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An acute hamstring pull is a common and frustrating injury occurring particularly in sprinters It can be related to some of the following factors1Lack of flexibility of the hamstring group2Imbalance in the ratio of strength and power between the hamstrings and the quadriceps In sprinters the quadriceps are usually stronger than the hamstrings while in long distance runners the ratio of quadriceps to hamstring strength may be a closer 113Inequality of strength of the left versus the right hamstring group4The fact that the biceps muscle receives two nerve supplies one to the short head and one to the long head This theoretically results in an inappropriate contraction of the one head while the other is relaxing5A poor running style particularly leaning backward when decelerating at the end of a sprint or when attempting to lengthen the stride With an acute strain the athlete is immediately aware of the condition Occasionally it feels as if something has popped in the back of the thigh In severe cases the athlete will describe an intense tearing sensation with pain from the ischial tuberosity down to the back of the knee There is usually generalized pain but tenderness is localized to the area of the actual disruption Swelling can occur fairly rapidly and obscure the defect of a severe tear Passive straight-leg raising is limited and there is inability to fully contract the hamstring against resistance After a few days considerable ecchymosis might be noted in the back of the thigh which will gradually descend to behind the knee Immediate treatment is with ice and compression using a cold wet elastic wrap The athlete should gently stretch the hamstrings while icing to help prevent the loss of flexibility that otherwise would occur Should spasm of the hamstrings prevent stretching a TENS may be useful An anti-inflammatory drug and analgesics are given as necessary If the athlete cannot walk normally crutches should be used A few days after the initial
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