HAMSTRING INJURIES - CURRENT TRENDS IN TREATMENT AND PREVENTION

Pre-exercise stretching and adequate warm-up are important in the prev ention of hamstring injuries. A previous mild injury or fatigue may in crease the risk of injury. Hamstring muscle tear is typically partial and takes place during eccentric exercise when the muscle develops ten sion while lengthening, but variation in injury mechanisms is possible . Diagnosis of typical hamstring muscle injury is usually based on typ ical injury mechanism and clinical findings of local pain and loss of function. Diagnosis of avulsion in the ischial tuberosity, with the ne ed for longer immobilisation, and a complete rupture of the hamstring origin, in which immediate operative treatment is necessary, poses a c hallenge to the treating physician. X-rays, ultrasonography or magneti c resonance imaging (MRI) may be helpful in differential diagnostics. After first aid with rest, compression, cold and elevation, the treatm ent of hamstring muscle injury must be tailored to the grade of injury . Conservative treatment is based on a knowledge of the biological bac kground of the healing process of the muscle. Experimental studies hav e shown that a short period of immobilisation is needed to accelerate formation of the granulation tissue matrix following injury. The lengt h of the immobilisation is, however, dependent on the grade of injury and should be optimised so that the scar can bear the pulling forces o perating on it without re-rupture. Mobilisation, on the other hand, is required in order to regain the original strength of the muscle and t o achieve good final results in resorption of the connective tissue sc ar and re-capillarisation of the damaged area. Another important aim o f mobilisation - especially in sports medical practice - is to avoid m uscle atrophy and loss of strength and extensibility, which rapidly re sult from prolonged immobilisation. Complete ruptures with loss of fun ction should be operated on, as should cases resistant to conservative therapy in which, in the late phase of repair, the scar and adhesions prevent the normal function of the hamstring muscle.