Hamstring PTSD 

by Kathleen Leninger, PT, DPT

We always talk about having chronic injury support groups.  I think one of our largest groups would be the chronic hamstring PTSD group. Once you have had a hamstring injury, the fear of recurrence sticks with you. Instead of trying so hard to get back to pre-injury running, maybe it would be better to embrace your new hamstring and adapt to it!? 

There are two studies out of the University of Wisconsin that look at the strength, flexibility and muscle anatomy of runners with a prior hamstring strain and the hamstring muscle tissue mechanics while running.  On the physical exam the strength appeared to be normal when compared to the non injured side as well as the hamstring length (flexibility). On imaging, there was a difference in the size of the attachment tendon.  This is the site of the high hamstring pain that most fear. 

When looking at the running mechanics, the strained tissue at the muscle-tendon junction doesn’t lengthen during the gait cycle as well as the uninjured tissue.  This makes the injured more vulnerable to re-injury.

I think this brings up some important points.  You can strengthen and train the muscle to return to it’s normal level of strength but it is important you consider a changed gait pattern, possibly forever.  It is never too late to have a gait assessment to properly address a chronic hamstring issue.   It is important not to let this discourage you but educate you on the importance of hamstring health.  If you can accept this new hamstring, I am sure you two can learn to work together!!!

Silder, A., Thelen, D., Heidersheit,B. Effects of prior hamstring strain injury on strength, flexibility, and running mechanics. Clinical Biomechanics. Aug 2010, V25, I7. 681-686.   

Silder, A., Reeder,S.,Thelen,D. The influence of prior hamstring injury of lengthening muscle tissue mechanicJournl of Biomechanics. Aug 2010, V43, I12. 2254-2260. 

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