Sports Injury Focus – Hamstring and Groin Injury

Here at Apple Physio we have worked with people with Hamstring and Groin injuries for many years and truly have a great knowledge of how to diagnose and manage this issue. We see people with minor strains to complete rupture, and the recovery plans and treatment process varies. We may be able to diagnose the area of the strain via Physical Assessment or we may request you get a scan of the area to ascertain the severity or grade of the tear. The hamstring/groin is divided into 4-6 different muscles, so it is important to determine which muscle belly is affected.  The injuries (and the recovery plans) provided in the weeks below are in no particular order of importance and they all have one thing in common – they all work. There’s a great saying that goes: Small hinges swing big doors. And it’s often the simplest advice that wins in the end.

Signs and symptoms:

Immediate sharp pain in the back of the thigh or inner thigh. Often when sprinting, or a challenge that stretches the muscles of the hamstring or groin forcefully and it’s not uncommon for bruising and swelling to appear and sometimes track to behind and side of the knee. Can be very disabling in the first few days and very painful to walk.

Tip 1

This is always about Ice and rest. Compression. Not much else.

Typically, I’d advise an athlete to go swimming, take one or two gentle walks and when possible, work on core stability exercises with a balance ball.

From a Physio point of view – after about day 5 I’d begin some deep massage and very gentle stretching. It’s here where we’ll determine if you need some additional investigations and may refer you to get an ultrasound scan in order to confirm the severity of the injury. Sports Taping and compression(via a thigh support or tubigrip) may help as well. Be careful if you have a flight soon after an injury like this. Consult your doctor or speak to your Physiotherapist if you are unsure.

Tip 2

Ice continues – often up to day 10 depending upon how much bleeding has taken place and how badly damaged the muscle tear is.

Typically, an athlete would now be exercising on a bike, swimming would continue and towards the end of week 2, I’d be aiming to have the athlete doing some very gentle jogging. The player or athlete can expect to feel some form of burning sensation, but as long as it isn’t “cramping” or “biting” this is fine – and a good thing.

From a Physio point of view – massage is now vital. It’s now that the scar tissue builds up is “dangerous” and if the massage isn’t done, it’s the number 1 reason for hamstrings or groin muscles tearing again in the first two weeks back to running or playing. Massage will be applied as the athlete can tolerate. Flushing is the term we would use.

Tip 3

Ice has stopped. More heat is being used rather than ice in this stage.

Stretching is now vital. I’d be recommending the athlete to attend Yoga classes, increase the amount of Pilates exercises and that he or she be working on their balance (using an exercise/ gym ball). However, stretch to the point of tolerance being careful not to hurt the healing tissue further.

Fitness levels are increased significantly. Swimming, cycling, long distance running is stepped up. And the athlete may or may not be asked to be doing three quarter paces running by now.

From a Physio point of view – hands-on treatment is vital; massage continues and work on the gluteal muscles and lower back is essential to prevent future reoccurrence.

PNF stretching is also introduced. (This simply means a contract relax technique to increase tensile strength of the muscle fibre and also increased the range of movement. PNF stretching can also modulate pain.)

Tip 4

Athlete 90% fit. CV work increases and a return to practice and full drills is possible and the goal, by the end of week 4.

Athlete is put through drills that will include sprints, shuttles and plyometric work.

From a Physio point of view – hands-on massage continues, PNF stretching is vital and passive and active/functional stretching is stepped up. Isolated hamstring strength and inner thigh work is included through a good full range of movement.

Tip 5

Athlete returns to sport, fitness and performance work increases.

From a Physio point of view – massage continues to prevent scar tissue build up and stretching is continued before, during and after training sessions. Isolated hamstring strength work is included through a good full range of movement. Here we include my favourite – Nordic hamstring curls and the squashed frog and side lunge for the inner thighs. The aim to make the hamstring and groin even more robust and strong to prevent re-injury.

Note: Hands-on massage will be needed for approximately another 2-3 weeks to prevent scar tissue (collagen) tightening the muscles.

Review of recovery:

Take it very easy early on, stretch and mobilize the injury at just the right time and no hamstring or groin muscle can ever recover fully without deep massage, stretching and the right amount of strength work vs the functional activity requirements.

Secret Tip:

When jogging or running for the first time… a *burning* sensation is to be expected and is OKAY. There’s no need to stop. But you must stop if it cramps or feels as though the muscle is “biting” sharply…

Too much rest in the first few weeks will increase the likelihood of re-injury.

Don’t be fooled by the lack of pain after two weeks. It does not mean you are fit to play or run and if you haven’t followed the rules listed above, you will damage the muscle again sometime soon.

Conclusion:

Truth is, without knowing you or your medical history intimately, I cannot tell you which of these will work best for you or if your recovery will follow the plan above. And even if I did know the root cause of your sports injury, there are no guarantees that any one single strategy will work. As a disclaimer please do seek professional help and get a proper assessment of your injury in order to tailor your treatment plan.

But imagine this… how great it would be if you try just one of the strategies below every day…within a few weeks you could have gotten some way towards winning back your active, healthy “sporty” lifestyle.

If you’d like to talk to an experienced Specialist Physio about the possibilities if you currently struggling with a hamstring or groin strain and you decide for yourself that Physio will add value to your health, like it does so many other people, then please connect with us.

If you’d like more info on this, and some easy, actionable tips you can use now to start easing your sports injury. Connect with us on 01344 489398 (Bracknell) , 01753 866274 (Windsor) or email us on windsor@applephysio.com and tell us what’s going on. A member of the team can take your details and we can email you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


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Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s, who want to keep healthy and active.



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