Further Outpatient Care
See the list below:
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See Physical Therapy section for a discussion of further outpatient care.
Deterrence
Prevention of reinjury is dependent upon successful completion of the rehabilitation program and preactivity warm-up and stretching, although there is limited evidence to prove this conclusion.
In a cluster-randomized controlled trial with 942 male soccer players, the authors explored the preventive effect of eccentric strengthening of the hamstring muscles using the Nordic hamstring exercise compared with no additional hamstring exercise. The results revealed 52 acute hamstring injuries in the control group compared with 15 injuries in the intervention group. The additional eccentric hamstring exercise not only decreased the rate of new injuries, but the overall and recurrent acute hamstring injury numbers were also lower compared with the control group. [22]
A study by Barbosa et al indicated that static hamstring stretching training used in isolation for performance improvement and prevention of hamstring strain injuries should be employed with caution owing to the possible negative impact of such exercises on knee flexor eccentric torque and—as demonstrated by reduced distance achieved on the triple-hop test—hamstring functional performance. [23]
Prognosis
See the list below:
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The prognosis usually is good for complete or near complete improvement in 6-18 weeks. Unfortunately, there are patients who develop chronic problems, possibly due to repeated stresses on the tendon that cause tendinosis. In this case, the tendon is not healing properly, and fibrotic changes take place in the tendon.
Patient Education
See the list below:
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Once the injury has healed and the rehabilitation program has been completed, emphasize the importance of proper warm-up and stretching before participation in vigorous physical activity.
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For excellent patient education resources, visit eMedicineHealth's First Aid and Injuries Center. Also, see eMedicineHealth's patient education articles Muscle Strain and Sprains and Strains.
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Normal sagittal alignment permits the knee to lock in full extension, aided by powerful quadriceps and an intact extensor mechanism. The ground reaction force passes anterior to the "center of rotation" of the knee, while the posterior cruciate ligament, posterior capsule, hamstrings, and gastrocnemius provide a tension band effect.
