Jock Doc

Pulled hamstring: How to get the muscle working again

Q. What is the best way to treat a hamstring strain? I strained it while playing tennis about three weeks ago. It just pulled up tight, but I did feel a pop. I had to stop playing and rested it for about two weeks. It felt good. I went back to play, and the same sensation recurred. When it is safe to return to play tennis?

A: There are three hamstring muscles that are in the back part of the thigh that are helpful in extending the hip and flexing the knee. Muscle strains or pulls are divided into three categories. A grade-I injury is a microtear of the muscle and usually responds to a brief period of rest and rehabilitation. A grade-II or partial tear of the muscle usually requires at least a couple of weeks to get better. Treatment is anti-inflammatory medication and rehabilitation. A grade-III or complete tear of the muscle is also usually treated with a period of rest and rehabilitation. If the tear occurs where the tendon pulls off the pelvis, this may require surgical intervention.

Rehabilitation and physical therapy involves decreasing the pain and swelling followed by working on improved flexibility and stretching as well as pain free strengthening. MRI scans can be helpful in assessing the severity of the injury. However, many times it is difficult to determine the safest time to return to sports activity. I usually require the athlete to have no symptoms before gradually returning to sports activity. Proper warm-up and stretching is absolutely crucial in preventing re-injury as well.

I recommend you see an orthopedic surgeon to assess the degree of your injury and most importantly start you on a physical therapy rehab program aimed at getting you better and preventing re-injury.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net

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