Digital Image Grant Trouville  © nrlphotos.com :  : NRL Rugby League Round 21 - Cronulla Sharks V Parramatta Eels at Remondis Stadium Saturday 2nd of August 2014.

Dr George Pitsis from the Sports Science Medicine Centre located on the Kingsway at Miranda, deals with any injury and illness which may come the way of the Sharks playing group or staff.

A highly respected doctor and specialist adult and paediatric sport and exercise medicine physician, Dr Pitsis joined the medical staff at the Sharks during 2013. He is highly qualified with over 15 years experience as physician for many high calibre sporting associations and teams.

As a regular feature in the Sharks weekly e-newsletter, Sports Medicine – with Dr George Pitsis, explains some common and also not-so-common sporting injuries. 

This week he takes a look at Hamstring injuries, what they are, how they happen and the prognosis for those who suffer such an injury. Unfortunately with the injury toll being experienced by the Sharks in 2014 hamstrings are something Dr Pitsis has come all-too-familiar with this season.

 

Hamstring injuries

What is it?
The hamstrings are a group of muscles which spans the back of the upper leg from above the hip to below the knee. It thus acts as a hip extensor (bringing the leg back from a flexed position) and a knee flexor. It consists of Bicep Femoris, Semitendinosus, and Semimembranosus. Part of the Adductor Magnus muscle also has a similar function.

How does it happen? (mechanism of injury)
Because this muscle crosses two joints, it can be placed under a great tensile load, particularly when the hip is flexed and the knee extended, such as striding out in full sprint and kicking. Hamstring injuries occur at the tendon origin off the hip bone (ischium), at the mid muscle belly, and lower hamstring tendon.

Symptoms
Pain is felt at the site of injury. If the injury is severe enough a snap can be felt or as if “someone hit the back of the leg”. There can be bruising if there is a tear, with associated stiffness and weakness.

Examination
Bruising can mark the area of tearing, with associated tenderness. Hamstring curl (knee flexion) will be variable weaker.

Investigations
An MRI scan is the gold standard to access for the grade and extent of injury.

An X-ray can be useful for picking up ischial avulsion fractures of the hip bony.

Treatment
Grade 1 – This is a strain injury. Rehab focuses on strength, stretching, and soft tissue and neural releases. Biomechanical issues need to be addressed. Depending on the physical therapist, a number of other modalities may be used such as acupuncture or dry needling. Ultrasound guided Platelet Rich Plasma (PRP) injections can assist with healing and recovery.

Grade 2 – Where partial tearing is involved. As above, unless high grade in which case surgical repair may be required.

Grade 3 – Full thickness tear. Surgical repair will result in over 95% of strength returning.

When can I play again (return to activity)?
Grade 1: 1 - 4 weeks

Grade 2: 4 - 8 weeks

Grade 3: up to 6 months

 

Dr Pitsis and his staff are available to look after the injuries and medical needs of people of all ages and backgrounds, from amateur and professional athletes, to the man, woman or child in need of his expert advice. Please see website www.specialistsportsmed.com.au for more information on practitioners, staff, and services available.

Contact the Sports Science Medicine Centre, located on the Kingsway at Miranda, on 02 9525 3444 for more information or to make an appointment.