Dr. Lokesh Arunagiri

From marathon runners to footballers, amongst athletes, 'pulling a hamstring' is the most common type of injury. The hamstring is a group of four muscles at the back of your thigh. When one of these muscles gets overloaded or begins to tear, it is known as a hamstring injury. While a hamstring injury is painful, it does not indicate the end of an athlete's career.

Minor hamstring injuries may heal by themselves. In cases where one of the muscles is torn, surgery is required to repair and reattach the muscles. Recovery time depends on the severity of the injury. Stretching and exercising the muscles of the leg are the most important parts of rehabilitation. The healing of a hamstring injury can be divided into four stages.

1. Acute phase: The first five days after a hamstring injury is known as the acute phase of rehabilitation. The aim of treatment at this phase is to reduce inflammation and keep the other muscles from atrophy. For minor hamstring injuries resting the leg, using ice packs and keeping the leg elevated can accelerate the healing process. Once the pain and swelling has decreased, patients can use a cane or crutch to exercise the leg.
2. Subacute phase: From the fifth day to the 3rd week after the injury, the focus of the treatment shifts from minimizing swelling to strengthening the leg and increasing the range of possible motions. At this time, an athlete can resume cardiovascular training. Swimming and other forms of aquatic training are said to be especially beneficial to the treatment of hamstring injuries.
3. Remodeling phase: The remodeling phase continues upto 6 weeks after the injury. Strengthening the leg is the focus of this stage of treatment. Using ankle weights can be beneficial towards strengthening the leg muscles. It is important to be careful about the weight being used and to gradually increase this weight to avoid an added injury.
4. Functional stage: This stage can last upto 6 months until the athlete can regain full function of his or her leg. As the athlete's gait gets back to normal, they may start jogging and short sprints. Gradually, more sport specific exercises may be added to the workout.

There is no fixed time when an athlete can return to active sports after a hamstring injury. While players with minor injuries may return to the field after 3 weeks, athletes with muscles tears may take upto 6 months to recover completely. Hamstring injuries tend to reoccur and hence before they can get back to active sports, an athlete must pass an isometric strength test and flexibility test. This ensures that there are no subtle after effects of the injury that can increase the risk of a repeat injury.

Throughout the lift you must attempt to retain the hollow in your low back

The lift should be applied by straightening the legs. Avoid using the back as a crane to lift the weight.

Correct lifting technique involves the following: 

• Stand close to the load; have a firm footing and a wide stance.

• Accentuate the lordosis.• Bend your knees to go down to the load and keep your backstraight.

• Get a secure grip and hold the load as close to you as possiible.

• Lean back to stay in balance and lift the load by straightening the knees.

• Take a steady lift; do not jerk.

• When upright, shift your feet to tum and avoid twisting the low back.

Lifting objects with your back rounded  has been found to raise the pressure in the discs to a much higher level than that existing when the weight is held with the body upright and the lordosis present. Just as back problems associated with bending seem to occur very frequently in the first four or five hours of the day, so it is with lifting; especially so if you are lifting repeatedly and frequently. If you use an in correct lifting technique while lifting heavier objects, you may cause damage and, of course, sudden severe pain.

In order to minimise the risks involved in lifting, you should always use the correct lifting technique

You should stand upright and bend backward five or six times immediately before and after lifting, especially when a Single heavy lift is involved. If there are many objects to be lifted, you should frequently interrupt the lifting and repeat the backward bending exercise. By standing upright and bending backward before lifting,you ensure that there is no distortion already present in the joints of the low back as you begin the lift. This is particularly important if you have been in a stooped position or have been sitting for a prolonged period immediately before you start lifting.

For example, many truck drivers after driving for prolonged periods are then called upon to remove heavy objects from the back of the truck. Removing heavy suitcases from the boot or trunk of the car immediately after a long ride is another example of this high-risk situation. By standing upright and bending backward a few times before and after lifting, you correct any distortion that may have developed in the joints as a result of lifting.If at present you are suffering a bout of low back pain, especially when this is caused by lifting, it is best to completely avoid lifting for a few weeks so that healing of damaged tissues may take place.Should this not be possible, then you must at all times use the correct lifting technique and avoid lifting objects that are awkward to handle and heavier than 30 pounds (15 kg).Once you have developed recurrent low back problems you should never again handle awkward or heavy objects by yourself,even though you may be completely pain free at the time of lifting.In addition, you should familiarise yourself with the correct lifting technique. After some practice at this, lifting correctly will become a habit.