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With a grade one hamstring strain the signs may not be present until after the activity is over. There may be a sensation of cramp or tightness and a slight feeling of pain when the muscles are stretched or contracted.
With a grade two hamstring strain there is immediate pain which is more severe than the pain of a grade one injury. It is confirmed by pain on stretch and contraction of the muscle.
A grade three hamstring strain is a severe injury. There is an immediate burning or stabbing pain and the athlete is unable to walk without pain. The muscle is completely torn and there may be a large lump of muscle tissue above a depression where the tear is. After a few days with grade two and three injuries a large bruise may appear below the injury site caused by the bleeding within the tissues.
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The immediate treatment of any muscle injury consists of the RICE protocol - rest, ice,compression, and elevation (never apply ice directly to the skin). This is aimed at reducing the bleeding and damage within the muscle tissue. Resting may be the common sense approach, but it is one that is often ignored by competitive athletes. This is unwise, since it does not take much to turn a grade one strain into a grade two, or a grade two strain into a grade three. As a general rule, grade one hamstring strains should be rested from sporting activity for about 3 weeks and grade two injuries for about 4 to 6 weeks. In the case of a complete rupture, the muscle will have to be repaired surgically and the rehabilitation afterwards will take about 3 months.
Regardless of the level of the injury the treatment in the first five days is the same. The hamstring should be rested in an elevated position with an ice pack applied for twenty minutes every two hours, if practical (never apply ice directly to the skin). A compression bandage should be applied to limit bleeding and swelling in the tissues. After the first five days have been spent resting, more active rehabilitation can be started.
Crutches would be necessary for any period time that you will be walking long distances or many steps. You should use it but not over use it. Short distances such as around the house you should not use the crutches however going places you should strongly consider the crutches. If over-using occurs it could result in a raise of the grade of strain.
Dislocations/subluxations, sprains and strains (Sx3 where x=0 to 9, 830-848)
|Shoulder and upper arm (x=4)||Dislocated shoulder - Separated shoulder - SLAP tear|
|Hip and thigh (x=7)||Dislocation of hip - Pulled hamstring|
|Knee and lower leg (x=8)||Tear of meniscus - Anterior cruciate ligament injury - Unhappy triad - Shin splints|
|Ankle and foot (x=9)||Sprained ankle - Metatarsalphalangeal joint sprain|
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