From the Guidelines
For a Grade 1 hamstring strain, the most effective treatment approach is to start with gentle stretching and progressive strengthening exercises as soon as possible, rather than relying on rest, ice, compression, and elevation (RICE), which is not advised as a treatment modality for similar injuries like lateral ankle sprains 1.
Key Considerations
- The treatment should focus on early mobilization and exercise to recover joint functionality, similar to the approach recommended for lateral ankle sprains 1.
- Non-steroidal anti-inflammatory drugs (NSAIDs) may be used to reduce pain and swelling, as suggested for lateral ankle sprains 1.
- Immobilization should be avoided, and functional support may be preferred, especially if it enhances the patient's ability to perform exercises and daily activities comfortably 1.
- Exercise therapy should be tailored to the individual's needs, focusing on strengthening the hamstring muscles and improving flexibility, with the goal of returning to full activity gradually to prevent reinjury.
Treatment Approach
- Gentle stretching exercises, such as seated hamstring stretches and standing toe touches, should be initiated early in the treatment process.
- Progressive strengthening exercises, including hamstring curls, can be added as the patient's condition improves.
- Supervised exercises with a focus on proprioception, strength, coordination, and function may be beneficial, similar to the recommendations for sport resumption after lateral ankle sprains 1.
- Patient education on proper warm-up techniques before exercise and regular stretching can help prevent future strains.
Recovery and Return to Activity
- Recovery from a Grade 1 hamstring strain typically takes 1-3 weeks, but this can vary depending on the individual's overall health, the severity of the strain, and adherence to the treatment plan.
- Returning to full activity should be gradual, with a focus on preventing reinjury by ensuring that the hamstring muscles are sufficiently strengthened and flexible.
From the Research
Grade 1 Hamstring Strain
- A grade 1 hamstring strain is a common injury that can occur in athletes, accounting for considerable time lost to play 2.
- The current return to play (RTP) criteria after hamstring strain injuries help clinicians decide whether an athlete is ready to safely resume previous sport activities, but the high re-injury rates indicate a possible inadequacy of the current RTP criteria 3.
- Studies have shown that functional recovery precedes the biological healing of the muscle, and it is recommended to consider a minimum period of 4 weeks before RTP after a grade 1 or 2 HSI 3.
Treatment and Rehabilitation
- Platelet-rich plasma (PRP) injection has been investigated as a means to accelerate healing of hamstring injuries, but the evidence is statistically nonsignificant 2.
- Eccentric training has been shown to reduce the incidence of hamstring injury by 56.8% to 70.0% and improve hamstring strength, fascicle length, and H/Q ratio 4.
- Nonoperative treatment options, such as activity modification and physical therapy, can be successful in managing hamstring injuries, while operative treatment is reserved for more severe cases 5.
Return to Play Criteria
- The current RTP criteria rely on subjective clinical assessments and performance tests, but more objective and clinically practical criteria are needed to reduce the ambiguity involved in the RTP decision-making process 6.
- Isokinetic dynamometry and the Askling H-test have been shown to be effective in reducing re-injury rates and improving RTP outcomes 6.
- A comprehensive RTP functional test battery with respect for the natural healing process is recommended to ensure a safe and effective return to play 3.