Recovery characteristics in first-time acute hamstring strains incurred during stretching.

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Hamstring strains can be of 2 types with different injury mechanisms, 1 occurring during high-speed running and the other during stretching exercises.

In a study involving Case series (prognosis); Askling CM et al found Stretching exercises can give rise to a specific type of strain injury to the posterior thigh. A precise history and careful palpation provide the clinician enough information to predict a prolonged time until return to pre-injury level. One factor underlying prolonged recovery time could be the involvement of the free tendon of the semimembranosus muscle.

About the study:
1. 15 professional dancers with acute first-time hamstring strains were prospectively included in the study.
2. All subjects were examined, clinically and with magnetic resonance imaging, on 4 occasions after injury: at day 2 to 4, 10, 21, and 42.
3. The clinical follow-up period was 2 years.

How & where injury occurred:
1. All dancers were injured during slow hip-flexion movements with extended knee and experienced relatively mild acute symptoms.
2. All injuries were located proximally in the posterior thigh close to the ischial tuberosity.
3. The injury involved the semimembranosus (87%), quadratus femoris (87%), and adductor magnus (33%).
4. All injuries to the semimembranosus involved its proximal free tendon.

Another important point that was found:
There were no significant correlations between clinical or MRI parameters and the time to return to preinjury level.

Reference:
Askling CM et al; Am J Sports Med. 2007 Oct;35(10):1716-24. Epub 2007 Jun 13

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