I felt a pop in my hamstring

The hamstring refers to tendons at the back of the thigh that attach the large muscles to the bone; the ’hamstring’ also refers to the muscles in the back of our thighs.

We can injure out hamstring in a number of ways. Most of these injuries will be self-limiting and will improve over time with home treatment, however occasionally we can sustain a more serious injury.

What level of treatment is required and the likely length of time it will take you to fully recover will depend on the severity of your injury. The severity of a hamstring injury may be referred to by ‘grade’ [NHS, 2021]:

• Grade 1 hamstring injury – a mild muscular strain
• Grade 2 hamstring injury – a partial tear in the muscle
• Grade 3 hamstring injury – a complete muscular tear.

Recovery times can vary from within a few days to up to a few months, depending on what grade your injury is [NHS, 2021]. I’m not sure whether you are experiencing any additional symptoms along with the pain, such as any swelling or bruising, but I think, as the ‘popping’ sensation could indicate that the injury is of a higher grade [Healthline, 2021], it would be sensible to get in touch with your GP for a further assessment and guidance on what treatments may be necessary.

In order to give a firm diagnosis, your GP may refer you on for some further investigations, such as an MRI, x-rays or an ultrasound scan to determine the extent of your injury [Healthline, 2021].

Possible causes of a hamstring injury

There are many activities that could cause us to incur a hamstring injury, the most common of which are those that involve the bending of the knee, such as running or jumping [NHS, 2021; Healthline, 2021].

Other risk factors for developing a hamstring injury include repetitive or overuse of the muscles or tendons and insuffiecient stretching and warming up exercises prior to exercising [Healthline, 2021]. The NHS has some useful guidance on strengthening exercises and how to best warm up prior to exercise on the webpages below (NHS, 2021):

Strength and Flex exercise plan – NHS (www.nhs.uk)

How to warm up before exercising – NHS (www.nhs.uk)

Home treatment

If you have a mild hamstring strain, there are things you can do at home to help ease down the pain and assist with your recovery. Most minor muscular injuries can be treated using the over the counter painkillers and what’s known as the ‘PRICE’ method [NHS, 2021]:

P – Protect – Protect your leg from any further injuries as much as you are able.

R – Rest – Rest the affected limb, especially for the first 48 hours post injury.

I – Ice – Apply an ice pack to the injured muscle to help to reduce inflammation. Please note, do not place ice directly onto the skin as this can cause further skin irritation.

C – Compression – Some people find that using a compression bandage helps to support the muscles during recovery. You should be able to purchase one of these from your local pharmacy

E – Elevation – Whilst at rest elevate your leg, ideally above the level of the heart (when lying down), supported by a foot stool or pillows for example.

After 48 it is beneficial to engage in some gentle stretching exercises to keep the joint mobile and prevent it from becoming ‘stiff’; this could include walking or cycling, for example [NHS, 2021].

Paracetamol would be the painkiller of choice in the first 48 hours post injury, but after this, anti-inflammatory medications, such as ibuprofen, can also be used if you are able to take these medications [NHS Inform, 2021]. If over the counter painkillers are not sufficient in managing your pain then you can speak with your GP about stronger, prescription pain killers. 

If you would like to discuss medications further, please do contact us here at Health at Hand and speak to one of our registered pharmacists. You can contact us directly on 0800 003 004; pharmacists are available 8am-8pm Monday to Friday, 8am-4pm on Saturdays and 8am-12pm on Sundays. If you call outside of these hours one of our nurses will be happy to arrange a call back for you at a convenient time. Alternatively you can submit your query online using our Ask the expert service.

Further support

If your injury does not seem to be improving with the home treatment methods, and you are a member with AXA Heath, you can get specialist support for any problem affecting the muscles, bones or joints, without the need for a GP referral, through our Working Body service. They’ll arrange for you to talk to a physiotherapist who can assess your symptoms, talk to you about what they could mean, and help you plan what to do next. Check your cover online or speak to your claims team for details on how to access this service. The policy team can be contacted on 0800454080; their opening times are 8am-8pm Monday to Friday and 9am-5pm on Saturdays.

If your GP has referred you on for any further investigations or specialist input, and you would like to see if you are able to access this through your private medical insurance, then the policy team can discuss this process with you as well.

If you would like to talk any of this through further, please give us a call and speak with one of the nurses at Health at Hand on 0800 003 004; our nurses are available 24/7 to provide medical information.

For more information and tips to speed your recovery from sports injuries, please see our article Is it a sprain or a strain? 5 common sport injuries and how to treat them.

Finally, you can find out more about how to exercise safely in the Exercise and fitness pages of our wellbeing centre.

Answered by the Health at Hand team.

References

Healthline, 2021. What you need to know about hamstring tear injuries. Available at: Hamstring Tear Causes, Symptoms, Treatment, and Recovery (healthline.com). (Accessed 10 May 2021)

NHS, 2021. Hamstring injury. Available at: Hamstring injury – NHS (www.nhs.uk). (Accessed 10 May 2021).

NHS, 2021. How to warm up before exercising. Available at: How to warm up before exercising – NHS (www.nhs.uk). (Accessed 10 May 2021).

NHS, 2021. Strength and flex exercise plan. Available at: Strength and Flex exercise plan – NHS (www.nhs.uk). (Accessed 10 May 2021).

NHS Inform, 2021. Should I take pain killers after an injury?. Available at: Should I take painkillers? – Injuries | NHS inform. (Accessed 10 May 2021).

Hamstring Tears: Signs and Symptoms

Depending on initial severity and location of a hamstring injury, a person can be significantly debilitated and be forced to take extensive time away from activity. ^1–4

Most people who suffer an acute hamstring strain will experience some of the following:

Sharp pain. When the injury occurs, one may feel an abrupt, sharp pain at the back of the thigh or buttocks.

A “pop” sound or sensation. This sudden pain is sometimes accompanied by an audible or palpable “pop” and a sensation of the leg giving way.^5–8

Difficulty moving and bearing weight. Following a hamstring injury, it may be hard or impossible to continue activity. The person may even have trouble walking with a normal gait, getting up from a seated position, or descending stairs.^9–11 Acute hamstring injury patients can also have a “stiff legged” gait with noticeable limp.⁶

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Bruising. Sometimes bruising and discoloration can be seen along the back of the thigh.

Swelling and deformity. For cases in which there has been a complete tear of the muscle-tendon junction (myotendinous rupture), there may be bruising along with palpable defects, such as muscle lumpiness, under the skin. These defects can be felt and seen with contraction.^5,6,8

Pain and discomfort when sitting. In avulsion type and proximal hamstring injuries, where the tendon breaks away from the pelvic bone, patients will commonly have sitting pain and discomfort.^12–15

In This Article:

In the rare case of a distal avulsion, in which the hamstring tendon has torn away from the tibia or fibula, a patient may experience significant bruising and thickening of soft tissue that can be felt near the site of the injury, which results in an inability to walk without assistance.^16–21

References

• 1. Marshall S, Covassin T, Dick R, Nassar L, Agel J. Descriptive epidemiology of collegiate women’s gymnastics injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004. J Athl Train 2007;42:234-40.
• 2.Caine D, Nassar L. Gymnastics injuries. Med Sport Sci 2005;48:18-58.
• 3.Feeley B, Kennelly S, Barnes R, et al. Epidemiology of National Football League training camp injuries from 1998 to 2007. Am J Sports Med 2008;36:1597-603.
• 4.Brooks J, Fuller C, Kemp S, Reddin D. Incidence, risk, and prevention of hamstring muscle injuries in professional rugby union. Am J Sports Med 2006;34:1297-306.
• 5.Garrett W. Muscle strain injuries. Am J Sports Med 1996;24 S2-S8.
• 6.Ali K, Leland J. Hamstring strains and tears in the athlete. Clin Sports Med 2012;31:263-72.32. Orchard J. Biomechanics of muscle strain injury. N Z J Sports Med 2002;30:92-8.
• 7.Orchard J. Biomechanics of muscle strain injury. N Z J Sports Med 2002;30:92-8.
• 8.Clanton T, Coupe K. Hamstring strains in athletes: diagnosis and treatment. J Am Acad Orthop Surg 1998;6:237-48.
• 9.Lempainen L, Sarimo J, Mattila K, Vaittinen S, Orava S. Proximal hamstring tendinopathy: results of surgical management and histopathologic findings. Am J Sports Med 2009;37:727-34.
• 10.Zissen M, Wallace G, Stevens K, Fredericson M, Beaulieu C. High hamstring tendinopathy: MRI and ultrasound imaging and therapeutic efficacy of percutaneous corticosteroid injection. AJR Am J Roentgenol 2010;195:993-8.
• 11.Cacchio A, Borra F, Severini G, et al. Reliability and validity of three pain provocation tests used for the diagnosis of chronic proximal hamstring tendinopathy. Br J Sports Med 2012;46:883-7.
• 12.Lempainen L, Sarimo J, Mattila K, Vaittinen S, Orava S. Proximal hamstring tendinopathy: results of surgical management and histopathologic findings. Am J Sports Med 2009;37:727-34.
• 13.Puranen J, Orava S. The hamstring syndrome–a new gluteal sciatica. Ann Chir Gynaecol 1991;80:212-4.
• 14.Zissen M, Wallace G, Stevens K, Fredericson M, Beaulieu C. High hamstring tendinopathy: MRI and ultrasound imaging and therapeutic efficacy of percutaneous corticosteroid injection. AJR Am J Roentgenol 2010;195:993-8.
• 15.Cacchio A, Borra F, Severini G, et al. Reliability and validity of three pain provocation tests used for the diagnosis of chronic proximal hamstring tendinopathy. Br J Sports Med 2012;46:883-7.
• 16.Cohen S, Bradley J. Acute proximal hamstring rupture. J Am Acad Orthop Surg 2007;15:350-5.
• 17.Folsom G, Larson C. Surgical treatment of acute versus chronic complete proximal hamstring ruptures: results of a new allograft technique for chronic reconstructions. Am J Sports Med 2008;36:104-9.
• 18.Colosimo A, Wyatt H, Frank K, Mangine R. Hamstring Avulsion Injuries. Oper Tech Sports Med 2005;13:80-8.
• 19.Domb B, Linder D, Sharp K, Sadik A, Gerhardt M. Endoscopic repair of proximal hamstring avulsion. Arthrosc Tech 2013;2:e35-9.
• 20.Harris J, Griesser M, Best T, Ellis T. Treatment of Proximal Hamstring Rupture- A Systemic Review. Int J Sports Med 2011;32:490-5.
• 21.Sarimo J, Lempainen L, Mattila K, Orava S. Complete proximal hamstring avulsions: a series of 41 patients with operative treatment. Am J Sports Med 2008;36:1110-5.

Hamstring injury – Symptoms and causes

Overview

A hamstring injury occurs when you strain or pull one of your hamstring muscles — the group of three muscles that run along the back of your thigh.

You may be more likely to get a hamstring injury if you play soccer, basketball, football, tennis or a similar sport that involves sprinting with sudden stops and starts. Hamstring injury can occur in runners and in dancers as well.

Self-care measures such as rest, ice and over-the-counter pain medications are often all you need to relieve the pain and swelling associated with a hamstring injury. Rarely, surgery may be needed to repair a hamstring muscle or tendon.

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Symptoms

A hamstring injury typically causes a sudden, sharp pain in the back of your thigh. You might also feel a “popping” or tearing sensation. Swelling and tenderness usually develop within a few hours. You may also experience bruising or discoloration along the back of your leg, as well as muscle weakness or an inability to put weight on your injured leg.

When to see a doctor

Mild hamstring strains can be treated at home. But you should see a doctor if you can’t bear any weight on your injured leg or if you can’t walk more than four steps without significant pain.

Causes

The hamstring muscles are a group of three muscles that run along the back of your thigh from your hip to just below your knee. These muscles make it possible to extend your leg straight behind your body and to bend your knee. When any one of these muscles stretches beyond its limit during physical activity, injury can result.

Risk factors

Hamstring injury risk factors include:

• Sports participation. Sports that require sprinting or running, or other activities such as dancing that might require extreme stretching, make a hamstring injury more likely.
• Prior hamstring injury. After you’ve had one hamstring injury, you’re more likely to have another one, especially if you try to resume all your activities at pre-injury levels of intensity before your muscles have time to heal and rebuild strength.
• Poor flexibility. If you have poor flexibility, your muscles may not be able to bear the full force of the action required during certain activities.
• Muscle imbalance. Although not all experts agree, some suggest that a muscle imbalance may lead to hamstring injury. When the muscles along the front of your thigh — the quadriceps — become stronger and more developed than your hamstring muscles, you may be more likely to injure your hamstring muscles.

Complications

Returning to strenuous activities before your hamstring muscles are completely healed might cause an injury recurrence.

Prevention

As part of an overall physical conditioning program, regular stretching and strengthening exercises can help minimize your risk of hamstring injury. Try to be in shape to play your sport; don’t play your sport to get in shape.

If you have a physically demanding occupation, regular conditioning can help prevent injuries. Ask your doctor about appropriate conditioning exercises.

Nov. 17, 2020

Hamstring Injuries

Introduction

Hamstring is the common name for the big group of muscles and tendons in the back of your thigh. These powerful muscles are often injured, especially by athletes. Though hamstring injuries can be very painful, they will usually heal on their own. But for the hamstring to return to full function, these injuries need special attention and a specially designed rehabilitation program.

Anatomy

The hamstrings are a group of three muscles that run from the pelvis to the knee. They form the back of the thigh. Their function is to pull the leg backward and propel the body forward while walking or running. This is called hip extension. The hamstrings also bend the knees, called knee flexion.

Most hamstring injuries occur in the area where the muscles and tendons connect (musculotendinous complex). The hamstring has an extensive musculotendinous complex.

When injured, the fibers of the hamstring muscles are actually torn. The body responds to the damage by producing enzymes and other body chemicals at the site of the injury. These chemicals produce swelling and pain.

In a severe injury, the small blood vessels in the muscle can be torn as well. This results in bleeding into the muscle tissue. Until these small blood vessels can repair themselves, less blood can flow to the area. With reduced blood flow, the muscles cannot begin to heal.

The chemicals produced and the blood clotting are your body’s way of healing itself. Your body heals the muscle by rebuilding the muscle tissue and by forming scar tissue.

In rare cases, an injury can cause the muscle and tendons to tear away from the bone. This happens most often where the hamstrings attach to the pelvis just under the buttock. These tears, called avulsions, sometimes require surgery.

Causes

Hamstring injuries happen when the muscles are stretched too far. Sprinting and other fast or twisting motions with the legs are the major cause of hamstring injuries. Hamstring injuries most often occur in running, jumping, and kicking sports. Water skiing, dancing, weight lifting, and ice-skating also cause frequent hamstring injuries. These sports are more likely to cause avulsions.

The major factors in hamstring injuries are low levels of fitness and poor flexibility. Children very seldom suffer hamstring injuries, probably because they are so flexible. Muscle fatigue and not warming up properly can contribute to hamstring injuries.

Imbalances in the strength of different leg muscles can lead to hamstring injuries. The hamstring muscles of one leg may be much stronger than the other leg, or the quadriceps muscles on the front of the thigh may overpower the hamstrings.

Symptoms

Hamstring injuries usually occur during heavy exercise. In especially bad cases, the person will suddenly become lame, or even fall to the ground. They may also hear a popping sound. The person may be able to walk with only mild pain even in a severe injury. But taking part in strenuous exercise will be impossible, and the pain will continue.

In less severe cases, a tight feeling or a pulling in their hamstring may be felt. This type of hamstring injury often turns into a long-lasting problem. The hamstring may be pulled or torn.

In the rare case of a complete tear, the pain is excruciating. The torn tissues may form a hard bunch in the back of the thigh when the leg is bent. The skin may also bruise, turning purple due to bleeding under the skin.

Diagnosis

The doctor will take a detailed medical history that includes questions about your exercise schedule, activities, and the way you warm up. The doctor will also ask for a description of your symptoms.

The doctor will examine the back of your thigh. The physical exam will involve flexing and extending your leg. The probing and the movement may hurt, but it is important to identify exactly where and when there is pain.

Radiological Tests

Your doctor may want to schedule imaging tests. X-rays usually don’t show hamstring injuries, but they may rule out other problems such as a bone injury. Magnetic resonance imaging (MRI) can be useful in showing the details of muscle injuries. These tests may not be required to diagnose your condition.

Doctors group hamstring injuries into three categories:

Grade One – mild. Grade one injuries are muscle pulls that do not result in much damage to the structure of the tissues.

Grade Two – moderate. Grade two injuries are partial tears.

Grade Three – severe. Grade three injuries are complete tears.

Grade one injuries are muscle pulls that do not result in much damage to the structure of the tissues. Grade two injuries are partial tears. Grade three injuries are complete tears.

Treatment

It is very important to treat and rehabilitate a hamstring injury correctly. Incomplete or improper healing makes re-injury much more likely.

For the first three to five days after the injury, the main goal of treatment is to control the swelling, pain, and bleeding. Hamstring injuries are initially treated using the RICE method. RICE stands for rest, ice, compression, and elevation.

Rest

The doctor may recommend a short period of immobilization (up to one week). Severe tears may require a longer period of rest. You may be required to spend most of your time lying down and use crutches to get around. If too much weight is put on your hamstring after an injury, more damage may occur and more scar tissue may form.

Ice

Ice applied to the injured hamstring controls swelling and pain but doesn’t stop it completely. This is important because the body’s inflammatory response actually helps muscles heal. Cold treatments slow the metabolism and blood flow in the area. Cold also reduces sensations of pain by numbing the nerves. Experiencing less pain helps you relax, reducing muscle spasms.

Cold gel packs, chemical mixtures, or cold sprays can also be used. A plastic bag full of ice cubes or crushed ice, held on with an elastic bandage, is the most effective type of cold treatment. The ice should be kept on the injury for twenty to thirty minutes. Cold treatments should be repeated at least four times a day for the first two to three days. They can be done as often as every two hours if needed.

Compression

Compression can help reduce the bleeding in the muscle to limit swelling and scarring. To apply compression, the doctor may suggest wrapping the hamstring firmly in an elastic bandage.

Elevation

Elevation can help reduce swelling. The idea behind elevation is to raise the injured body part above the level of the heart. In the case of a hamstring injury, this requires lying down and supporting the leg up on pillows.

Medication

The doctor may also prescribe a short course of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to help relieve the swelling and pain. For muscle injuries, pain relief may be the major benefit of NSAIDs.

Surgery

Surgery will be required to reconnect the hamstring if there is a complete rupture. An orthopaedic surgeon will perform this surgery and will give advice on post-surgical care.

After surgery, there will be a period of rest, which may involve using crutches. Most likely a physical therapist will work with you to learn exercises for rehabilitation after surgery.

Rehabilitation

A physical therapist or athletic trainer may oversee your rehabilitation program. For minor muscle pulls, four to six weeks may be needed to safely get back to your activities. For more severe muscle tears, rehabilitation for up to three months may be needed, with complete healing occurring by four to six months.

At first, the therapist may use the RICE method. After three days, treatments may include contrast applications where heat and ice are alternated over twenty to thirty minutes. Ultrasound treatments may also be applied to improve blood flow and healing in the injured tissues.

As the hamstring begins to heal, it is critical that you follow an exercise program to regain strength and mobility. Specially designed exercises encourage your body to rebuild muscle instead of scar tissue. The exercises also help prevent reinjury. Rehabilitation can be slow, so it is important to be patient and not push yourself too hard or too fast.

Early in rehabilitation, exercises may be done in a swimming pool or on a stationary bike set to low resistance. These exercises allow the hamstring to go through its range of motion without having to hold up your weight. When you can walk without a limp and feel very little tenderness, you can start a walking program. Eventually you can work up to jogging.

Stretching will be a key feature of a rehabilitation program. You will be shown how to stretch. Plan to continue these stretches even after healing, because a re-injury of the same hamstring muscle is common. Increasing flexibility may help you avoid another hamstring injury in the future. It is important to maintain good flexibility to keep your hamstring muscles healthy.

Strengthening exercises usually begin with isometric exercises. These exercises involve contracting the muscles without moving the leg joints. As the hamstring gets stronger, light weights are used. It is important that you feel no pain during these exercises.

You should maintain your general level of fitness throughout rehabilitation. A therapist can suggest workouts that don’t stress the hamstring muscles.

Most hamstring injuries get better with treatment and rehabilitation. Even world-class athletes with severe hamstring injuries are usually able to return to competition. By keeping the muscle flexible and giving the body time to heal, you should be able to return to the activities you enjoy.

Pulled Hamstring- How to Heal » SportStars Magazine

 How to heal a pulled Hamstring? The hamstring muscle, which makes up the back of your thigh, is the most frequently strained muscle in the body. A hamstring strain, is both common and painful. It can affect runners, football, soccer, basketball players and so on. 

The hamstring is actually a group of muscles called the semitendinosus, semimembranosus and biceps femoris. Their primary function is to bend the knee and move the thigh backwards (extend the hip). During a strain, one or more of these muscles gets stretched too far, or may even start to tear. This can happen with exercise that involves a lot of running, jumping or sudden start or stopping type of activity. 

Symptoms

Symptoms of a hamstring strain include : sudden sharp pain at the back of the thigh during exercise, possible snapping or popping feeling, pain with walking, tender to touch and sometimes bruising. A strained hamstring makes it hard to straighten the leg or bend over.

You can get a hamstring strain if you don’t stretch or warm up properly. We here at the Sports Medicine Center for Young Athletes recommend warm up with a brisk walk or jog followed by dynamic warm up of the primary muscles for your sports specific activity prior to start of practice or competition.

The majority of hamstring strains are either called 1st or 2nd degree, or graded 1 or 2 depending on the severity. A 3rd degree or grade 3 strain is rare but involves a severe or complete rupture of the muscle which may need surgery performed by an orthopedic surgeon.

A quick glance at the various strains and their symptoms:

1st degree/Grade1: May have some tightness in the back of the thigh, or feeling sore; no obvious pain or swelling; may walk normal but with some discomfort.

 2nd degree/Grade 2: May be limping when trying to walk; may have heard or felt a pop during the activity; may notice some swelling; tender to touch, and may not be able to fully straighten the knee; some bruising may be present

3rd degree/Grade3: Most likely will need crutches; obvious swelling and bruising; severe pain when trying to bend the knee

How to heal? The best course of treatment for a hamstring strain is to see a medical professional (whether you consult with your school trainer or physical therapist, who may refer you to a sports medicine physician). Also, the recommendation may include rest, ice, compression, elevation, and when able, to practice stretching and strengthening exercises in a pain free range of motion. 

When returning to your physical activity, you should be able to move your leg as freely as the uninjured side, strength should be equal when compared to the uninjured side, and you should not have any pain when you try to walk, jog, sprint or jump. In addition, the best way to prevent hamstring strains is to stretch and strengthen. Stop exercise if you feel pain in the back of your thigh. 

Kelli Adams is a certified athletic trainer and physical therapy assistant for Children’s Hospital Oakland and its Sports Medicine for Young Athletes division. 

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Hanging on by a Hamstring – by Adam Meakins

Today on RunningPhysio we’re doing a ‘blog swap’ – I’ve handed the keys to Adam over at TheSportsPhysio and I’m trusting him not to redecorate or put up any of those horrid 80’s posters with wolves on or dolphins jumping a reflection of the moon! Luckily Adam is pretty trustworthy and I’m sure the blog is in safe hands! He has worked in elite sports and has a wealth of experience to draw from, follow him on Twitter via @adammeakins.

So the hamstrings, the ‘hammy’s’ those muscles that run down the back of your leg, the ones that commonly get overlooked until it’s too late. You only had to be watching the recent London 2012 Olympic 100 metres final to see Asafa Powell pull up 60m down the track or watch Andy Carroll limp off and be ruled out for 6 weeks after his debut game with West Ham a few weeks ago to realise how common hamstring injuries in sport can be, but what about in running?

Well Tom has asked me to talk to you about hamstring tears in running, what are the chances of you having one? What happens when they tear and what you can do to reduce your risk and optimise your recovery quickly?

Now luckily, or unluckily depending which side of the treatment couch you’re on, I have dealt with plenty of hamstring tears especially in my years of working as a physio in football, as this is one of, if not the most common injury in football.

However they are also fairly common in other sports, but what about running, well I can tell you from first hand experience having suffered a hamstring injury a few years ago, they do occur in running, but to tear a hammy, you usually have to be sprinting hard or trying to slowing down rapidly, or changing direction sharply or kicking something, which runners do do, (apart from kicking something… except maybe that mad dog chasing you) just not as often as in a sport such as football, I did mine leaping through the Forest of Dean on a trail run.

There are other ways to tear a hamstring , the overstretch tears that dancers experience a lot but these tend to be done at slower speed and less traumatic than the high speed explosive tears from sprinting and running and its these that will be more relevant to runners.

So we know they are common but what are your chances of suffering a hamstring tear as a runner, well unfortunately I can’t tell you, as I was unable to find any specific study on just runners alone, all the studies are done in sports such as football, rugby or athletic track events, for example a great study done by Woods et al 2004 done over two years back in 1997-1999 in professional football found the incidence of hamstring tears to be the highest prevelant injury with rates as high as 28% with between 8-25 days out per injury depending on severity and where it tore.

But it’s fair to say that if you’re a runner who sprints, jumps and leaps a lot, such as a trail or fell runner, or someone who does regular hill sprints or any high intensity sprint session then your chances will be significantly higher to tear a hamstring rather than a runner who maintains a consistent steady pace, you’re more likely to develop a hamstring tendinopathy, but that’s another article completely.

So why do these hamstrings tear?

Hamstring Anatomy

Well its due in part to their anatomy and the role they play when running. First their anatomy, the three hamstrings control movement at two big joints, the hip and the knee, and we know that muscles that have to work this way, simultaneously controlling movement at two joints are more at risk of injury, it’s also believed that most hamstrings usually tear during the late swing phase or the running cycle, just at maximal knee extension i.e. just before your foot is about to land on the floor, this phase of the running cycle is when the hamstrings are having to act like a brake, slowing your leg down as its been powerfully swung forward underneath you by the strong forceful contraction of the quads and hip flexors muscles, but as they are acting as a brake they are also being elongated to near their maximal length by both the straightening knee and the flexing hip. This is called eccentric muscle contraction (concentric contraction is the opposite when the muscle shortens such as when the heel comes up towards your buttocks in the early swing phase)

So the hamstring has to stretch to near is max length and simultaneously contract to slow your leg down, this produces a great deal of tensile strain within the muscle and if it reaches a critical point it will tear. It tears usually at its weakest point that being an area called the musculotendinous junction, this is where the muscle belly changes into the tendon, and its usually the biceps femoris muscle (the hamstring down the outside of your leg) that this occurs in, but they can tear in other areas and in any of the other hamstring muscles depending on a lot of different factors.

So how do you know if you have torn your hamstring rather than just strained it?

Well this can be extremely obvious, but also very tricky, for example, a severe or complete tear of a hamstring called a Grade 3 injury is easy to diagnose and spot, for starters you will have felt something ‘go’ or ‘pop’ or ‘crack’, you will also be lying on the floor feeling as if you have been shot or hit with an axe behind your leg, you will not be able to walk and will be in a lot of pain, you will notice bruising quickly appear in the next hour or so as the torn muscle leaks blood ‘a lot’ and it will be hot and swollen to touch, this class of tear is normally managed by surgical repair and then physiotherapy and will mean 6 months to a year out.

For a less severe partial tear called a Grade 2, you will have still probably felt something ‘go’ again but no popping sensations, you will have pulled up but still be standing and limping around, you will be able to walk but it will hurt, you may or may not get any bruising, and maybe able to feel some heat and swelling but might be harder to see, this is usually managed conservatively meaning no operation but lots of physio treatment and anywhere from 6 weeks to 6 months out.

However for the much more common smaller tears called a Grade 1, it can be harder to recognise, these are tricky little buggers it can almost feel like a small strain or niggle that can come on during a run, you can continue to run although it will cause a diffuse soreness behind your leg that can settle very quickly once you have stopped, so leading you to think you have not torn anything especially as you won’t see any bruising or feel any heat or swelling and feel nothing in normal day to day activities except maybe a twinge on getting up out of chairs or up/down stairs, most of these class of tears need to be properly managed and normally its anywhere of 3 -12 weeks of physio treatment

The reason it can be from 3 weeks to 3 months for the same injury is due to a couple of reasons first and most obviously with a Grade 1 tear runners can continue to run which they like to do, and tend to do, even in pain, this disrupts the healing processes and prevents the tear from healing, secondly it can depend on where the tear is located, if more in the tendon it heals slower than if in the muscle belly, all due to the differing bloody supply. Finally they are commonly misdiagnosed as just a strain and so again back to the same issue of allowing the runner to continue to run or even doing inappropriate rehab such as stretching the hamstrings in the early stages and so not allowing the tear to heal.

So what do you do if you think you have a Grade1 hamstring tear?

Well its simple if you’re a professional football player you go and have an MRI, that’s the gold standard, no room for misdiagnosis there (well 98% of the time), but you’re not going to get MRI when you go and see your GP or physio and complain of your hamstring pain as 1) they cost a fortune and 2) the waiting time to get one means it will be useless by the time you do.

MRI showing grade 1 tear of biceps femoris

So my advice if you think you have just a hamstring strain, err on the side of caution and treat it like a Grade 1 tear and go and see a physio for some advice and treatment. In my experience dealing with them like this, yes may take a little longer and may be frustrating at the start, but it will mean in the long run you won’t be back to see the physio a few weeks later with same problem.

So how do you treat a Grade 1 hamstring tear?

So first and foremost STOP RUNNING, this will be for at least THREE weeks, and yes I can hear you all groaning from here… believe me I don’t ask people to stop their sport lightly but if I think you have a hamstring tear I will insist.

Follow the RICE programme, Rest we covered above, Ice for a week or so regularly, Compress with either cycle shorts or tubigrip, and Elevate

DO NOT STRETCH your hamstrings for these three weeks or so, you will need to let the scar tissue lay down over the tear without disrupting it, if you keep stretching it will be unable to lay down effectively, you will be stretching plenty later on, save your energy for then.

Once the physio feels you have gone through the healing phase then the fun rehab can begin and eventually get you back out running, how long this last again varies and is based on individual factors and you will have to reach certain checkpoints before the physio lets you back 100% but on average it’s a few weeks.

Great so you’re recovered and back out running, well a word of warning, you are now in the high risk category for suffering with another hamstring tear, with around 33% suffering another tear especially in the first few weeks after return to running, again I can hear you groaning from here… but you can reduce your risk of re injury.

So how do you reduce your chances of suffering a hamstring tear as a runner?

Well I’m sorry to say this again but I couldn’t find any specific studies done just on runners on how to prevent hamstring tears (us runners seem to be the poor relation of sports when it comes to good quality research), most prevention studies again have all been focused where the money is… football. But we can still use their findings and incorporate it for us runners.

First we need to identify your risk factors for getting a hamstring injury and as we said previous hamstring injury is a factor, in fact it’s the only conclusive risk factor that the research has found.

But there are other modifiable risk factors found in the research but they aren’t conclusive, they are a lack of flexibility of both the hamstrings but also the hip flexors and quads, poor strength ratios between the quads and hamstring , poor coordination of the pelvic and trunk muscles, fatigue and poor warm up strategies prior to exercise. So although not conclusive if we use our common sense and address these then your chances of suffering a hamstring tear have got to be reduced.

First let’s look at flexibility.

The hamstrings are notorious as being a tight group of muscles but this isn’t the only group to look at the relationship between the hamstrings and the hip flexors and quads is complex and addressing tightness in all of these is essential.

If we keep it simple for sake of time and just say if the hamstrings and hip flexors and quads are tight then the movement at the hip and knee joints is restricted and place extra strain on the soft tissue around them so loosening them allows better joint movement, so less strain.

Some of the best stretches I feel for these muscle are as below

There has been much debate of the role of stretching before running etc, and I don’t want to get into this now, but it’s safe to say if you loosen these tight muscles regularly not just before you go running you won’t be going far wrong. (More on stretching from Adam here)

Next let’s look at hamstring strength.

Keeping the hamstrings strong, but especially the eccentric phase, which if you remember a while back we said is when the muscle is lengthening as it’s contracting is also key. All running activities tend to be quad dominate and these quad muscle get stronger and stronger when running so the ‘pulling’ on the hamstrings gets more and more as the leg swings forward underneath us, if the hamstring can’t keep up with the stronger quads it will be prone to tearing.

A ratio of 1:0.6 or 66% has been used for a long time for the hamstrings but this is only for its concentric strength, for example if your quads can push 100kg your hamstrings should be able to pull 66kg.

But a much more useful and important ratio is the eccentric ratio and opinion here is divided as what’s the best, but for most a ratio of 1:1 is used, (1:1.2 if you’re an elite athlete) for example for every 100kg your hamstring can pull as the knee bends, it must be able to resist 100kg as your knee gets straightened (120kg if you’re an elite athlete)

A good way of testing this and finding out if you are achieving these ratios is with an Isokinetic Dynometer as shown below, this is me testing one of our young Watford FC lads last season, but again not many will have access to this, instead just take it as read that you won’t have these ratios, I haven’t met many that do, so doing some hamstring strengthening exercises is a must especially the eccentric phase is essential

Some good hamstring eccentric strengthen exercises

The last exercise the single leg RDL (Romanian Dead Lift) is also really good for helping that other factor mentioned the coordination and control of movement around the hip and pelvis as it challenges your balance as well as gets you strong.

Finally a word on warming up.

Ensuring you are prepared for any athletic activity is a must but even more so for explosive or sprinting activities.

In my opinion no runner spends long enough warming up, when I first started working in football I was amazed by the length of the warm up compared to the length of the training sessions, sometimes the warm up can be as long if not longer than the planned training session.

I have brought this philosophy back to not only my training, but also my patients and with great success. I now insist that all my patients especially those with past hamstring issues to do a dynamic warm up for at least 50% for the time you have planned for any high intensity session sprints etc and at least for 25% for a ‘normal’ paced run, this is minimum, so, for example if you have planned a 30 min interval sprint session then warm up for at least 15 min, or, going for a 30 min jog, then at least a 7 min warm up, how many of you do this…. None I bet,

Again there is much debate as to what’s the best warm up etc etc, I don’t want to get into this instead here are a few of my favourite warm up drills for runners.

Lunge walking, Donkey kicks, High kick pull backs, Sideways running, Backwards running, Toes walking, Dead leg running

The list could go on and on…

My final thoughts are, running at a steady constant pace is low risk of producing a hamstring tear but this risk increases if you start to do any sprinting, leaping, jumping or sudden changes of direction, and increases even further if you have had a previous injury.

You can reduce this this rick by ensuring you have good flexibility in not just your hamstrings but also hip flexors and quads and ensuring your eccentric hamstring strength is better. Finally make sure you warm up for a lot longer than you normally do.

Thanks and happy running…

Adam

Leg Strain – Harvard Health

What Is It?

A muscle strain is a stretch or tear of muscle fibers. In the leg, muscle strains happen when a muscle is either stretched beyond its limits or forced into extreme contraction. Because the leg has many different muscles, it is vulnerable to several different types of muscle strains. Some of the more common ones are:  

• Calf muscle strain (gastrocnemius strain). The calf muscle typically gets strained when the foot suddenly bends upward, stretching the calf muscle beyond its limits. At the time of injury, you may hear or feel a pop inside your calf — the sound of the muscle tearing or shearing away from the Achilles tendon. Calf muscle strains are common in athletes, especially tennis players and joggers. However, they also can happen during a simple stroll, if your foot flexes upward when you step into a hole in the sidewalk or if your heel slips off the edge of a curb. 
• Plantaris strain. The plantaris is a thin muscle that begins at the lower end of the femur (the large bone of the upper leg), stretches across the knee joint and attaches to the back of the heel along with the Achilles tendon. Because the plantaris doesn’t contribute much force in bending the knee, a tear in this muscle may not seriously affect your knee function. However, a severe plantaris strain can cause significant pain, usually at the back of your calf rather than near the knee. A plantaris strain can occur alone or accompany a gastrocnemius strain or a tear of the anterior cruciate ligament (ACL), a major, stabilizing ligament in the knee. 
• Hamstring strain (pulled hamstring). Hamstrings are long muscles that extend down the back of the thigh. Because hamstrings work to pull back the leg and bend the knee, they can be injured during running, kicking or jumping. You may feel a pop, usually at the back of the thigh, when the muscle tears. 
• Quadriceps strain. The quadriceps is a large group of muscles in the front of the thigh that straighten out the knee, the opposite action from the hamstrings. Quadriceps strain is a common injury in runners. However, it also may occur during a strenuous leg press at the gym. The pain of a quadriceps strain is felt in the front of the thigh. The strain may be described as a groin pull if the tear is fairly high in the muscle.  

To help simplify diagnosis and treatment, doctors often classify muscle strains into three different grades, depending on the severity of muscle fiber damage.  

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should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Meaning, Synonyms, Definition, Sentences. What is a tendon

Where does hip pain come from and what to do about it

The hip joints (HJ) are the largest joints in the human body.Both left and right take on a huge load every day: it is they who transfer the weight of the body to the legs and allow us to maintain balance while standing. In addition, the hip joints loaded with body weight are in constant motion, providing leg mobility when walking, running, and squatting.

Illustration: Alila Medical Media / Shutterstock

Even metal gets tired under constant stress, so it comes as no surprise that hip discomfort and pain are common. However, unpleasant sensations do not always indicate joint problems.Other options are also possible – sometimes dangerous.

When you urgently need medical attention

As soon as possible contact the surgeon, the nearest emergency room or even, depending on the condition, call an ambulance if ^:

• pain in the joint area appears suddenly, it is severe, unbearable;
• pain occurred after a fall or other injury;
• While falling, you heard a crackling or popping sound in the joint area;
• The joint appears to be deformed;
• the skin in the area of ​​the hip joint turns red, becomes hot, you notice tissue edema;
• you cannot move your leg or hip;
• stress on the hip joint (for example, trying to sit down) causes pain or is not possible at all;
• The hip joint aches and hurts at night or when you are resting.

These symptoms indicate serious injury or inflammation. Without medical attention, this can lead to complications, up to the loss of the ability to walk or to blood poisoning.

Why does the hip joint hurt?

There are many possible reasons. Here are the most common ^.

1. You have overtrained

This reason can be assumed if pain, discomfort, crunching occurs after heavy or prolonged physical exertion.For example, you ran a half marathon, took on a previously unattainable weight, or brought a couple of sofas to the fifth floor.

Long repetitive movements, especially under stress, can cause bursitis (inflammation of the sacs that separate the tendons and bone) or tendonitis (inflammation of the tendons that connect the gluteus muscles to the pelvic bone). As a rule, these violations are not dangerous, and the body copes with them on its own in a day or two. It is enough to give him time to breathe and recover.

2.You have been lying or sitting in the same position for too long

Restricted movement can also cause tendonitis.

3. You have a muscle or tendon strain

Pain sometimes radiates to the hip area caused by a stretching of one of the groin muscles or hamstrings. This disorder can be earned through physical exertion, a fall, or even an awkward turn of the leg.

4. You suffer from spinal problems

Our brain does not always know exactly where the pain is coming from.A pinched nerve, rubbing of the vertebrae against each other due to worn out cartilage – all this can cause pain in the lateral part of the thigh, including the hip joint.

5. Perhaps it is osteoarthritis

Due to age, injuries, constant excessive physical exertion, the cartilaginous tissue, which softens the friction of the bones inside the joints, begins to deteriorate. As a result, the bones rub against each other during movement. And this causes pain, stiffness, loss of mobility. This condition is called osteoarthritis.

Osteoarthritis is perhaps the most common ^{cause of regular hip pain.}

In the United States alone, 27 million people suffer from such discomfort every day.

6. Or problems with internal organs

There are many organs in the pelvic region. Pain in any of them can give ^{to the hip joints.}

If you are a woman and joint soreness coincides with ovulation, PMS, or menstruation, it could be caused by endometriosis or fibroids, not hip problems.Urological and gastrointestinal disorders such as gastroenteritis or prostate cancer can also cause discomfort that can be easily confused with hip pain.

7. Dislocation of the hip joint

It is usually the result of a sharp blow to the hip (for example, in a car accident) or a sports injury. As a result of the dislocation, the bone leaves the articular capsule. This is very painful. In addition, the dislocation immobilizes the hip joint, making walking impossible.

8. Hip fracture

Most often, the fracture occurs in the elderly. This is because bones become weak and brittle with age, and the slightest drop can cause them to crack.

The fracture is accompanied by severe pain, swelling, redness or numbness of the skin over the affected bone and severely restricts the mobility of the joint.

9. Osteonecrosis

This condition occurs when blood flow to the bone slows down and bone begins to die off.Osteonecrosis can affect any bone in the body, but it is the hip joint that most often attacks.

10. Other diseases, including bone cancer

In rare cases, autoimmune diseases (such as rheumatoid arthritis), infections (which cause septic arthritis and osteomyelitis), or cancers affecting the bones can damage the joint.

What to do for hip pain

If you do not have symptoms that require immediate medical attention (they are listed at the beginning of the article), try to manage your pain at home ^.

• Temporarily limit physical activity to allow the damaged joint to heal.
• Apply cold compresses to the affected joint to relieve pain and swelling. For example, a cloth soaked in cool water or an ice pack wrapped in a napkin.
• Take an over-the-counter pain reliever if needed. Naturally, strictly following the instructions.

The discomfort will most likely subside by itself within a couple of days.

But there are signs in which you cannot get out of a visit to the doctor.Be sure to go to the therapist if the pain persists within 7 days, you have a fever or a skin rash, you feel pain not only in the hip, but also in other joints.

The doctor will ask you about your symptoms, conduct an examination, and issue a referral for tests, such as blood tests, pelvic ultrasound, x-rays. Depending on the results of the examination, the therapist will make a preliminary diagnosis. Then, if necessary, you will be sent to a specialized specialist (traumatologist, orthopedist, physiotherapist, urologist, gynecologist, gastroenterologist, oncologist) who will help you cope with the problem and prevent complications.

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Knee fracture – how to distinguish from rupture and sprain

Seemingly – knee fracture – how can it be broken at all? But as practice shows, this phenomenon is not only real, but also widespread. It is enough to get hit on the knee or fall from a great height – and it is quite possible that you will have to get acquainted with the methods of treating this injury. And her treatment is at least not the most pleasant and often quite lengthy.

What the knee is made of

If you look at the knee joint, it is far from being as simple as it might seem at first glance. It is formed by as many as four bones:

• tibia;
• femoral;
• tibia;
• patella.

In addition to bones, the system also consists of a complex interlacing of cartilage, tendons, muscles and ligaments.

What trauma can be

Fracture, bruise, sprain or even rupture of the ligaments have a number of differences.But if in general terms, then any damage is not pleasant and can cause similar pain sensations, therefore, to clarify the diagnosis, you need to consult a specialist – he will determine exactly what befell the patient.

Diagnostics

There are a lot of differences in injuries that can tell you what exactly overtook you:

• With a fracture it becomes impossible to stand on your leg, a severe pain syndrome occurs. If nerves have been touched, a feeling of numbness may occur.
• Stretching is often accompanied by a slight crunch on movement. During the first few hours, there is swelling, a feeling of instability, stiffness, or vice versa – severe laxity of the knee joint.
• With a ligament rupture , the victim can literally hear a clap during the rupture itself. There may be bruising and a feeling of instability in the knee, sometimes even a hematoma. Mobility is severely limited or even impossible.

What are the types of fractures

If you look at the classification of fractures, they are divided into intra-articular (damage to the synovial bursa) and extra-articular (damage to the bone).

Cartilage injury is characterized by pain on movement and almost no pain during rest. Exactly what problem befell the knee in a particular case can only be understood with the help of an X-ray examination or, better, three-dimensional diagnostics (CT or MRI).

Treatment

First of all, the injured knee must be immobilized so as not to add pain and worsen the situation.After the diagnosis has been clarified, the bone and its fragments (if any) are repositioned. This can be done both in a closed form and promptly. After reduction, the fracture site is fixed until healing. This can take several weeks or even months. It is important after the restoration of the bone to undergo proper rehabilitation in order to restore the normal functionality of the leg and return to the usual way of life.

In any case, a knee injury requires special attention, because only a specialist can determine its seriousness, and if the treatment is delayed, the consequences can be dire.Enjoy life, not knee pain.

After stretching, hurts under the knee

The hamstring connects the patella to the quadriceps. If it is damaged, leaning forward, people cannot reach their toes with their fingertips. The stiffness of the hamstring tends to flatten the normal curvature of the lower back and makes the muscles of the lower back less elastic. Both adults and children face problems in this area.

Hamstring structure and function

The knee tendon is formed by three muscles that are found on the back of the thigh and below the knee.They join the ischial bones of the pelvis.

The main purpose of the tendons is to bend the limbs at the knee joint and pull the heel towards the buttocks. They also straighten the hip and keep your back straight. It is because of them that people do not fall forward when walking and running.

You can check hamstring stiffness at home. You need to lie on the floor on your back and stretch your legs. Then raise one limb as high as possible. This should be done so that the knees remain straight and the buttocks are pressed to the floor.Relax your neck and shoulders. Raising your leg, the toe should be directed towards the ceiling, trying to form an angle of 80-90 degrees. Bent knees, a curved back, or a more obtuse angle indicate that the hamstrings are stiffer than they should be.

Squeezing of the tendons in the knee area leads to the appearance of stress points. For example, an uncomfortable chair or playing sports can cause discomfort.

Localization of pain

If tension occurs in the biceps femoris, pain occurs in the back of the knee.If in the semi-membrane or semitendinosus muscle – in the lower region of the buttocks and at the top of the thigh. Pain can spread down to the back of the thigh, lower leg, or the front of the knee and thighs.

Pain syndrome is sometimes so severe that it provokes the development of lameness when walking. Most often, the pain does not subside until the stiffness of the knee tendon and quadriceps muscle is weakened.

Tendon injury

The main types of tendon injuries are stretching, partial or complete rupture.In especially difficult cases, injuries require immediate medical attention and treatment in a surgical hospital.

It is quite easy to damage the tendons. Excessive exercise, sudden movements, falls, bumps and bruises can all lead to injury.

Damage to this area can be experienced by people of all age groups, regardless of the type of activity.

Tendon rupture

When a muscle is torn, a fairly deep protrusion appears under the knee.If the injured limb is immobilized, the pain practically does not bother. When you try to bend the leg or lean on it, the painful sensations resume with renewed vigor. Trauma is often accompanied by swelling, bruising, and swelling of the affected area.

As a first aid, it is necessary to immobilize the limb and take pain relievers. For further treatment, it is necessary to transport the victim to a hospital. Rehabilitation can last for several months and include physical therapy, massage, and physiotherapy.

Tendon Stretch

The main causes of stretching are age-related changes in the body, improper warm-up before exercise, and insufficient mobility and elasticity of the tendons themselves. Uncomfortable shoes can also lead to sprains due to improper flexion of the leg.

Depending on the severity of the injury, there are 3 degrees of stretching, which are characterized by different levels of pain.

• Severe knee pain is felt several hours after injury;
• edema and hematoma appear;
• muscle stiffness develops, movement becomes limited;
• The leg is involuntarily tucked when trying to lean on it.

Cold compresses and pain relievers are used as first aid. The injured limb must be immobilized and fixed with a bandage or tight bandage.

It is strictly forbidden to use warming ointments and compresses for the treatment of back stretch under the knee.

Inflammatory process in the tendons

Inflammation of the tendon between the tibia and patella is often encountered by athletes after 35 years of age who have been jumping and football players.The first stage of the disease is characterized by barely noticeable pain, later it becomes paroxysmal during training and light loads. Over time, the pain syndrome constantly worries, even at rest.

In addition to pain, the main symptoms of the inflammatory process are swelling, swelling and redness of the skin in the area of ​​the knee joint.

Initial treatment begins with pain relievers and anti-inflammatory drugs. Physiotherapy is used.

Tendonitis of the knee joint

Tendonitis is an inflammatory disease that causes changes and destruction of the tendon structure.

• excessive muscle strain;
• Injury, contusion, tendon rupture;
• immune diseases;
• metabolic disorders;
• age-related changes;
• infections;
• inflammatory and degenerative diseases of the joints.

Symptoms of the disease depend on the degree of tendon involvement. Most often, tendonitis presents with pain, skin redness, swelling, and swelling. Tendinitis is diagnosed by X-ray, CT, MRI, or ultrasound.

Treatment of an ailment is prescribed based on its form, degree, site of localization and the damaging factor. With a prolonged absence of drug therapy, there is a high likelihood of complications: tendovaginitis and tenosynovitis.

Health Exercise

For a speedy recovery from injuries, a special course of exercise therapy has been developed. You need to do it daily until the painful sensations disappear completely. In addition to a set of exercises, walking, extension and swinging legs with resistance are used.

Exercise should not be painful. Warm up slightly before starting your workout. Warming up will reduce the risk of new injuries. Loads should be moderate but regular.

Loosen tendon stiffness and relieve pain

The following exercises are recommended to relax stress points:

1. Sit on the floor and extend your leg to the side. You need to try to reach your feet with your fingers. At the same time, it is undesirable to bend the knee.Maintain this position for about 20 seconds.
2. Place your heel on a chair. Lean forward slightly. Hold this position for seconds 20.

Repeat the exercises several times a day. They will help lengthen and strengthen the tendon, the muscles of which are very similar to adductors (adductors). You need to stretch them until they are completely relaxed. It is allowed to use stretching techniques for adductors. The process can last from a week to several months

Stretch

A hamstring stretch is necessary to restore elasticity and firmness after injury.You need to start doing the exercises gradually. If you do gymnastics systematically, the tendons will stretch over time and become less rigid.

Here are some effective tricks:

1. Lie on your back and raise straight legs up. Grab the calves and hold them without bending the limbs at the knees.
2. Put your feet shoulder-width apart, sit down slightly and hold for 10-15 seconds in this position.
3. Get up, put your hands behind your back and clasp them into the lock. Bend down, take your hands back.Stay in this position for 30 seconds.

Stretching is an easy way to get your tendons back into shape after injury. It is very important to do gymnastics carefully, the amplitude of the inclinations should be increased gradually.

Yoga for Tendon Training

Practicing yoga significantly increases the flexibility of the erector spine and hamstring. It will also help strengthen muscle tissue and ligaments, increase their elasticity and restore knee joint mobility.

In addition, yoga classes are aimed at normalizing weight, reducing muscle mass and fluid content in the body. Being overweight puts more stress on the knees and increases the likelihood of developing many joint diseases.

Before starting a workout, you need to consult a specialist. You need to choose a set of exercises based on the level of physical fitness. Do not replace traditional medication with yoga and postpone a visit to the doctor.

Prevention of hamstring injuries

Care must be taken to avoid injury to the knee, both in sports and in daily life.In no case should physical exercise be completely ruled out. They help maintain strength, flexibility and elasticity in muscles and joints.

• Do a warm-up before training and a cool down after it;
• Do not play sports until you are completely exhausted – being tired increases the risk of an accident;
• Avoid falls, impacts and sudden movements;
• Eat right to keep muscles, bones and joints strong and strong.

For frequent stretching before training, experts recommend using special braces or wrapping an elastic bandage around vulnerable joints. There is a set of exercises aimed at strengthening the muscle corset. Their implementation will reduce the risk of injury to a minimum.

Any disease is easier to prevent than to cure. Knee tendon injury is no exception. Feasible physical activity, proper nutrition and timely access to a doctor when problems arise will keep the joints healthy for a long time.

Stretching the ligaments of the knee joint, within the framework of dosed and smooth physical exertion and the implementation of other measures, is an important element to reduce the likelihood of re-injury to the corresponding structures. How to quickly stretch the ligaments under the knee and hamstrings? Why does it hurt under the knee when stretching? Read about this and much more in our article.

What is a knee ligament and tendon stretch for?

Activities for stretching the tendons and ligaments of the knee joint (in fact, training of nearby soft tissues in the form of muscles occurs) have several main goals:

• First of all, this is the training of the corresponding structures of the designated localization, which allows, within the framework of the implementation of preventive measures, to reduce the risks of re-injury;
• Secondly, such training, in general, improves the condition of the flexible elastic components in the designated areas of the lower extremities, which can improve athletic performance, especially in those sports that involve running, walking, and so on.

Contraindications to exercise

There are a number of limitations and direct contraindications to the procedures described above. The most famous and significant:

• Older age. In most cases, people over the age of 40 are unable to exercise fully due to a significant decrease in the elasticity and flexibility of the corresponding components of the knee joint. Moreover, regular dynamic physical activity, as for a healthy person, can significantly increase the risks of injury to the above-mentioned structures in the form of ligaments and tendons;
• The presence of acute pain and other negative symptoms.The presence of pain syndrome, limitation of amplitude and rotational movements, swelling, and other signs of any type of damage to the ankle joint are direct contraindications to physical activity. In this situation, it is necessary to contact a traumatologist, orthopedist, rheumatologist or surgeon, undergo diagnostics, appropriate therapy, and then, with the agreement of the physiotherapist, start restorative measures. After their completion, it is possible to perform full-fledged physical exercises;

• Presence of chronic diseases of the musculoskeletal system.In the presence of arthrosis, arthritis, flat feet, other types of pathologies of the chronic spectrum in relation to the musculoskeletal system in general and the lower extremities in particular, stretching measures are prohibited until special instructions from the attending physician.

Warm-up and Safety

Before performing any kind of exercises for relative stretching of ligaments and tendons, it is necessary to properly prepare for the event. First of all, light warming up is important, which allows you to tone the corresponding structures and muscles.

Light walking, active massage, implementation of rotational and translational movements without load, and other necessary actions, including light jogging, are allowed. At the same time, as part of performing the basic exercises , you should carefully adhere to the safety precautions:

• Observe the required standards for the duration of procedures and the number of approaches;
• Perform activities smoothly, without significant effort and jerking;
• If you experience pain or other discomfort, stop exercising immediately.

How to Stretch the Hamstrings

Most effective hamstring stretching exercises:

• Reach for the foot. Starting position – sitting with a straight back and one of the lower limbs. The second leg is bent at the knee, while the foot is adjacent to the inner thigh. Keeping your back straight, you need to grip the toe with your palms. At the peak of the exercise – make a delay of 10 seconds, then slowly take the starting position.For each of the legs, you need to perform 15 actions;

• We reach for the knee. Starting position – standing, legs are on the same line as “open scissors”. Lean forward slowly without rounding your back or twisting your hip so that your belly is pressed against your leg. At the peak of the exercise, you should linger for 5 seconds, then exhale and slowly return to its original state. For each of the legs, 12 bends should be performed;
• Draw in the foot. Starting position – lying on your back. Straighten your legs in front of you, place your hands along the body on both sides. Bend one knee and place your foot on the floor. Then raise the selected limb and pull the foot down below using a rope or other devices. At the same time, the tailbone remains pressed to the floor, the neck also lies straight, does not shorten or bend. Keep your chest relaxed and your elbows apart. At the peak of the exercise, hold the limb for 10 seconds, then return to the starting position.For each of the legs, 10 actions should be performed;

• Fold up. Starting position – sitting, legs extended forward and brought together. The socks are stretched to the face as much as possible, the back remains straight. Slowly bending forward, and clasping the top of your feet with your palms, try to bend straight and reach your knees with your chest, which also does not bend during exercise. At the peak of the exercise, hold for 7 seconds, then relax and return to the original pose.In total, you need to do the exercise 10 times;
• We bend. From a standing position with a straight back, bend your feet forward and try to reach the floor with your palms. At the peak of the exercise, linger for 5-10 seconds, then slowly return to the starting position;

Stretching the ligaments of the knee joint

Many people associate stretching procedures with knee tendons, believing that these structures are identical.However, modern medicine clearly separates these two concepts and determines the very erroneousness of the term in relation to the indicated elements.

Ligaments as secondary supporting components of the joint, although flexible, do not have elasticity, like tendons. The maximum coefficient of their critical stretching does not exceed 3%, after which they either return to their original state or are injured.

Any measures directly aimed at stretching in this context, at best, will have no effect, and at worst, they will provoke micro-ruptures of structures.That is why qualified specialists mean strengthening of all components of the knee, performing exercises for training exclusively muscles in the designated localization. How to stretch the popliteal ligaments, watch the video:

Knee hurts after stretching

Quite often, ordinary people and even athletes complain about the appearance of pain after stretching the lower extremities in general and the knee joint in particular. There may be several reasons for this problem:

• Lack of preliminary preparation. If the muscles are not sufficiently “warmed up” before the exercises, pain may develop during the exercise;
• Non-observance of the technique of carrying out events. With too intense loads, carried out faster or slower than required, a number of unpleasant symptoms are formed, one of which is pain;
• Presence of microtraumas. In some cases, old microtrauma of individual components of the knee joint can “respond” to any physical impact with pain syndrome and other pathological manifestations;
• Poor training. If a person has not regularly engaged in active physical activity on the lower extremities before, in the process of performing a wide range of exercises immediately after their completion, he may feel quite severe pain.

What to do in case of pain syndrome? First of all, it is worthwhile to properly prepare for the exercises, appropriately carrying out preliminary warming up gymnastics.

In addition to this, measures should be carried out on a regular basis to avoid sudden overloads and stresses.Also, do not forget about the technique of performing the procedures, as well as regularly undergo a medical examination and identify injuries, even minor ones.

These include popular drugs like Diclac, Ibuprofen, Ketorolac, Apizartron, and so on. It is undesirable to apply cold in this situation, so as not to overcool the skin and soft tissues. Warm compresses are sometimes used as an alternative.

Viktor Sistemov – site expert 1Travmpunkt

Abstract: Pain under the knee is most often associated with damage to the lumbar spine or ligamentous apparatus of the knee joint.In the presence of varicose veins, the pain may be associated with thrombosis.

pain under the knee

Pain under the knee: what is it and is there cause for concern?

The knee is the largest joint in our body. Knee injuries and injuries are common. It consists of bones that can break or dislocate, as well as cartilage, ligaments and tendons that can stretch or break.

Some knee injuries can heal on their own, others require surgery or medical treatment.Sometimes, pain under the knee can be a symptom of a chronic medical condition such as arthritis. Pain under the knee can also be caused by a pinched nerve in the lumbar spine.

Causes of pain under the knee

1. Sciatica

The sciatic nerve is formed from the roots of the spinal cord at the level of the lumbar spine, passes through the hips and buttocks, and then descends into the legs. The sciatic nerve is the longest nerve in our body and one of the most important. It directly affects our ability to control and feel the lower extremities.If this nerve is pinched, then sciatica symptoms occur.

Sciatica itself is not a separate disease, but a complex of symptoms. A pinched sciatic nerve can cause pain of varying intensity in the back, buttocks, and legs. In addition, you may feel numbness and weakness in these areas. Sciatica is a symptom caused by damage to the sciatic nerve, or an area in contact with the sciatic nerve, such as a vertebra or intervertebral disc.

Sciatica most commonly affects people between the ages of 30 and 50.

Sciatica symptoms

Typical symptoms of sciatica include pain radiating to the buttocks and lower extremities. Other symptoms of sciatica include:

• pain worse with certain movements;
• numbness or weakness in the legs or feet along the sciatic nerve;
• tingling sensations in buttocks, legs and feet;
• Incontinence of urine or feces (with cauda equina syndrome).

What are the causes of sciatica?

Sciatica can be caused by a variety of diseases and conditions, as well as injury and swelling.

Common causes of sciatica include:

• herniated disc;
• spinal stenosis;
• spondylolisthesis;
• piriformis syndrome.

Treatment of sciatica can be either conservative (spinal traction, massage, gymnastics) or surgical. Sciatica patients generally respond well to conservative treatments. The most common cause of sciatica is herniated disc. In this case, pain under the knee can be an isolated symptom of a herniated disc (rarely), most often with a herniated disc, pain under the knee is combined with pain in the lower back, hip, lower leg or foot.With such symptoms, it is urgent to do an MRI of the lumbar spine and consult a doctor.

2. Spasm in the legs

Spasm is a contraction of a muscle. The most common causes of cramping are exercise and pregnancy. Other possible causes include:

• problems with the nerves of the leg;
• dehydration;
• infections, eg tetanus;
• toxins such as lead or mercury;
• liver disease.

During a spasm, you feel a sudden, painful muscle contraction.Spasm pain can last from a few seconds to 10 minutes.

3. “Jumper’s knee”

“Jumper’s knee” is an injury to the tendon, which is the cord that connects the patella to the tibia. An alternative name for the “jumper’s knee” is patellar tendonitis. The main cause of the “jumper’s knee” is jumping in a change of direction, such as when playing volleyball or basketball.

These movements can cause tiny tears in the tendon. Ultimately, the tendon swells and weakens.

Jumper’s knee causes pain below the kneecap. The pain gets worse over time. Other symptoms include:

• weakness;
• stiffness;
• Problems in straightening and bending the knee.

4. Tendonitis of the biceps femoris (hamstring injury)

The hamstring consists of three muscles located on the back of the thigh:

• semitendinosus muscle;
• semimembranosus muscle;
• biceps femoris.

These three muscles are responsible for flexion of the knee.

Injury to one of these muscles is called a hamstring strain or rupture. A hamstring stretch occurs when a muscle has been stretched too much. In addition, the muscle can tear completely. If the tendon is completely ruptured, recovery may take several months.

When the hamstring is injured, the person feels sudden pain. An injury to the biceps femoris (biceps femoris tendinopathy) causes pain along the back of the knee.

Other symptoms of a hamstring strain include:

• edema;
• hematomas;
• Weakness on the back of the leg.

This type of injury is very common among athletes who must run fast: football players, basketball players and tennis players. Stretching before playing can help prevent injury to the hamstring.

5. Baker’s cyst (popliteal fossa cyst)

Baker’s cyst is a fluid-filled sac that forms behind the knee.The fluid in the cyst is the synovial fluid. This fluid normally works as a lubricant, but if you suffer from arthritis or a knee injury, your knee may produce too much synovial fluid. Excess fluid can build up and form a cyst.

Baker cyst symptoms include:

• Pain in the knee and behind the knee;
• swelling on the back of the knee;
• Stiffness and trouble bending the knee.

These symptoms may worsen when you are active.If the cyst ruptures, you will feel a sharp pain in your knee.

Sometimes Baker’s cysts go away on their own, but to treat a large, painful cyst, you may need steroid injections, physical therapy, or drying the cyst. In some cases, another condition, such as arthritis, may be the cause of Baker’s cyst. If so, then you need to treat the underlying disease.

6. Tendinitis of the gastrocnemius muscle

The calf and soleus muscles form the lower leg.These muscles are involved in flexion of the knee and movement of the toes.

Any sport that involves a sudden transition to running from a standing position – like tennis or squash – can stretch or rupture the calf muscle. Stretching of the gastrocnemius muscle is accompanied by sharp, sudden pain along the back of the leg.

Other symptoms include:

• Pain and swelling in the lower leg;
• hematoma in the lower leg area;
• Trouble standing on tiptoe.

The rate of healing is directly related to the size of the rupture.Bed rest and applying ice to the damaged area can speed up the healing process.

7. Rupture of the meniscus

The meniscus is a wedge-shaped cartilage that cushions and stabilizes the knee joint. Each knee has two menisci located on the right and left.

Meniscus tear is a common injury among athletes. With age, the meniscus weakens and wears out, which can lead to tearing during rotation.

You may hear a crackling sound during the meniscus tear.The injury may not hurt at first, but pain appears after a few days. Other symptoms of a torn meniscus include:

• Knee stiffness
• edema;
• weakness;
• “jamming” of the joint.

Bed rest, applying cold, and keeping the leg elevated can help relieve symptoms and speed healing. If the tear does not heal on its own, surgery may be required.

8. Injury of the anterior cruciate ligament

The anterior cruciate ligament is located on the anterior side of the knee joint.It connects the femur to the tibia and provides movement and stability to the knee.

Most ACL injuries occur when a person slows down, stops, or changes direction while running. An anterior cruciate ligament sprain or rupture can also occur as a result of a failed landing after a jump or impact.

Injury to the anterior cruciate ligament may be accompanied by cotton. Later, the knee becomes painful and swollen.

Bed rest and physical therapy can help heal sprains. If the ligament is torn, you may need surgery.

9. Injury of the posterior cruciate ligament

The posterior cruciate ligament is another ligament that connects the femur to the tibia. The posterior cruciate ligament is not injured as often as the anterior cruciate.

A posterior cruciate ligament injury can occur if you hit your knee hard, for example, in an accident.Sometimes the posterior cruciate ligament is injured as a result of skipping a step while walking.

Other symptoms of a ruptured posterior cruciate ligament include:

• edema;
• stiffness;
• trouble walking;
• Weakness in the knee.

Bed rest, applying cold, and keeping the leg elevated can help relieve symptoms and speed healing. If multiple ligaments are damaged, knee instability, or cartilage damage, you may need surgery.

10. Chondromalacia of the knee joint

Chondromalacia is the destruction of articular cartilage. Cartilage is an elastic material that absorbs friction between bones.

Chondromalacia may be caused by gradual wear of cartilage, arthritis, or overuse. Cartilage is most commonly worn under the patella.

The main symptom of chondromalacia is a dull pain under the kneecap. The pain may worsen when you climb stairs or after sitting for a long time.

Other symptoms include:

• pain that worsens during physical exertion;
• edema;
• Distinct crunch in the knee joint.

Applying cold, taking pain relievers, and physical therapy can help manage pain. However, the cartilage cannot be restored with conservative methods.

11. Arthritis

Arthritis is a degenerative disease in which the cartilage gradually wears out.There are several types of arthritis:

• Osteoarthritis is the most common type. Osteoarthritis is a consequence of the aging of the body;
• rheumatoid arthritis is an autoimmune disease in which the immune system begins to damage the joints;
• systemic lupus erythematosus, an autoimmune disease characterized by inflammation of the knee and other joints;
• psoriatic arthritis, Crohn’s disease can also cause joint pain.

Common arthritis is treated with exercise, injections, and pain relievers.In inflammatory forms of arthritis, patients are prescribed anti-inflammatory drugs, as well as drugs that weaken the immune response.

12. Deep vein thrombosis

Deep vein thrombosis is the formation of a blood clot in a deep vein. With deep vein thrombosis, the patient feels pain in the leg, especially when he stands up. Other symptoms of thrombosis include:

• leg swelling;
• temperature rise in the area of ​​thrombus origin;
• skin redness.

Treatment of deep vein thrombosis should be performed in an emergency mode, as the thrombus can break off and reach the lung. If a blood clot enters an artery in the lung, a condition called pulmonary embolism occurs. Pulmonary embolism can be fatal.

Deep vein thrombosis is treated with blood thinners. If there is a large blood clot, the doctor may give the patient a thrombolytic agent.

The article was added to Yandex Webmaster on 2018-06-07, 17:56.

: Injuries of the knee ligaments 2021

Injuries of the knee ligaments

Sports injuries Hamstring injuries Pulled groin (groin deformity) Ankle injury (dislocated or broken ankle) Sprains and deformities Knee tears Meniscus tears

However, they can sometimes get hurt.

Knee ligament injuries

• What is a knee ligament injury?
• What are the symptoms of a knee ligament injury?
• How is a knee ligament injury diagnosed?
• How to treat a knee ligament injury?
• How long does a knee ligament injury take to heal?
• Can knee ligament injuries be prevented?

There are four bones around the knee joint: the femur (femur), the main tibia (tibia), the outer tibia (fibula), and the patella (patella).The main movements of the knee joint are the femur, lower leg and patella. Tough connective tissue (articular cartilage) covers the ends of the lower leg and thigh and the back of the patella around the knee joint. Articular cartilage reduces friction between the bones of the knee joint and facilitates smooth movement between them.

Each knee joint also contains an internal and external meniscus (medial and lateral meniscus). Menisci (plural of meniscus) are thick rubber pads of cartilage tissue.They are C-shaped and thinner towards the middle of the joint. Meniscus cartilage sits on top of the usual thin layer of articular cartilage that covers the top of the tibia. The menisci act as shock absorbers to absorb the impact of the upper leg on the lower leg. They also help to smooth knee movements and help to stabilize the knee.

There are four ligaments around the knee joint. A ligament is a tough strip of connective tissue that connects one bone to another around a joint.Knee ligaments help stabilize and support the knee as it moves to different positions.

Each ligament does its job:

• Medial Collateral Ligament (MCL) is one of the ligaments on the side of the knee joint. It runs between the thigh and lower leg on the inside of the knee. This helps to protect and stabilize the knee joint from any force on the side of the leg. This helps limit the amount of side-to-side movement of the knee.
• Collateral Lateral Ligament (LCL) Another major ligament on the other side of the knee joint. It runs between the thigh and the fibula on the outside of the knee. This helps to protect and stabilize the knee joint from any force on the side of the leg. This ligament also helps limit the amount of side-to-side movement of the knee.
• The anterior cruciate ligament (ACL) is one of the ligaments inside the knee joint. It runs diagonally, connecting the anterior (anterior) tibia and the posterior (posterior) femur.This ligament helps stabilize the knee joint by controlling back and forth movement of the knee. It stops the movement of the tibia in front of the femur.
• The posterior cruciate ligament (PCL) is another ligament within the knee joint. It also runs diagonally across the knee, connecting the posterior (posterior) tibia to the anterior (anterior) femur. The ACL and PCL intersect with each other inside the knee joint, and some people call them cruciate ligaments (cruciate means cruciate).PCL helps control the forward and backward movement of the knee.

The knee joint is surrounded by a protective joint capsule. This is lined with a special membrane called the synovial membrane. The synovial membrane produces synovial fluid that helps lubricate and reduce friction in the knee joint. There are also muscles that help support the knee joint. The main muscles are the thigh muscles (quadriceps) and the hamstrings (hamstrings) in the legs.

What is a knee ligament injury?

They may be stretched (stretched) or sometimes torn (torn).A sprain occurs when the fibers that make up the ligament are stretched and only a few fibers are torn. The rupture can be partial (more fibers are torn than when the ligaments are sprained, but the ligament is still intact) or complete (the ligament is torn completely). Most knee ligament injuries are sprains, not lacerations, and they tend to calm down quickly.

There are many different causes that can damage the ligaments in the knee:

• You may have a direct hit to the knee or a blow to the knee.
• Your knee can be moved outside of its normal range of motion. For example, it can happen during a fall, if you land awkwardly while exercising or after a sudden movement.

Injury of the middle collateral ligament (MCL)

MCL injuries can occur in almost any sport and can affect people of all age groups. They often happen when your leg is extended in front of you and the outside of your leg is hit at the same time – for example, while playing rugby or football.

Lateral collateral ligament (LCL) injury

LCL injuries are less common than MCL injuries. This is because your other leg usually protects against injury to the inside of the knee. (This is usually a direct hit to the inside of the knee that causes an LCL injury.) But sometimes this ligament injury can occur if one leg is extended in front of you and does not have the other leg to defend — for example, while playing rugby or football.

Anterior cruciate ligament (ACL) injury

ACL injuries most commonly occur during sports activities such as football, basketball, skiing, and tennis.Injury happens if you land on your leg and then quickly twist or twist your knee in the opposite direction when it is slightly bent.

Women are more likely than men to injure their ACL. While it is not clear why this is so, it may be because, in general, the muscles around a woman’s knee are not as strong as the muscles around a man’s knee. About half of people with ACL injury also have damage to their meniscus or other ligament in the same knee.

Injury to the posterior cruciate ligament (PCL)

Injuries to this ligament are less common than injuries to the ACL.This is because the PCL is wider and stronger than the ACL. There are several ways in which the PCL can be injured. For example, he could be injured in a car accident if the front of your bent knee touches the dashboard and your lower leg is pushed back. He may also be injured from falling onto a bent knee. In addition, your PCL can be damaged if your leg is kicked from the front when it is extended in front of you by the foot on the ground – for example, while playing football.

Some people with PCL injury may have mild symptoms at first (see below). It may take you a while to realize that there is a problem. For example, you may later notice pain when going up and down stairs or when starting a run; or the knee may feel unstable when walking on uneven ground.

What are the symptoms of a knee ligament injury?

If you have injured one or more ligaments in your knee, the symptoms are likely to be the same regardless of the damaged ligament.The severity of symptoms depends on the degree of damage to the ligament. For example, a completely torn ligament can cause more symptoms than just a sprain.

Symptoms may include:

• A popping sound (or clicking or clicking sensation) during injury – this can sometimes be heard (or felt) if the ligament is completely torn.
• Knee edema. When a ligament is damaged, there may be some bleeding in the knee joint from the damaged ligament.This can lead to swelling of the knee. The degree of swelling will depend on the severity of the injury. Minor sprains can cause slight swelling, and the swelling may not appear for several hours. However, completely torn ligaments can lead to large knee swelling that occurs very quickly (within two hours) and is very painful.
• Knee pain. Again, the degree of pain may depend on the severity of the knee injury.
• Tenderness around the knee when touched.It can be mild tenderness in relation to the actual ligament with minor sprains, or more general and severe tenderness with a ruptured ligament.
• Unable to use or move knee normally. With complete tears of the ligaments, movement can be significantly reduced; while with more minor sprains, you can have relatively good knee movement.
• Feeling that your knee is unstable or might give in if you try to stand on it.This can lead to lameness. Again, this depends on how severe the ligament injury is. You may be able to stand if you only have a slight sprain.
• Sometimes bruising appears around the knee, although not always. It may take some time for bruising to develop.

How is a knee ligament injury diagnosed?

If you feel you may have a knee ligament injury, you should see your doctor. Your doctor will usually start asking you questions about the injury, what happened and where you are feeling pain.They may then examine your knee for signs of knee swelling. They can also move your leg to different positions to check your knee ligaments. From this exam, they can get an idea of ​​the possible injury you have.

If your doctor is concerned that you may have a more serious knee ligament injury, he or she may refer you for further tests, such as an ultrasound scan or magnetic resonance imaging (MRI). Such tests should be able to detect any tears or tears in your ligaments.Sometimes an x-ray of your knee may be offered if they suspect a fracture.

If your knee swells severely after an injury, doctors may sometimes suggest draining some of the fluid that is causing the knee swelling. To do this, a needle can be used to pierce the skin around the knee, and the liquid can be drained into a syringe attached to the needle. Special precautions are taken to ensure that the area and procedure are sterile to avoid contamination of the knee joint.

How is a knee ligament injury treated?

Self Help

For the first 48-72 hours, consider:

• Paying PRICES – Protect, Rest, Ice, Squeeze, Elevate; and
• Do No Harm – No heat, alcohol, running or massage.

Payment of the PRICE:

• n remove the injured knee from further injury.
• p Affected knee remained within 48-72 hours after injury. Consider using crutches to keep your weight off your injured knee. However, many doctors say that you really shouldn’t keep your injured knee stationary for too long. You can usually start some exercises to keep your knee joint flexible and mobile.Start them as soon as you can tolerate the exercise without causing too much pain. You can ask your doctor to tell you when you can start moving your knee and what exercises you should do.
• i After knee injury, apply as soon as possible – within 10-30 minutes. In less than 10 minutes, it doesn’t do much. More than 30 minutes can damage the skin. Make an ice pack by wrapping ice cubes in a plastic bag or towel. (Do not put ice directly next to your skin, as this may cause burns.) An alternative could be a bag of frozen peas. Carefully slide the ice pack onto your injured knee. The coldness from ice is believed to reduce blood flow to the damaged ligament. This can limit pain and inflammation. After the first use, some doctors recommend reapplying for 15 minutes every two hours (during the day) for the first 48-72 hours. Do not leave ice on while sleeping.
• C Compression with a bandage will limit swelling and help relax the knee joint.A tubular compression bandage can be used. Moderate pressure that is not uncomfortable or too hard to stop blood flow is ideal. The pharmacist will advise on the correct size. Remove before bed. You may be advised to remove the bandage permanently after 48 hours. This is because the bandage can restrict movement of the joint, which usually needs to move more freely after this time. However, knee bands are sometimes held for longer to keep the swelling and make the sore knee more comfortable.Ask your doctor what is best for you.
• E The goal is to limit and reduce any swelling. For example, when you are sitting, keep your foot on the affected side in a chair with a pillow under your knee. It may be easier to lie on the couch and rest your feet on the pillows. When you are in bed, place your foot on the pillow. The goal is to keep your affected knee above your heart level.
• p is sometimes added to this list to make a PRICER.The R stands for Rehabilitation, which is the most important part of treating knee ligament injuries – to get you and your knee back to normal. You may need to see a physical therapist or sports therapist for advice on exercises to help strengthen and stretch the muscles around your knee if your symptoms persist.

Note Despite general guidance on ice application to injuries, some animal studies suggest that it may delay healing, and some researchers in this field suggest that the evidence base for ice application to injuries is currently should be viewed as questionable.

Avoid HAZARD for 72 hours after injury. That is, avoid eating

• HOUR – for example, hot baths, saunas, thermoses. Heat has the opposite effect of ice on blood flow. That is, it stimulates blood flow. Therefore, high fever should be avoided when inflammation develops. However, after about 72 hours, inflammation does not develop and the heat can be soothing.
• alcoholic beverages, which may increase bleeding and swelling and decrease healing.
• p unning or any other form of exercise that could cause further damage.
• M Assage, which may increase bleeding and swelling. However, as with heat, after about 72 hours, a gentle massage can be soothing.

Medication

• Paracetamol and Codeine : Paracetamol is useful for pain relief. It is best to take paracetamol regularly, over several days, rather than every now and then.The adult dosage is two 500 mg tablets four times a day. If the pain gets worse, you may be prescribed codeine, which is more severe but may make some people drowsy and constipated.
• Anti-inflammatory pain relievers These medicines are also called non-steroidal anti-inflammatory drugs (NSAIDs). They relieve pain and can also limit inflammation and swelling. There are many types and brands. You can buy some (like aspirin and ibuprofen) from pharmacies without a prescription.You need a prescription for others. Side effects sometimes occur with anti-inflammatory pain relievers. Stomach pain and stomach bleeding are most severe. Some people with asthma, high blood pressure, kidney failure, poor digestion, and heart failure may not take anti-inflammatory pain relievers. So, check with your doctor or pharmacist before taking them to make sure they are right for you.

  But note : The National Institutes of Health and Human Services (NICE) Clinical Brief, a renowned source of advice for physicians in the UK, does not recommend the use of anti-inflammatory pain relievers in the first 48 hours after injury.This is due to concerns that they might delay healing. The logic is that some inflammation is a necessary part of the healing process. Thus, it is possible that reducing inflammation too much with these drugs can impair the healing process. This is an alleged (theoretical) problem, as no tests have confirmed this view. Further research is needed to clarify the use of these drugs after injury.

  Also, if you have surgery to repair a torn ACL (see p.Below), it is believed that, in theory, NSAIDs may not be a good idea for a long period of time after surgery, as they may have an impact on the success of the surgery.

• Natural Anti-Inflammatory Pain Relievers Again, there are different types and brands of topical anti-inflammatory pain relievers. Some are available over the counter at pharmacies. You need a recipe for the rest. There is debate about how effective anti-inflammatory pain relievers are when rubbed into the skin compared to pills.Some studies suggest that they may be as good as pills for treating sprains. Some research suggests they may not be as good. However, the amount of medication that enters the bloodstream is much less than with pills, and there is less risk of side effects.

Physiotherapy

This may be helpful after some knee ligament injuries. A physical therapist or sports therapist can help you improve the range of motion in your injured knee.You will also be encouraged to regularly exercise at home to strengthen the muscles that support the knee joint. If you are planning surgery to repair a torn knee ligament, you may be advised to see a physical therapist before surgery.

Knee Pads

Depending on the knee ligament injury you have suffered, your doctor may advise you to wear a knee brace while the damaged ligament heals. Knee braces usually have a hinge mechanism that allows you to flex and extend the movement of your knee joint a little.The mechanism does not allow the knee to move from side to side. However, a knee brace is not recommended for all knee ligament injuries. You can discuss the use of a knee brace with your doctor.

Surgery

Sometimes surgery may be suggested after a knee ligament injury. This is more likely if:

• You are someone who plays a lot of sports or you are a very active person and you have damaged your ACL.
• You have injured more than one ligament in your knee, or you have injured a ligament in your knee, and you have injured another part of your knee.
• You tore your LCL.
• Physiotherapy and rehabilitation did not help.

Surgery is most commonly suggested to repair ACL damage. However, it’s fair to say that the best way to treat a torn ACL is still being debated. Physical therapy and other measures may be all that is needed for some and may prevent the need for surgery. The decision about whether to use surgery depends on:

• How effective physical therapy is to relieve your symptoms.
• Activities and sports that you do.
• How active your lifestyle is in general.
• Your basic health.
• Any other knee injury you may have.

You can discuss all the pros and cons of the operation with your doctor.

If surgery is being done to repair a ruptured ACL, your doctor usually advises you to wait a few weeks after the initial injury. It is so that:

• Any tumor had a chance to descend.
• Physiotherapy and Rehabilitation had the opportunity to work:
• You got more back movement in your knee.
• You have built strength in your thigh muscles, which help support your knee joint.

ACL cannot be simply sewn back. Instead, an operation is usually performed to repair or rebuild the ACL. More often than not, a portion of a tendon or tendon somewhere else in your body is used to repair your ACL. For example, the following can be used:

• Part of the tendon at the bottom of the patella (patellar tendon).
• Part of the tendon that attaches the patella to the quadriceps muscle in the front of the thigh (quadriceps tendon).
• Part of the tendons running from the back of the knee to the back of the thigh (hamstring tendon).
• Sometimes tendons from someone else (donor) may be used to repair your ACL.

The tendon is held in place within the knee joint with staples or screws. Once fixed in place, the new ligament should grow over the used tendon.Keyhole surgery is commonly used to repair your ACL.

There is some controversy about how best to treat PCL injury – with or without surgery. You can discuss this with your doctor. If surgery is performed, as with an ACL injury, the damaged ligament is replaced with a tendon or tendons elsewhere in your body, or a donor tendon.

Surgery is rarely required for MCL injuries.

How long does a knee ligament injury take to heal?

This will depend on which knee ligament you received and how severe your injury is.Also, if you have injured more than one ligament in your knee, recovery may take longer.

If you have ACL repair surgery, it usually takes about six months before your knee has recovered enough so that you can return to your previous sports activities. However, for some people, it may take longer. Overall, surgery to repair the ACL works well in 8 out of 10 people in the short term, but the risk of re-injury to the ACL is high, especially in younger athletes.In the longer term, many people who have had an ACL tear develop osteoarthritis in the knee, whether they have reconstructed the ACL or not.

If your PCL was treated with surgery, it may take 9 to 12 months to fully recover.

After a sprain injury (sprain) or partial tear of the MCL, the ligament is completely healed in most people after three months. If there is a full tear, it may take a little longer to heal, but most people return to their normal activities after 6-9 months.

Note : You should consult your doctor about when it is safe to start exercising or playing sports after a knee ligament injury. It is important that you do not start exercising until your knee is painless and completely stable. If you start exercising too early, it can lead to further knee injuries.

Can knee ligament injuries be prevented?

Injuries to the knee ligaments can be unpredictable and can affect anyone, including healthy people who exercise a lot.It is recommended to exercise regularly. Building strength in the leg and thigh muscles that help support your knee joint (specifically the hamstring and quadriceps muscles) can help reduce the chances of injury to the knee ligaments. If you are not used to exercising regularly, you should start carefully and gradually increase the frequency and intensity of your exercise. See the separate brochure called Physical Activity for Health for more information.

When exercising or playing sports, make sure you warm up at the beginning of your workout. Warming up is 5-10 minutes of balance exercises and a gradual increase in activity. This increases blood flow to the muscles and helps to relax your joint movements. Warming up can also help prevent injury.

Some people wear a knee brace when exercising or playing sports, if they have previously had a knee ligament injury, or even just to prevent knee injury.Some studies have shown that wearing braces can help reduce the likelihood of other injury. Other studies have not shown this to be the case. One case study looked at people with previous damage to their ACL. The study found that those who wore a knee brace while skiing were less likely to suffer further knee injury than those who did not wear a knee brace. Overall, more research is needed to consider the use of knee braces to prevent knee injury.

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PAIN IN THE BACK OF KNEE: CAUSES, TREATMENT AND MUCH MORE – HEALTH

Contents:

Is this cause for concern?

The knee is the largest joint in your body and one of the most prone to injury. It is made up of bones that can break or break out of a joint, as well as cartilage, ligaments, and tendons that can stretch or tear.

Some knee injuries will eventually heal on their own with care and care. Others require surgery or other medical intervention. Sometimes pain is a sign of a chronic condition, such as arthritis, that gradually damages the knee over time.

Here are some of the conditions that can cause pain in the back of the knee, and what to expect if you have one.

1. Leg cramps.

A cramp is a muscle tension.The muscles in the calves are more likely to contract, but other leg muscles, including the hamstrings near the knee, can also cram.

You are more likely to have leg cramps when exercising or during pregnancy. Other possible causes include:

• nerve problems in the legs
• dehydration
• infections such as tetanus
• toxins such as lead or mercury in the blood
• liver disease

When you have a cramp, you suddenly feel a contraction muscle or spasm.The pain lasts from a few seconds to 10 minutes. After the spasm has healed, the muscle may ache for several hours. Here’s how to stop pain and prevent future leg cramps.

2. Jumper’s knee.

The jumper’s knee is an injury to the tendon, the ligament that connects the patella (patella) to the tibia. It is also called patellar tendonitis. This can happen when you jump or change direction, such as when playing volleyball or basketball.

These movements can cause tiny tears in the tendons. Over time, the tendon swells and weakens.

The jumper’s knee causes pain below the kneecap. The pain gets worse over time. Other symptoms include:

• weak point
• stiffness
• problems with flexion and extension of the knee

3. Tendonitis of the biceps femoris (hamstring injury)

The hamstring consists of three muscles that run along the back of the thigh:

• semitendinosus
• semimembranosus
• biceps

…

Injury to one of these muscles is called a hamstring or hamstring strain. A hamstring stretch occurs when a muscle is stretched too much. The muscle can rupture completely, which can take several months.

If you have a hamstring injury, you will feel sudden pain. Injuries to the biceps femoris – biceps femoris tendinopathy – cause pain in the back of the knee.

Other symptoms include:

• swelling
• bruise
• weakness in the back of the leg

This type of injury is common in athletes who run fast in sports such as soccer, basketball, tennis, or a treadmill.Stretching your muscles before playing can help prevent injury.

4. Baker’s cyst.

Baker’s cyst is a fluid-filled sac that forms behind the knee. The fluid inside the cyst is the synovial fluid. Typically, this fluid acts as a lubricant for the knee joint. But if you have arthritis or a knee injury, your knee may be producing too much synovial fluid. Excess fluid can build up and form a cyst.

Symptoms include:

• Pain in and behind the knee
• Swelling behind the knee
• Stiffness and problems with flexing the knee

These symptoms may worsen when you are active.If the cyst bursts, you will feel a sharp pain in your knee.

Baker’s cysts sometimes go away on their own. To treat a large or painful cyst, you may need steroid injections, physical therapy, or drainage of the cyst. It is important to determine if a cyst is causing an underlying problem, such as arthritis. If this is the case, then first fixing the problem may clear up Baker’s cyst.

5. Gastrocnemius tendinitis (calf deformity)

The gastrocnemius muscle and soleus muscle make up the calf, which is the back of the lower leg.These muscles help to flex the knee and point the toes.

Any sport that requires a rapid transition from standing to running, such as tennis or squash, can stretch or rupture the calf muscle. You will know that you have tense this muscle by the sudden pain it causes in the back of your leg.

Other symptoms include:

• Pain and swelling in the calf
• Bruise in the calf
• Trouble standing on tiptoe

The pain should subside depending on the size of the tear.Resting, lifting your leg, and applying ice to the damaged area will help it heal faster.

6. Meniscus tear

The meniscus is a wedge-shaped piece of cartilage that softens and stabilizes the knee joint. Each of your knees has two menisci, one on each side of your knee.

Athletes sometimes tear the meniscus when squatting and twist the knee. As you get older, your meniscus weakens and degrades, and it is more likely to rupture with any rotational motion.

When you tear the meniscus, you may hear a popping sound. The injury might not have hurt at first. But after you walk on it for a few days, the knee may become more painful.

Other symptoms of a torn meniscus:

• stiff knees
• swelling
• weak point
• blocking or yielding knee

Rest, ice, and elevation of the affected knee can help relieve symptoms and speed healing.If the tear does not heal on its own, you may need surgery to repair it.

7. Injury of the anterior cruciate ligament.

The anterior cruciate ligament (ACL) is a strip of tissue that runs through the front of the knee joint. It connects the femur to the tibia and helps stabilize the knee and provide movement.

Most ACL injuries occur when you slow down, stop, or suddenly change direction while running.You can also stretch or tear this ligament if you land on a wrong jump or get caught in a contact sport like soccer.

You may feel a “popping sound” when injured. After that, the knee will hurt and swell. You may have problems with knee movement and pain when walking.

Rest and physical therapy can help heal ACL deformities. If the ligament is torn, you will often need surgery to fix it. Here’s what to expect during ACL reconstruction.

8. Injury of the posterior cruciate ligament.

The posterior cruciate ligament (PCL) is a partner of the ACL. This is another strip of tissue that connects the femur to the tibia and supports the knee. However, the PCL is less likely to be damaged than the ACL.

You can damage the PCL if you hit the front of your knee hard, such as in a car accident. Sometimes injuries are caused by twisting the knee or skipping a step while walking.

Too much stretching of the ligament causes tension.With enough pressure, the ligament can break in two.

Along with pain, PCL injury causes:

• Knee swelling
• Stiffness
• Walking problems
• Knee weakness

Rest, ice, and standing up can help the PCL injury heal faster. You may need surgery if you have injured more than one ligament in your knee, have symptoms of instability, or if you also have cartilage damage.

9.Chondromalacia.

Chondromalacia occurs when the cartilage within a joint breaks down. Cartilage is an elastic material that softens bones so they don’t scratch against each other as they move.

Knee injury or progressive aging, arthritis, or overuse may cause chondromalacia. The most common site of cartilage destruction is under the patella (patella). When the cartilage is missing, the knee bones scratch each other and cause pain.

The main symptom is a dull pain behind the patella.The pain may get worse when you climb stairs or sit for a while.

Other symptoms include:

• Problem with moving the knee above a certain point
• Weakness or curvature of the knee
• Cracking or grinding sensation when flexing and extending the knee

Ice, OTC pain relievers, and physical therapy can help with pain. If the cartilage is damaged, chondromalacia does not pass. Only surgery can repair damaged cartilage.

10. Arthritis

Arthritis is a degenerative disease in which the cartilage that softens and supports the knee joint gradually wears out. There are several types of arthritis that can affect the knees:

• Osteoarthritis is the most common type. It is the gradual deterioration of cartilage with age.
• Rheumatoid arthritis is an autoimmune disorder in which the immune system mistakenly attacks the joints.
• Lupus is another autoimmune disorder that causes inflammation in the knees and other joints.
• Psoriatic arthritis causes joint pain and scaly patches of the skin.

You can manage arthritis pain with exercise, injections and pain relievers. Rheumatoid arthritis and other inflammatory forms of the disease are treated with disease-modifying drugs that weaken the immune system’s response and reduce inflammation in the body. Learn more about arthritis pain.

11. Deep vein thrombosis.

Deep vein thrombosis (DVT) is a blood clot that forms in a deep vein inside the leg.You will feel pain in your leg, especially when you get up. Here’s how to tell if you have a blood clot.

Other symptoms include:

• leg swelling
• warmth around
• red skin

It is important to treat DVT as quickly as possible. The clot can break out and travel to the lungs. When a blood clot enters the pulmonary artery, it is called pulmonary embolism (PE). PE can be life threatening.

DVT is treated with blood thinners. These medicines prevent clot enlargement and the formation of new ones.Ultimately, your body will break down the clot.

If you have a large clot that is dangerous, your doctor will prescribe drugs called thrombolytics to break it down faster.

Quick Relief Tips

You should

• Place your knee back until it heals.
• Keep ice on it for 20 minutes several times a day.
• Wear a compression bandage to support your knee, but make sure it is not too tight.
• Raise your injured knee on a pillow or some pillows.
• Use crutches or a cane to lift weight off your knee.
• Take non-prescription non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin (Buferin), ibuprofen (Advil), and naproxen (Naprosyn) to relieve pain.