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Physical Therapy: Q & A

As of January 1st, I decided I would work out at least 4 times a week. Unfortunately, while working out, I felt a snap in the back of my thigh and then severe pain. A subsequent visit to my doctor revealed a pulled hamstring muscle. What exactly does that mean? What should I do and how do I make sure it doesn’t happen again?

A muscle strain (pull or tear) is a common injury and occurs when a muscle is stretched beyond its limit, tearing the muscle fibers. A similar injury occurs if there is a direct blow to the muscle. As you described, a popping or snapping sensation is often followed by sudden severe pain. Most people experience tenderness in the injured area and bruising occurs when blood vessels are broken.

The thigh has three sets of strong muscles: the hamstrings in the back of the thigh, the quadriceps in the front, and the adductors (groin) on the inside. The quadricep and hamstring muscles work together to straighten (extend) and bend (flex) the leg. The adductor muscles pull the legs together. The hamstring and quadriceps muscle groups are at a greater risk for muscle strains as they cross both the hip and knee joints and are used for high-speed activities.

Once a muscle strain occurs, the muscle is vulnerable to re-injury. Allowing the muscle to heal properly and following preventative protocols is crucial to avoid future problems. As the pain and swelling subside, physical therapy will help improve range of motion and strength. Take the time needed to let the muscle heal before you return to routine exercise, physical activity or sports. Wait until your muscle strength and flexibility return to pre-injury levels; this can take 10 days to 3 weeks for a mild strain, and up to 6 months for a severe strain.

Conditions that predispose you to muscle strains:

Muscle tightness. Tight muscles are vulnerable to strain. Follow a year-round program of daily stretching exercises.

Muscle imbalance. Because the quadriceps and hamstring muscles work together, if one is stronger than the other, the weaker muscle can become strained.

Poor conditioning. If your muscles are
weak, they are less


Prevention: Improve range of motion and reduce stiffness.

Warm up before any exercise or physical activity.

Stretch slowly and gradually. Hold each stretch, giving the muscle time to respond and to lengthen.

Condition with a routine and balanced strengthening program to enhance endurance and reduce weakness.


Treatment: Most muscle strains can be treated with the RICE Protocol:

Rest: Take a break from the activity that caused the strain and activities that involve the injured muscle.

Ice: Use cold packs for 20 minutes, several times a day. Do Not apply ice directly to the skin.

Compression: Wear an elastic compression bandage to prevent additional swelling and blood loss.

Elevation: Keep your leg up higher than your heart to minimize swelling.

A qualified physical therapist can help design a program for you to address any factors, including a previous injury, predisposing you to any type of muscle strain. A Physician’s Tale illustrates the symptoms and successful treatment of an actual groin pull.

Written by Brooks Juneau

March 25, 2008 at 3:27 pm

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