Despite being pain-free with typical daily activities, many athletes continue to have pain with their sport several months and even years after a hamstring injury.  Unfortunately, there is a high recurrence rate of hamstring strains because of incomplete rehabilitation or returning to sport too soon.  Residual scar tissue and persistent muscle weakness are two common reasons for the persistent pain and high recurrence rate following a hamstring strain.

Fortunately, regardless of how long the injury has persisted, Trigger Point Dry Needling and Astym treatment can help  reduce or eliminate scar tissue and knots in the muscle called trigger points.  These hands-on treatments combined with the appropriate exercise routine can help resolve even the most chronic hamstring strains.

Considering there is such a high recurrence rate of hamstring strains, many have asked what can be done to prevent these injuries from recurring  and even better, prevent them from happening in the first place.  Although hamstring stretching is commonly recommended for injury prevention, a hamstring flexibility program has not been shown to reduce the incidence of hamstring injuries and in fact it may lead to what is called stretch weakness, where the muscle is highly flexible but weak and prone to injury.  In contrast, several studies have found the incorporation of specific strengthening called eccentric exercises into a training program can significantly reduce  hamstring strain injuries.  Eccentric exercise involves slowly straightening your knee against resistance (working your hamstring muscles) so that the muscle is engaged while it is lengthening.  If you are recovering from an acute or chronic hamstring strain, your physical therapist can help you determine when it is appropriate to begin eccentric training.  It is important to start slowly when beginning an eccentric strengthening program, as there tends to be greater muscle soreness associated with this type of strengthening.

In addition to eccentric training, exercises that focus on neuromuscular control of your core muscles and lower extremities have been shown to accelerate injury recovery and prevent re-injury.  Think of neuromuscular control as the system that creates coordinated movement.  This control system frequently “shuts down” following injury.  Simply strengthening the muscles is usually not enough to restore neuromuscular control.  Exercises to re-establish the motor control are critical in preventing injury recurrence.   Examples of such exercises following a hamstring strain include high knee marching, skipping, and explosive running starts with a focus on leg power development.  Finally, a program emphasizing varying trunk movements during running (e.g. upright posture, forward flexed and forward flexed and rotated) has been shown to reduce hamstring injury recurrence by 70%.

If you participate in sports where hamstring injuries are more common such as running, soccer, softball, and tennis, remember to include exercises similar to those listed above to reduce your risk of hamstring injury.  Your physical therapist or personal trainer can help you develop the optimal training program.  If you happen to be one of the unfortunate ones who is still suffering from a chronic hamstring injury, remember you do not need to put up with the pain.  There are effective treatments available to help you return to the sport you love.


Meet today’s guest bloggers:

Dr. Terry Gebhardt, PT, DPT

Dr. Terry Gebhardt, PT, DPT
Dr. Gebhardt completed his Master of Physical Therapy at the U.S. Army-Baylor University Graduate Program in 1998. During Dr. Gebhardt’s 7 years of physical therapy practice in the Army he specialized in treating a broad range of musculoskeletal injuries. He has worked extensively with injury prevention initiatives and has been a leader in the development of training programs designed to maximize fitness while preventing injury. Dr. Gebhardt relocated to Colorado in 2004 to complete his Doctorate of Physical Therapy degree and Fellowship in Manual Therapy at Regis University. His areas of clinical expertise and interest include spine and sports rehabilitation where he incorporates his passion for fitness with physical therapy. Continue reading Hamstring Strain and Injury: Advice From The Experts, Part II