1. Hamstring Strain PE 709 Advanced Care and Prevention Of Athletic Injuries Diane Stankevitz

2. What is a hamstring strain? A stretch, tear, or rip in the muscle or adjacent tissue of the biceps femoris, semitendinosus, and/or semimembranosus.

3. Movement of the Hamstrings The semimembranosus and semitendinosus performs hip extension, knee flexion and hip internal rotation. The biceps femoris performs hip extension, knee flexion and hip external rotation.

4. Injury Report

5. How did the injury occur? Running very quickly after the ball causing extreme hip flexion and knee extension.

6. Insert Video

7. History Michael Allen Approximately 30 years of age Midfielder Injury occurred 11/11/2010 at 4:00 PM during a game in the stadium on a cool night on a grass surface Mechanism of injury: Excessive Hip Flexion and Knee Extension There was no pre-existing condition Pain was dull to achy and was superficial with a pain of a 7 out of 10. Pain was constant with no radiating pain. Athlete appeared hydrated and in excellent physical condition. Athlete is not currently taking any medications

8. Observations Swelling has appeared on the middle third of the medial side of the right hamstring. Athlete has difficulty walking. Noticeable limp.

9. Palpations There is point tenderness, as well as a palpable defect on the middle third of the medial side of the right hamstring. Sensory nerves (dermatomes) are intact.

10. Special Tests Athlete has pain and limited range of motion on hip extension and knee flexion. Muscle grade is a 3 of 5. Resistance was removed for contraction.

11. Suspected Condition Athlete appears to have a 2 nd degree muscle strain of the semimembranosus and/or semitendinosus of the hamstring group of the right thigh.

12. Immediate Treatment Athlete is unable to compete. Must rest, ice, compress, and elevate.

13. Rehabilitation Week 1 - Days 1 through 7: Must rest, ice, compress, and elevate. Include muscle stimulation on a normal, continuous, biphasic setting for 20 minutes with an intensity high enough for a contraction and low enough to be comfortable to control pain and inflammation.

14. Rehabilitation Week 2 - Days 1 through 7: Hot pack for 15 minutes 10 minutes at a comfortable pace on the bicycle Begin Stretching Exercises.

15. Rehabilitation Stretching Exercises include: 5 sets of 30 seconds with a 30 second rest of the following:

16. Rehabilitation

17. Ice for 15 minutes at the end of rehabilitation.

18. Rehabilitation Week 3 - Days 1 through 7: Hot pack for 15 minutes 10 minutes at a comfortable pace on the bicycle Continues Stretching Exercises.

19. Rehabilitation Add range of motion exercises: 5 sets of 15 of the following:

20. Rehabilitation Add range of motion exercises: 5 sets of 15 of the following:

21. Rehabilitation Add range of motion exercises: 5 sets of 15 of the following:

22. Rehabilitation Ice for 15 minutes at the end of rehabilitation.

23. Rehabilitation Week 4 - Days 1 through 7: Continue with: Hot pack 15 minutes Bicycle for 10 minutes Stretches Range of motion exercises

24. Rehabilitation Add Strengthening Exercises: 3 sets of 15 with a moderate weight: Lunges Squats Leg Curls

25. Rehabilitation Ice for 15 minutes at the end of rehabilitation.

26. Rehabilitation Week 5 - Days 1 through 7: Continue with: Hot pack 15 minutes Bicycle for 10 minutes Stretches Range of motion exercises Strengthening exercises

27. Rehabilitation Add sports specific skills: Kicking a soccer ball Soccer foot skills Sprinting on the soccer field

28. Rehabilitation Ice for 15 minutes at the end of rehabilitation.

29. Rehabilitation Week 6: Athlete should be able to return to play.