Understanding Hamstring Tears Let’s get clued up on hamstring strains; why you may have one, what you can do to help and how to prevent a future injury. WHAT ARE THE HAMSTRINGS? The hamstrings are a group of three muscles; the biceps femoris, semimembranosus and semitendinosus. You can feel these muscles if you place your hands on your sitting bones where the muscles originate and slide your hands down the back of your legs. The main action of these muscles is to bend your knee, take your leg out behind you and to assist rotation of your knee, especially when performing accelerating and decelerating actions. How does a hamstring strain/tear occur? A strain/pull/tear is when the muscle fibres are overstretched. Injuries are frequently felt as a short sharp pain in the back of your thigh whilst exercising. A hamstring strain will typically happen when running just before your foot hits the ground. At this point, the hamstrings are working eccentrically to control the forward motion of the two lower leg bones, your tibia and fibula. Pain is often the most debilitating symptom affecting your ability to continue exercising and may cause a limp. Other symptoms include swelling, bruising, muscle spasm and reduced movement at your knee. How long will it take to heal? Strains can be categorised into 3 different grades. 1 being the mildest with a small number of fibres being torn to grade 3 being the most severe which can be a complete muscle rupture. The good news is muscles have a fantastic blood supply and should heal within 3-12 weeks depending on the degree of injury. However, the flexible skeletal muscle fibres, which your muscles are made up of, are replaced with much more inflexible tough scar tissue, which is where physio’s come in. Specific rehabilitation such as specialist stretching, strengthening, taping and soft tissue techniques can dramatically influence how muscle fibres are restructured reducing the amount of scar tissue speeding up the healing process helping you return to sport quicker. With any soft tissue injury, R.I.C.E (rest, ice, compression, elevation) should always be your first response. What will a Physiotherapist do? A physio will be able to perform a thorough assessment and educate you on why you sustained a hamstring strain in the first place. Common factors that can predispose you to hamstring strains are not warming up or cooling down properly, tight hamstrings or hip flexors, weak hamstrings or gluteal (butt) muscles, training at a high intensity without adequate training or altered biomechanics. Who is particularly susceptible? Runners often have short, weak hamstrings, tight hamstrings will restrict the length of your strides when running meaning you have to work harder to cover the same distance as you would with adequately lengthened hamstrings. Chronically tight hamstrings can cause not only hamstring strains but can contribute to back pain, knee pain and leg length discrepancies. So even if you have never stretched before it may be a good time to start stretching! Prevention for “Pulling a hammy” So to prevent yourself pulling a hammy make sure you warm up and cool down properly including effective stretching of not just your hamstrings but hip flexors, quadriceps and calf muscles, do sport specific strength and conditioning and avoid sudden increases in intensity of exercise. On your next visit why not ask your physio and find out how healthy your hamstrings are. For more information or to make an appointment, you can BOOK ONLINE or call your local clinic. What is a Rotator Cuff and have I torn it? WHAT IS IT? The rotator cuff is a group of four small muscles that surround the shoulder joint. Their tendons attach to the humerus, close to the joint line and act as a cuff that provides support and control to the shoulder. They also play a primary role in creating rotational movements of the shoulder. Rotator cuff tears are common injuries and can occur in any of the four muscles, usually at their weakest point, which is the junction between the muscle and tendinous tissue. These tears are common in racket and throwing sports and are one of the leading causes of shoulder pain. The prevalence of rotator cuff tears increases as we age due to age related degenerative changes in the tissues. What are the symptoms? Many people have rotator cuff tears with no symptoms at all, and are unaware of the injury. However, for others, these tears can be very painful and lead to difficulty moving the shoulder, particularly with overhead activities. They may find their range of movement is restricted and the arm feels weak. They often experience pain that radiates down to the arm and pain at night, which can cause sleep disturbances. It is interesting to note that the size of a tear is not necessarily related to the amount of pain and dysfunction experienced, with small tears sometimes creating large problems and large tears going unnoticed. What are the causes? Movements that create a rapid twisting motion or overstretching of the shoulder often cause rotator cuff tears. The most common mechanism of injury is a fall onto an outstretched hand. These tears can be acute or chronic, developing over a period of time or related to degenerative changes, where tendon tissue is damaged by everyday activities due to reduced strength and elasticity. Other causes of rotator cuff tears include overuse, lifting or carrying heavy objects and repetitive overhead activities. Poor biomechanics can cause weakening of the shoulder’s tendons with insufficient blood supply to the rotator cuff over a long period of time. This can leave the tendon more susceptible to injury as is a significant contributing factor to the development of tears and the outcomes of recovery. How can physiotherapy help? The primary objectives of physiotherapy treatment are to reduce pain, increase range of motion and strength and improve shoulder function. Your physiotherapist will work with you to help set goals assist to reach them with a targeted rehabilitation program, manual therapy and education on how to achieve the most from your recovery. While severe tears are often repaired surgically, research is increasingly showing that even in severe tears, a comprehensive rehabilitation program under a physiotherapist leads to similar outcomes to surgery. For this reason, a conservative approach guided by a physiotherapist is often recommended to patients as the first option for treatment. The exact time frame of treatment and recovery will vary from person to person and is affected by a variety of factors including if surgical repair was chosen, the severity of the injury and function prior to injury. For more information or to make an appointment, you can BOOK ONLINE or call your local clinic. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury. Facts about Osteoporosis Osteoporosis is a condition characterised by very low bone mass or density. This is caused by the body either losing too much bone, not making enough or both. Osteoporotic bones become weak and fragile and can break from small forces that would normally be harmless. In osteoporotic bones, as well as loss of bone density and mass, there may also be abnormal changes to the structure of the bone matrix, which further contributes to the bone weakness. Osteoporosis is an extremely common bone disease and women are more affected than men. As it is a progressive disorder that worsens with age, while the disease process might begin earlier, the effects are usually only noticed and diagnosed in people who are 50 years and older. What are the Signs and Symptoms? Often called a silent disease, many people with osteoporosis will have no idea that they have the disease, as there are no obvious symptoms. In fact, sometimes the first sign that an individual has osteoporosis is when the first bone is broken. Along with fractures, which are the most serious signs of this disease, osteoporosis can cause the upper back to become excessively hunched (itself often a result of spinal wedge fractures) and there maybe widespread pain as bony tissue is increasingly unable to withstand normal forces. Fractures are a serious problem, especially in the elderly population. Bone breaks due to osteoporosis occur most frequently in the wrist, spine or hip. When the spine is affected by osteoporosis, people may develop a hunched or stooped posture, which can itself lead to respiratory issues and places pressure on the internal organs. Osteoporosis can severely impact a person’s mobility and independence, which can have a huge impact on quality of life. What Causes It? As this is primarily a metabolic disorder, there are a variety of things that can cause osteoporosis if they either interfere with the body’s ability to either produce bone tissue or encourage excessive breakdown. This can be anything from gastrointestinal conditions that prevent absorption of calcium, lack of dietary calcium or low levels vitamin D, which is essential for absorption of calcium. Certain medications may also cause bone loss especially if they are taken for a long time or in high doses. A good example is the long-term use of steroids. Although steroids are used to treat various conditions, it has been proven that steroids can cause bone loss and eventually, osteoporosis. As bones respond to force and weight bearing by building more bone, having a sedentary lifestyle or doing activities with low impact can also lead to osteoporosis and this has been shown be an issue amongst professional swimmers and cyclists. How Can Physiotherapy Help? Physiotherapy can help you to improve your overall bone health, avoid or recover from fractures.