Have you ever felt a pain in your hamstring during sitting, at night or during a workout that sends you into a writhing, screaming heap on the floor? If the answer is yes, then you have most likely experienced a hamstring cramp. A cramp is an involuntary, strong contraction in a muscle. Hamstring cramps, in particular, are both common and extremely painful. The hamstring muscle is actually a group of three muscles that lie on the back of the leg and run from the pelvis to the knee. Their muscle action is to bring your hip back and bend your knee. Because the hamstrings cross the hip and the knee, they are more prone to cramping as many muscles crossing two joints are.
There is a lot that we don’t know about hamstring cramps but here is what we do know:
SYMPTOMS OF HAMSTRING CRAMPS
A powerful involuntary contraction of the hamstring at the back of the thigh
Snapping or popping feeling in the muscle
Difficulty straightening the knee
Pain in the back of the thigh and lower buttock when walking, straightening the leg, or bending over
Tenderness in the muscle even after the contraction has subsided
Bruising in the muscle
CAUSES OF HAMSTRING CRAMPS
The exact causes of cramps has not been determined. There are, however, a number of possible metabolic causes. They are:
Dehydration
Low potassium or sodium levels
Low carbohydrate levels
If you are suffering from repeated hamstring cramps, do your best to cancel out the effects of dehydration and low potassium, sodium and carb levels by sipping an isotonic drink throughout your workouts. Many trainers and healthcare professionals recommend coconut water.
However, I believe that hamstring cramping is primarily due to musculoskeletal factors such as decreased flexibility, muscle imbalances, faulty movement patterns and poor biomechanical alignment.
Decreased Flexibility:
Your hamstrings need to be at the right length in order to fire without cramping...especially because they span two joints.
Muscle Imbalances:
1. Both the hamstrings and glutes extend the hip. If the gluteal muscles are weak, the hamstrings will take over the work of extending the hip and will be overloaded. IN OTHER WORDS: THE HAMSTRINGS ARE OVERUSED AND THE GLUTEAL GROUP IS UNDER USED 2. If the psoas muscle is tight, it will cause weakness of the gluteal muscle group on that side and the hamstring muscle will be overloaded and strained.
Faulty Movement Patterns:
The sequence of muscle firing between the hamstrings and the gluteal group often causes the hamstrings to cramp. The hamstring is usually the stronger of the two muscle groups and therefore is programmed to fire first, inhibiting the gluteal group from firing. This results in an overused hamstring muscle.
Poor Biomechanical Alignment:
Your hamstrings attach on the pelvis and any change in the position of your pelvis may cause cramping in your hamstrings.
If your alignment is off and your pelvis is tipped forward, your hamstrings will be put on continuous stretch and may cramp as a result.
If your alignment is off and your pelvis is tipped backwards, your hamstrings will be considerably shortened and may cramp as a result.
If one of your legs is longer than the other, the height of one side of your pelvis will be altered and may place stress on either hamstring. This may cause cramping.
TREATMENT
Hamstring cramps may cause damage to the muscle. Fibers of the muscle may be torn due to the shear strength of the muscle contraction and the muscle as a result, may be painful for some time after the cramping. It is essential that a PT evaluate and treat the muscle to restore it to its original condition for pain free return to activities of daily living and sport.
In the acute stage of a hamstring cramp the following treatment is indicated:
RICE: Rest the hamstring muscle and stop doing anything that “fires it off”. If you push through the pain and continue to use muscle you may tear it. Ice the muscle immediately and continue to do so for the first 48 hours. Compress the muscle using an elastic bandage to reduce the swelling. Elevate the leg to reduce the swelling.
NSAIDS: Your doctor may prescribe an anti-inflammatory to keep the swelling down.
Drink an isotonic drink that increases potassium, sodium, carbs and fluids.
Gently perform range of motion exercises to the leg starting with simply bending and straightening your knee holding the knee in the straightened position for longer than in the bent position. Progress slowly to sustained static hamstring stretches.
Self-massage or roll the hamstring muscle.
In the subacute and chronic phases of a hamstring cramp the following treatment is indicated:
More intensive stretching, self-massage and rolling of your hamstring muscle.
Stretch the hip flexors so that the hamstring is not working so hard to overcome a tight hip flexor.
Strengthen your gluteal group to prevent the hamstrings from being over used to extend the hip.
PREVENTION
We can prevent further cramping of the hamstring muscle and maximize our physical performance either during activities of daily living, sport or working out by taking measures to keep our muscles healthy.
Stay hydrated.
Stretch or foam roll your hamstrings to increase flexibility.
Warm up your hamstring muscles before intense exercise.
Increase the intensity of your exercise slowly...no more than a 10% increase in intensity per week.
Strengthen your hamstrings.
Strengthen your gluteal muscle group to prevent overload of your hamstrings.