Evidence-Based Health Care For Optimal Health & Functioning

32% of all muscle injuries in runners are…

…Hamstring strains/pulls and are generally caused by tight hamstrings that may not be properly warmed up or stretched prior to engaging in activity. It’s no surprise that soccer players commonly incur this injury as well.

In addition to the tight hamstrings, quadriceps-to-hamstring strength imbalances have been noted to increase risk of said injury, but there is no agreed upon normal strength ratio for the two muscle groups. However, in bilateral comparison, if a hamstring is weaker by 10% or more on one side, or the hamstring:quadriceps (size) ratio is less than 2:1 the athlete is at an increased risk of hamstring injury. If imbalances are not corrected, re-injury is common and most likely will occur.


Muscles are most commonly injured during the eccentric phase of the contraction due to the fact that this phase has fewer muscle fibers firing, meaning there is greater load placed on each fiber. This eccentric phase leg movement occurs during the deceleration of the swing phase or right after kicking a ball.Image

Treatment will vary by clinician but the first choice of treatment in RICE (rest, ice, compression and elevation). Cross-friction massage at the site of injury to reduce scar tissue cross-linkage/speed recovery, and isokinetic exercises are effective go-to treatments early on in the plan.

Lumbar, lumbo-sacral, and sacro-iliac adjustments have all been noted to reduce spasm caused by joint dysfunction at L4/5, L5/S1, and the SI joints as well as to significantly increase muscle strength in the involved hamstring.

Examination of the in these cases will most likely reveal tightness. Chronic psoas tightness leads to reciprocal inhibition of the gluteal muscles causing the gluteals to become weak and dysfunctional. This will place additional stress on the hamstring in conjunction with its already inherent weakness and further increase the risk of injury. Treatment of tight psoas is often involves mysofascial release and stretching.


Dr. Rashaad Nauth-Ali, BHK, DC

Adapted from Hyde and Gengenbach’s Conservative Management of Sports Injuries 2nd edition.

Posted on August 30th, 2012 [Chiropractic, Injury, Pain, Running, Sports]