Physical Therapy Exercises for Hamstring Muscle Strain Common Muscles Strained of the Hip Hip Adductors Gracilis Pectineus Adductor Longus Adductor Brevis Adductor Magnus Hip Flexors ID: 302343
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Slide1
By Alisha Johnson
Physical Therapy Exercises for Hamstring Muscle Strain Slide2
Common Muscles Strained of the Hip
Hip Adductors
GracilisPectineusAdductor LongusAdductor BrevisAdductor Magnus
Hip Flexors
Iliopsoas
Quadriceps group –More common of the group is Rectus Femoris
Hip Extensors
Hamstrings group –Most commonSlide3
General Info
The most commonly sprained muscles of the hip is the Hamstring group
The Hamstring muscle group consists of the Biceps Femoris, Semitendinosus and Semimembranosus
Running sports poses an increased risk for a sprain A strain results from a rapid contraction of the muscle during an explosive actionAfter a Hamstring, there is an increased risk of reinjuryInjury disrupts normal gait mechanics because of pain and weaknessFull recovery is necessary before continuing on with sport activity and even normal mobilitySlide4
Hamstring Muscle GroupSlide5
Causes of Injury
Prior hamstring injury
Lumbar DJD
Biomechanical inadequacies such as: anterior pelvic tilt, leg length discrepancies, anatomical arrangement Poor posture
Muscle imbalance
Decreased flexibility
Hamstring strength
FatigueSlide6
Cause of Injury
Prior Hamstring Strain
Due to loss of extensibility and eccentric strength
Lumbar DJDDecreased ROM and hamstring extensibility. LBP has been shown to decrease proprioception & neuromuscular control of the LE’sFatigueFrom overtraining or overexertion is easily damaged
Posture
Adaptive shortening of hip flexors place hamstrings in a lengthened position
Decreased Flexibility
Primary cause of injurySlide7
Cause of Injury
Biomechanical Inadequacies
Anterior pelvic tilt:
innonimate bone in injured side increases tension on hamstrings and cause lengthened position of O&ILeg Length Inequality: The shorter leg develops overly tight hamstringsAnatomical: The hamstrings are a biarticular muscle (cross two joints) group which are more susceptible to shortening
Muscle Imbalance
Agonist/Antagonist muscle groups
The hamstrings are antagonistic to the quadriceps group
Eccentric to concentric rations
Hamstring to trunk stabilizer ratiosSlide8
Conservative Treatment
Phase I (Acute)
RICE—Rest, Ice, Compression, Elevation
Modalities such as Ultrasound, Cryotherapy and Electric StimulationAROM-Knee flexion and extensionManual therapy such as massageAquatic therapy Phase II (
Subacute
)
When patient has full ROM w/o pain, mild concentric strengthening
such as hamstring sets and curls, heel slides, hip extension
can be introduced
For cardiovascular fitness: stationary bike or swimming can be initiatedSlide9
Treatment cont.
Phase III (Remodeling)
Begin Hamstring stretching
Eccentric Strengthening can be initiatedConcentric strengthening is introduced first because eccentric causes a greater force than concentricPhase IV (Functional)Prepare patient’s to return to sportContinue and progress strengthening and flexibility
Introduce running activities: a light jog increasing to a sprint
Phase V (Return to Sport)
Goal is to avoid re-injurySlide10
Hip Strengthening Program
Quadruped Hip Extension Knee Bent
Bring knee in toward chest, while keeping
your knee bent extend hip and reach foottoward the ceiling. Keep buttocks tight. Donot arch back.
Quadruped Crossover
While keeping knee bent, extend hip and
reach foot toward the ceiling while keeping
buttocks tight. Lower knee over opposite leg.
Touch knee to the floor and reach foot toward
the ceiling and repeat.
Bridges with Ball Squeeze
Lift hips up while squeezing the ball
between legs. Keep buttocks tight.
*Progress by lifting one leg, hold for 5
seconds and switch legs.
Bridges with Hamstring Ball Curl
With legs and feet on the exercise ball,
lift hips up while squeezing your
buttocks. Roll ball toward you then
underneath buttocks while maintaining
a bridge.Slide11
Hip Strengthening Program
Sidelying
Adductor Strengthening
Lie on your side, bend the knee of your top leg,set the foot flat on the floor behind your oppositeleg. Keep bottom leg straight. Lift & lower in a straight plane then clockwise/counter clockwisecircles.
Hip IR/ER with Ball
Sitting with band around ankles and ball
between ankles. Squeeze ball and hold 5 sec.
Push out into band and hold 5 sec. Keep knees
close together throughout exercise.
Supine Straight Leg Raise
Lie on your back with band around ankles. Hold one
leg on the floor while slowly lifting opposite leg off
floor while keeping the band tight. Repeat with other
leg. Keep your back flat on the floor.
Clamshells with Band
Lie on your side with both knees bent with band
around knees. Keep ankles together. Lift & lower top
knee slowly while keeping pelvis still and back
straight. Slide12
Hip Strengthening Program
Butt Busters
Use support surface to keep balance if necessary.
Take side steps by lifting one foot, then the other.Keep toes pointed forward & upper body vertical.
Monster Walks
Walk forward, stepping as far as possible. Keep feet
18'' apart. Return to starting point by walking
Backward with the above instructions. Keep toes fwd
5 Way Hip
Place band around ankles. Stand on one leg
with the other leg pushing forward 3x,
pushing to the side 3x, pushing back 3x,
clockwise circles 3x and counterclockwise
circles 3x. Repeat with other leg. Use support
surface to maintain balance if necessary.Slide13
Works Cited
Opar
D, Williams M, Shield A. Hamstring Strain Injuries: Factors that Lead to Injury and Re-Injury.
Sports Medicine [serial online]. March 2012;42(3):209-226. Available from: Academic Search Premier, Ipswich, MA. Accessed November 20, 2012.Proske U, Morgan D, Brockett C, Percival P. IDENTIFYING ATHLETES AT RISK OF HAMSTRING STRAINS AND HOW TO PROTECT THEM. Clinical & Experimental Pharmacology & Physiology [serial online]. August 2004;31(8):546-550. Available from: Academic Search Premier, Ipswich, MA. Accessed November 20, 2012.Gokaraju
K,
Garikipati
S,
Ashwood
N. Hamstring injuries.
Trauma
[serial online]. October 2008;10(4):271-279. Available from: Academic Search Premier, Ipswich, MA. Accessed November 20, 2012.
Petersen J,
Hölmich
P. Evidence based prevention of hamstring injuries in sport.
British Journal Of Sports Medicine
[serial online]. June 2005;39(6):319-323. Available from: Academic Search Premier, Ipswich, MA. Accessed November 20, 2012.Slide14
Questions?