Hamstring injuries can be brutal. The powerful muscles in the back of your legs can become tight and very sore from running. Left untreated, hamstring soreness can worsen to the point where the pain is so severe that even walking or sitting is difficult. Making matters worse, severe hamstring injuries can take forever to heal. This type of common injury is something you definitely want to avoid.
Typically, hamstring injuries are associated with sprinters (or athletes in ballistic events) who often have sharp pulls in the final meters of a race. When these occur, it looks like the sprinter has been stabbed in the back of the leg and he or she writhes on the ground in terrible pain. Not a pretty sight.
With distance runners, the actual injury to the hamstring usually isn’t quite as dramatic as it is with sprinters. But we still suffer from all sorts of hamstring ailments that can be just as debilitating as the type that can hammer sprinters or jumpers.
Needless to say, any hamstring injury is serious because once the muscles have been damaged, they can take several months to heal properly. Clearly, it’s easier to prevent hamstring injuries than to bounce back quickly and recover from them.
The hammies—the group of huge, powerful muscles that cover the back of the upper thigh—are one of the driving forces to running effectively. And even though these are very strong muscles, injuries to the hamstrings are the most common soft tissue injuries to the thigh area.
The hamstrings are vitally important because they work to extend the hip joint and flex the knee. If the hamstrings have been strained, ripped or partially torn, you can’t run without some discomfort that ranges from mild to excruciating.
Frequently, a hamstring injury is termed “a pull”. What that commonly means is one of the fibers in the hamstring has been torn or strained. In the type of less severe hamstring injuries distance runners suffer, the hamstring muscle fibers get stretched too far and there is internal bleeding of the muscles which causes the discomfort.
Usually, the onset of hamstring injuries distance runners suffer from happens very gradually. It normally isn’t a single traumatic event such as what happens to sprinters when they push too hard and a hammie pops.
The most frequent causes of hamstring injuries for distance runners typically involve overtraining (either too many miles or too much speed work). But leg-length differences (the shorter leg can develop a tight hamstring) or lack of flexibility, strength or muscular imbalance can also lead to injuries of the hammies.
Muscular imbalances—namely, too much quadriceps strength on the front of the thigh (quadriceps) and too little hamstring strength on the back—can also lead to strains. Typically, the quads are much more powerful than the hamstrings and the quads can overpower the hammies, creating an imbalance.
When a distance runner’s hamstring fibers tear or are strained, the pain typically isn’t as severe as afflicts a sprinter. It’s not much consolation, but a distance runner’s hamstring pain is more muted though it gradually worsens with use.
Symptomatically, a hamstring injury falls into one of four categories:
Bruising: Small tears within the muscle fiber cause internal bleeding and possible bruising.
Swelling: The accumulation of blood from the injury causes swelling. This makes further training impossible.
Spasm: Muscle spasm and soreness is the most common hamstring injury among distance runners. Sometimes, mild muscle relaxants are prescribed to help with spasms.
Difficulty contracting: Flexing the knee is often painful after a severely torn hamstring, and can even prevent the runner from normal walking. Typically, this is what happens to sprinters in mid-race. The worst type of hamstring injury is a complete rupture which can take months of recovery. In some severe cases, surgery is needed.
When your hamstring gets injured—regardless of the severity—the most immediate treatment is the simplest: Ice. Even if the injury is a mere soreness after a long run, race or hard speed workout, pack it (or wrap it) in ice immediately. Doing so, will reduce any soreness, inflammation or pain and possibly, limit the severity of the injury.
Other steps to take to treat a hamstring injury:
- Stop running. If there’s pain or intense soreness, don’t even think about running. You can make a relatively mild strain much worse by running on it.
- Continue icing. Apply ice for about 10 minutes every few hours on the injured hamstring.
- Take over-the-counter anti-inflammatories such as Advil, Ascriptin or Aleve. These will help reduce the inflammation in the muscle.
- Massage. Once the initial swelling has gone down, a massage will speed up the healing.
- Acupuncture. A session with a sports-oriented acupuncturist will ease the soreness and speed the healing.
- Gently stretch. Once the soreness has subsided, a very gentle stretching of the hamstrings is helpful so scar tissue doesn’t form. Only stretch the hamstring to the point of slight tension. Don’t overstretch past that point or you can strain it again.
- Cross-train. Again, once the soreness has been reduced, some forms of cross-training are fine and may help the muscles recover. Usually working out on an Elliptical Trainer is OK (if there’s pain, stop). So is swimming and deep water pool running. Cycling in a low gear is also usually fine. After each cross-training activity, ice the hamstrings. If there’s pain, back off.
- Avoid sitting for long periods. If you can, avoid long plane or car rides. If at work, get up every half hour from your desk and walk. Often, sitting on a hard ball or firm pillow helps to alleviate some of the soreness due to sitting.
Once you’re on the road to recovery, you will need to make sure you don’t injure it again. Prevention is always the best policy.
- Learn to stretch properly. Spend 15-20 minutes after every run stretching the illiotibal band, quadriceps, hamstrings and gluteal muscles. Stretch slowly and hold each stretch for 20-30 seconds. If you don’t know how to stretch properly, join a yoga class or stretching for runners group.
- Start a strengthening program for the hamstrings. Hamstrings are always weaker than the quadriceps, but by strengthening them you will get better muscular balance. Doing so, will prevent the quads from overpowering the hams. Best way to strengthen the hammies is by using a hamstring curl machine at your gym. Aim for 2/3rds the strength of your quads.
- Work to strengthen your core muscles (abdominals, glutes and adductors). These muscles act as stabilizers for your pelvis.
- Wear well-cushioned, supportive running shoes. Make sure you aren’t running in worn-out shoes with little cushioning or support.
- Try to run on a soft dirt or grass surface at least a few times a week. Avoid highly cambered roads and sidewalks. If possible, go to Zilker Park and run around the soccer fields or find a football or soccer field.
- Warm up thoroughly before every run. Warm up the hamstrings with a heating pad before you run. (Never heat the muscles after running.) Don’t run on cold muscles.
- Shorten your stride. Long strides can increase your risk of hamstring injury. Especially when running downhill.