Brief Outline of Hamstring Strain

Hamstring Rupture

A hamstring strain, or a pulled hamstring as it is commonly referred to, is a stretch or tear of the hamstring muscles or tendons. This is a very common injury, especially in activities that involve sprinting or explosive accelerations. A common cause of a hamstring strain is a muscle imbalance between the hamstring and quadriceps, with the quadriceps being much stronger.

Anatomy and physiology

The hamstrings are three separate muscles that work together to extend the hip and flex the knee, and correspond to the flexors of the elbow in the upper limb. During running, the hamstrings slow down the leg at the end of its forward swing and prevent the trunk from flexing at the hip joint. The three muscles are the biceps femorissemitendinosus, and the semimembranosus. Any of the muscles can be strained. Commonly tears or ruptures usually pull away from this attachment as well. Excessive force against the muscles, especially during eccentric contraction (when the muscle is stretching against force), can cause stretching, minor tears, or even a complete rupture.

Cause of Hamstring Strain Injury

Strength imbalance between the hamstrings and quadriceps. Forceful stretching of the muscle, especially during contraction. Excessive overload on the muscle.

Signs and symptoms

Pain and tenderness in the hamstrings; very little in a grade 1, to debilitating in a grade 3. May affect the ability to walk, from causing a limp, to a complete inability to bear weight. Swelling with grades 2 and 3.

Complications if left unattended

Pain and tightness in the hamstring will continue to get worse without treatment. The tightness in the hamstring could lead to lower back and hip problems. Untreated strains can continue to progress to a full rupture.

Treatment

Grade 1: Ice, anti-inflammatory medicines

Grade 2 and 3: anti-inflammatory medicines; seek medical help if a complete rupture is suspected or if the patient is unable to walk without aid. Then physiotherapy to promote healing.

Rehabilitation and prevention

Stretching after the initial pain subsides will help speed recovery and prevent future recurrences. Strengthening the hamstrings to balance them with the quadriceps is also important. When re-entering activity, proper warm-up must be stressed and a gradual increase in intensity should be followed.

Long-term prognosis

Hamstring strains that are rehabilitated fully seldom leave any lingering effects. Complete ruptures may require surgery to repair and long-term rehabilitation.

Call +65 64712674 to make an appointment to see our specialist to treat hamstring injury today.

Joint Pain

Brief Outline of Quadriceps Strain

Quadriceps Strain

A muscle strain, which is a forceful stretch or tear of the muscle or tendon in a weight bearing muscle such as the quadriceps, is painful and difficult to rest. The quadriceps are involved in supporting the hip and knee structure to hold the body weight. A quadriceps strain can result from a forceful contraction of the quadriceps or unusual stress placed on the muscles. As with other strains it is graded 1 through 3, with 3 being the most severe tear.

Anatomy and physiology

The quadriceps are composed of four muscles; the vastus lateralisvastus medialisvastus intermedius, and rectus femoris. A strain may occur in any of these muscles, but the rectus femoris is most commonly strained. Due to the force generated in activities such as sprinting, jumping, and weight training, the musclee may microtear, but when the muscle is stretched forcefully under a load such as with high impact sports like football and hockey, it may also pull away from the attachment or completely tear.

Cause of Quadriceps Strain

Forceful contraction or stretch of the quadriceps.

Signs and symptoms

Grade 1: Mildly tender and painful, little or no swelling, full muscular strength.

Grade 2: More marked pain and tenderness, moderate swelling and possible bruising, noticeable strength loss.

Grade 3 (full tear): Extreme pain, deformity of the muscle, swelling and discolouration, inability to contract the muscle.

Complications if left unattended

grade 1 or 2 tear left unattended can continue to tear and become worse. A grade 3 tear left untreated can result in loss of mobility and a severe loss of flexibility in the muscle.

Treatment

  • Anti-inflammatory medication
  • Immobilisation
  • Physiotherapy

Rehabilitation and prevention

After the required rest period, activities should be approached cautiously. Avoid activities that cause pain. Stretching and strengthening of the quadriceps will be necessary. Ensuring a balance strength between the quadriceps and hamstrings is important to prevent a strain. Poor warm-up techniques must be observed to prevent strains and gradually increasing intensity will help as well.

Long-term prognosis

Quadriceps strains seldom result in long-term pain or disability. Surgery is only needed in rare cases where a complete tear does not respond to immobilisation and rest.

Joint Pain

Brief Outline of Femur Fracture

Femur Fracture

It takes tremendous force to fracture the femur due to its strength, as well as the supporting musculature. Football, hockey, and other high impact sports are often associated with femur fractures.

Anatomy and physiology

The femur, also known as the thigh bone, is the heaviest, longest, and strongest bone in the body. Its proximal end has a ball-like head that articulates with the pelvic bone at the acetabulum and forms the hip joint. Distally are the lateral and medial condyles, which articulate with the tibia to form the knee joint. The quadriceps, hamstrings, adductor and abductor muscles surround the femur. The femur is more likely to fracture at the femoral neck, as it is smaller in diameter than the rest of the bone, and is composed of cancellous bone, which has a relatively low density. This would usually involve a hard impact, or excessive landing force from a high fall. The femur may also fracture along the shaft, which is usually caused by tremendous impact from a motor vehicle accident or sheering force across the femur.

Cause of Femur Fracture

Super high impact across the femur, such as a car accident or aggressive tackle in football. High impact directed through the femur such as from landing from a high fall. Direct impact on the upper portion of the hip.

Signs and symptoms

Severe pain. Deformity and possible shortening of leg length. Swelling and discolouration. Inability to move the leg or bear weight.

Complications if left unattended

Permanent disability will result if this injury is left untreated. The large amount of blood loss due to internal injuries to the muscles and arteries could lead to shock and death.

Treatment

Surgery is usually required to fix the fracture.

Rehabilitation and prevention

Femur fractures involve extensive rehabilitation due to the time involved in healing and the musculature involved. The bone will most likely need to be surgically repaired with a plate, rod or pins, which increases the rehabilitation time. Rehabilitation will usually involve a physical therapist working on range of motion and strengthening of the muscles.

Prevention of a femur fracture requires avoiding activities that might result in high impact on the femur. Strengthening the muscles of the quadriceps, hamstrings, adductors, and abductors will also provide extra protection for the femur.

Long-term prognosis

With immediate treatment and repair of the femur along with rehabilitation to strengthen the supporting muscles, there should be no long-term limitations. Full recovery may take up to nine months.

Joint Pain

Brief Outline of Tibiofibular Joint Dislocation

The tibiofibular joint is the point where the tibia and fibula of the lower leg connect. This junction is at the inferior surface of the lateral epicondyle of the tibia, just below the knee joint. The tibiofibular joint only allows for very limited movement between the two bones. A tibiofibular joint dislocation is most commonly caused by a high impact injury, such as a fall onto a bent knee with the foot pointing inward (inverted).

Cause of Tibiofibular Joint Dislocation

Impact to the knee or lower leg. Twisting of the knee.

Signs and Symptoms of Tibiofibular Joint Dislocation

Pain and swelling around the lateral epicondyle. Pain on weight bearing. Pain when bending or straightening the knee or ankle. In some cases there is a visible deformity at the joint.

Complications If Left Tibiofibular Joint Dislocation Unattended

Dislocation of the tibiofibular joint causes tearing of the ligaments that hold the joint together. This results in the knee joint being considerably more prone to successive dislocations and other injuries.

Treatment to Tibiofibular Joint Dislocation

Ice and Rest. Seek Medical Help Immediately.

Rehabiliation and Prevention for Tibiofibular Joint Dislocation

During rehabilitation, activities that do not aggravate the injury should be sought, such as swimming or cycling instead of weight-bearing activities like running. Strengthening the muscles around the knee will help to provide support. A knee brace may also be used to provide extra support when initially returning to activity.

Long-term Prognosis and Surgery for Tibiofibular Joint Dislocation

For relatively minor dislocations a closed reduction is used where the bones are placed back in line using manual manipulation, which does not require any incision or opening of the joint. Where the dislocation is quite severe, surgery is usually required to fix or attach the bones back together.

Call (+65) 6471 2674 (24 Hour) to fix an appointment to treat Tibiofibular Joint Dislocation Today.

Hamstring Rupture

Brief outline of hamstring rupture

hamstring rupture or strain, or a “pulled hamstring” as it is commonly called, is a stretch or tear of the hamstring muscles and/or tendons. This is a very common injury, especially in activities that involve sprinting or explosive accelerations. A common cause of a hamstring strain is a muscle imbalance between the hamstrings and the quadriceps, with the quadriceps being much stronger. The hamstrings actually consist of three separate muscles that work together to extend the hip and flex the knee. The three muscles of the hamstrings are the biceps femoris, semitendinosus, and the semimembranosus, and any of these can be strained. Commonly, minor tears happen in the belly of the muscle closest to the knee. Complete tears or ruptures usually occur when the muscle pulls away from this attachment as well.

Hamstring Rupture

 

Cause of hamstring rupture

Strength imbalance between the hamstrings and quadriceps. Forceful stretching of the muscle, especially during contraction. Excessive overload on the muscle.

Signs and symptoms of hamstring rupture

Pain and tenderness in the hamstrings, ranging from very little with a Grade 1 to debilitating Grade 3. May affect the ability to walk, causing symptoms ranging from a limp to a complete inability to bear weight. Swelling with Grades 2 and 3.

Complication if left hamstring rupture unattended

Pain and tightness in the hamstrings will continue to get worse without treatment. The tightness in the hamstrings could lead to lower back and hip problems. Untreated strains can continue to progress to a complete rupture.

Immediate treatment for hamstring rupture

Grade 1: Ice, anti-inflammatory medicines.

Grade 2 and 3: R.I.C.E., anti-inflammatory medicines, seek medical help if a complete rupture is suspected or if walking unaided is impossible.

Heat, massage and very gentle static stretching can be used after 72 hours to promote blood flow and healing.

Rehabilitation and prevention for hamstring rupture

Stretching after the initial pain subsides will help speed recovery and prevent future recurrences. Strengthening the hamstrings to balance them with the quadriceps is also important. When restarting activity, a proper warm-up must be stressed and a gradual increase in intensity should be followed.

Long-term prognosis and surgery

Hamstring strains that are fully rehabilitated seldom leave any lingering effects. Complete ruptures may require surgery to repair and long-term rehabilitation.

Call (+65) 6471 2674 (24 Hour) to make an appointment to see our knee specialist regarding your hamstring rupture today.