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DESCRIPTIONA hamstring thigh injury is an injury to a hamstring tendon. The hamstrings connect the muscles of the thigh to the back and side of the knee. These tendons can be felt behind the knee on either side. They feel like tough rope. Hamstring tendons, muscles and bone comprise units that stabilize the knee and allow its motion. The injury, usually a strain, occurs at the weakest part of a unit. Severe strains require surgical repair. Acute strains are caused by direct injury or overstress. Chronic strains are caused by overuse. Appropriate health care includes: doctor's care; application of tape, plaster splints, or a cast (sometimes) if a muscle ruptures or the muscle-tendon-bone attachment loosens; self-care during rehabilitation; physical therapy (moderate and severe injury); surgery (severe injury).
SIGNS & SYMPTOMS
Pain when moving or stretching the child's leg; muscle spasm of the injured muscles; swelling over the injury; weakened leg (moderate or severe strain); crepitation ("crackling") feeling and sound when the injured area is pressed with fingers; calcification of the child's hamstring tendon or muscles (visible with X-rays); inflammation of the sheath covering the hamstring tendon.
CAUSES
Prolonged overuse of muscle-tendon units in the child's leg; a single violent injury or force applied to the muscle-tendon unit in the leg.
RISK FACTORS
Contact sports; running, jumping, and quick-start sports; medical history of any bleeding disorder; obesity; poor nutrition; previous pelvic or knee injury; poor muscle conditioning.
PREVENTING COMPLICATIONS OR RECURRENCEYour child should build strength with a long-term conditioning program, warming up adequately before participating in sports. The child should use proper protective equipment, such as knee pads and thigh pads, during contact sports.
BASIC INFORMATION
MEDICAL TESTSX-rays of the child's pelvis, femur, and knee to rule out fracture.
POSSIBLE COMPLICATIONSProlonged healing time if activity is resumed too soon; proneness to repeated injury; an unstable or arthritic knee following repeated injury; inflammation at the attachment to bone (periostitis); prolonged disability (sometimes).
PROBABLE OUTCOME
If this is a first-time injury, proper care and sufficient healing time before the child resumes activity should prevent permanent disability. Torn ligaments and tendons require as long to heal as fractured bones. Average healing times are: mild strain-- 2 to 10 days; moderate strain--10 days to 6 weeks; severe strain -- 6 to 10 weeks. If this is a repeat injury, complications listed above are more likely to occur.
TREATMENT
FIRST AIDUse instructions for R.I.C.E., the first letters of rest, ice, compression, and elevation. See Appendix 39 for details.
HOME CARE
Continue using an ice pack 3 or 4 times a day. Place ice chips or cubes in a plastic bag. Wrap the bag in a moist towel, and place it over the injured area. Use for 20 minutes at a time. Provide the child with whirlpool treatments, if available. Wrap the injured leg with an elasticized bandage between ice or heat treatments. Massage gently and often to provide comfort to the child and decrease swelling.
MEDICATION
For minor discomfort, use non-prescription medicines such as aspirin, acetaminophen, or ibuprofen; topical liniments and ointments.
Your doctor may prescribe stronger medicine for pain, if needed; injection of a long-acting local anesthetic to reduce pain; injection of a corticosteroid, such as triamcinolone, to reduce inflammation.
ACTIVITY
For a moderate or severe injury, the child should use crutches for at least 72 hours, then resume normal activities gradually.
DIET & FLUIDS
During recovery, serve the child a well-balanced diet.
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of a hamstring injury, or a mild injury.
Pain or swelling worsens despite treatment.
Any of the following occurs with a cast or splints: pain, numbness, or coldness below the injury; dusky, blue, or gray toenails.
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