Muscular

Muscular strain is associated with pain and swelling.

Typical Hamstring Injuries

A hamstring strain can be classified as a pull, a partial tear, or a full tear. Muscle strains are classified based on their severity. A grade 1 strain is usually mild and recovers quickly, but a grade 3 strain is a total tear of the muscle that may take months to recover. The thick, core portion of the muscle or where muscle fibres meet tendon fibres is where the majority of hamstring injuries occur. The tendon tears completely away from the bone in the most severe hamstring injuries. It could even take a chunk of bone with it. This is known as an avulsion injury.

The most common cause of hamstring muscle injury is muscular overuse. When a muscle is stretched past its limit or is suddenly loaded, this can occur. Hamstring muscle strains are common when the muscle lengthens or shortens as it contracts. As the back leg is bent and the toes are utilised to push off and move forward during running, the hamstring muscles flex eccentrically. At this point in the stride, the hamstring muscles are not only stretched, but also loaded with both body weight and the force necessary for forward motion.

Physiotherapy

Muscular strain is associated with pain and swelling. Pain relief modality vary for acute strains and chronic strains.

Acute muscular strain 

  • Cryotherapy (ice pack), goal is to reduce the inflammation. 
  • Soft tissue manipulation,  the effleurage technique will be applied with a deep and firm stroke to remove waste product from the injured area. Followed by taping to protect from any exertion movement. 

Chronic muscular strain 

  • Thermal therapy (hot pack). 
  • Soft tissue mobilization; myofascial technique and scar mobilization technique will be implemented to break adhesion and tightness. 
  • Therapeutic ultrasound therapy to enhance healing. 
  • Pain-free mobility exercises and stretching will be introduced to maintain tissue extensibility and joint mobility. Then, isometric exercises for the injured muscle and targeting the surrounding muscle group will be implemented. This is to maintain muscle mass throughout the rehabilitation process. In the mid phase of rehabilitation, the goal of recovery will target muscular strength (combination of isometric, concentric, and eccentric), endurance, balance and coordination. As the injured area is healed and pain is alleviated, overall fitness exercises and preparations for return to sport will take place.

Muscular Sports Therapy

Sports Therapy is an aspect of healthcare that is specifically concerned with the prevention of injury and the rehabilitation of the athlete back to optimum levels of functional, occupational and sports specific fitness, regardless of age and ability. It utilises the principles of sport and exercise science incorporating physiological and pathological processes to prepare the participant for training, competition and work.

Muscle therapy is a form of musculoskeletal treatment that treats the body as a whole but at the same time targets specific injuries to give the patient the most beneficial form of treatment to their condition. Muscle therapy also incorporates rehabilitation exercises and stretches to re-balance the body and prevent the injury from returning. Muscle Therapy utilizes functional movement based techniques, deep tissue massage, trigger point therapy, myofascial release, dry needling and corrective exercise to get the patient out of pain so that the body can perform at its best.

Successful sports injury rehabilitation protocols are the application of modern rehabilitation protocols under appropriate supervision. Injury specific rehabilitation protocols are being introduced according to the nature of the sport as well as available facilities. The primary aims are safe return to sports and minimizing re-injury on return to sport; this involves rehabilitation in stages.

Prevention & Reconditioning

P&R focuses on long lasting recovery & minimising the risk of re-injury based on the principle of Strength & Conditioning. In this program, any residual weaknesses or imbalance is addressed and a tailored program is designed targeting the deficiency.

The main focus of P&R for muscular injury would be first to target whatever the cause of the injury was in the first place. This may be lack of fitness, low muscular/tendon tolerance to high load or repetitive use and lack of muscular extensibility. 

The key to improving muscular/tendon tolerance to high load would be to increase muscular strength. Indirectly, this will also increase tolerance to repetitive use. Additionally, a low load high volume program is prescribed to increase the muscular tolerance to repetitive use.  

In order to improve muscle extensibility, manual mobilisation techniques and exercises are prescribed, specific to the direction of movement lacking said mobility. On top of that, weak muscles have to be strengthened and tight muscles have to be released and stretched.

Fitness being one of the underrated components in preventing reinjury, the program will cover general endurance and slowly focus on sports specific fitness.

It would be safe to say that you would have graduated the P&R programme once all your metrics (strength, endurance & mobility) have surpassed the pre-injury state.

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