Dr. John Post says muscular injury patterns can be graded according to a 1-3 scale.
If you’ve ever felt a sharp pain in a muscle—let’s use the hamstrings as an example—that’s caused you to cut a run short, you probably wondered: Did I just pull a muscle or, worse, tear it?
Made up of three muscles, known as the biceps femoris, semimebranosus and semitendinosus, the hamstrings originate at the sit bones and run down the back of the thigh to just below the knee joint. These muscles aid in extension of the hip and provide front flexion power at the knees. Frequently the source of pain and injury for sprinters, middle- and long-distance runners, the hamstrings incur pulls or tears, like all muscles, when they’re stressed past a capacity they can handle. Muscular injuries occur in runners who are fatigued, have muscular imbalances and poor conditioning, when the muscles are too tight, or a combination of these issues.
According to Dr. John Post, medical director of Training Bible, orthopedic surgeon and triathlete, muscular injury patterns can be graded according to a 1-3 scale: Grade one is a pulled muscle, grade two is a partial tear of the muscle substrate, and grade three is a complete tear that may require surgery. Using the hamstring example, if pain in the back of the thigh is accompanied by swelling, bruising and decreased strength of knee flexion, you’ve definitely suffered from a pull and possibly a tear. In this instance, Dr. Post would examine the limb for bruising, areas of tenderness and for a possible gap along the course of the muscle—this happens in serious cases when the muscle has been torn off its bony origin.
Of course, treatment options depend on the severity of the injury. Dr. Post usually recommends: For the first 48 hours, try to elevate the leg or affected area. No running, short-term crutches and rest so the hamstring, or other muscle, can heal. Icing the affected area several times a day can help with swelling and alleviating some pain. Wrap the area with a straight-leg brace or an ace bandage to keep swelling and bleeding to a minimum during the day, and remove the brace or bandage before going to sleep at night. Again, surgery isn’t recommended unless the runner has pulled off the attachment of the muscle from the pelvis or has suffered a complete tear of the muscle belly.
“At some point, the services of the local physical therapist may be of benefit to help mobilize the extremity, recover strength and develop a plan which minimizes the potential for re-injury,” Dr. Post said. “Depending upon the degree of the tear, the level of swelling, any history or previous hamstring injury, athletes can be back to slow running in a matter of weeks, where those who’ve required surgical repair can take six months or more to be back to full strength. If a runner doesn’t follow instructions, they can suffer from a recurrent hamstring tear that can lead to a permanently injured muscle that never provides full function again. Fortunately, this is a rare occurrence, as most get back to their original sport even if it takes time.”
As a precaution, Dr. Post advises athletes to have a trusted source to turn to before an injury occurs. “If they’ve taken the time to figure this out, then when a problem pops up, they have at least some direction and can get back to training and racing with the least time out.”