NFL Injury Series- Hamstrings

Reviewing the hamstring strain, severity, and rehabilitation.

Today’s post will look at the all too common hamstring strain. This is an injury even the best conditioned athlete can sustain. This article will not focus on one specific player, but rather educate and inform what the hamstrings are, how they operate, why they’re injured, and prevention.

hamstrings-anatomy.jpg
Credit: myprotein.com

The hamstrings are made up of 3 muscles in the back of the thigh consisting of the biceps femoris on the outside and the semimembranosis and semitendonosis on the inside. Together these three muscles attach to parts of the upper femur and bottom of the hip which is called the ischial tuberosity . This is the bony part that everyone sits on when they are in a chair. At the other end, they connect to the top of the tibia and fibula, which is the lower leg bones. Due to the muscles crossing over two joints, they have different functions. Together, these muscles allow the leg to extend and drive the body forward, along with bending the knee. During running and blocking, these muscles cycle through the process of shortening and lengthening at regular intervals depending on the position of the leg.

453452733.jpg
Credit: livestrong.com

To help you envision the hamstring functioning, picture a sprinting athlete. Typically, one foot is in contact with the ground, the other in the air. During the foot that is in contact with the ground, the hamstrings with other muscles assist in extending the thigh to assist in moving the body forward. As the body moves forward and begins to push off, the other leg begins the process towards beginning to make contact with the ground. Once the original leg finishes pushing off, the knee begins to bend to assist in clearing the foot to bring the leg forward. Even during the portion where the leg makes contact with the ground, the hamstring is loading back up and eccentrically contracting which means that it is accepting a load while lengthening, which is the most taxing type of muscle contraction. When the foot makes contact with the ground is where most hamstring injuries can occur which is why you see most players stop quickly due to the sudden nature of the injury. While the hamstring does sound confusing, it can be, but know that without them, you’re not doing much walking without them

During times of injury, the muscle can be overworked, overstretched, or fatigued, leading to part of the muscle to become injured. Depending on the severity and location can dictate the recovery time. A strain is due to the injury to the muscle or the muscle bone attachment. Grade 1 tears are the least severe in which a small portion of the muscle tears during excessive activity. This can heal up rather quickly but several days of rest, stretching, and light exercise can remedy the muscle.

Grade 2 hamstring tear is where at a moderate portion of the muscle tears with a greater force, leading the player to limp and be unable to properly use the affected leg as intended. Typically, there is greater bruising and swelling with initial difficulty placing weight, keeping the player off it for some time. Bruising, poor functional control, and tenderness may occur during this time which could cause the athlete to miss several weeks before they are back to playing shape.

Grade 3 hamstring tear is where the muscle nearly or completely tears. It can also pull a chunk of the bone away from the bony attachment, most likely at the ischial tuberosity, known as an avulsion. This is due to this area being the anchor point, meaning the harder the muscle contracts, the harder it pulls on the anchor point, leading to eventual overload. At this level of injury, the muscle is quite weak and function is no longer normal. With this injury, the athlete is in danger of missing significant time or can be potentially season ending. Recovery time with surgery can be anywhere from 3-6 months with some resources stating closer to 8 months.

muscle-tear-gradfes.jpg
Credit: physioprescription.com

These types of injuries occur when an athlete suddenly tries to decelerate and change direction, hurdling a player, or trying to push their body faster and faster. This can also occur during blocking, trying to maintain their ground as their being pushed forward and backwards, eventually the muscle gives out and the player becomes injured as a result. There are countless ways for the hamstring to be injured, these are just several of the more common mechanisms of injury.

While the injury is not fully preventable, there are certain steps that can be taken to reduce the incidence. Some preventable measures that can be taken is ensuring proper hydration, conditioning, stretching, and strengthening. Some things that can’t be controlled is previous hamstring injury and increased age. The best method to treat an injury is to prevent. However, I would be hard pressed to find an athlete that has not sustained some sort of hamstring injury during the course of their athletic endeavors.

As Bills fan, we have already seen several players deal with hamstring injuries this season with varying degrees of severity. As a PT, I am not concerned about the long term management of the injuries. I know these players need time to rest, recover, and not to rush back. I would expect to see these injuries increase as the season wears on and the bodies begin to break down. So far, only Matt Milano has been slowed up by hamstring strains and has been brought along slow so far in training camp after re-injuring in OTA’s.

Continue to check back for the latest Bills news and injury updates. Follow on Twitter @BangedUpBills, on Facebook at Banged Up Bills and on reddit at u/BangedUpBills. As always, thank you and GO BILLS!!

Week 7 Recap- Buccaneers

Breaking down the latest on EJ Gaines and Jordan Poyer injuries and following the exciting win over the Buccaneers.

The Buffalo Bills continue to thrill and excite the fan base with a fantastic 30-27 win over the Tampa Bay Buccaneers! Despite giving up 27 points to the Bucs, the Buffalo defense made key stops including a late fumble recovery by Tre’Davious White to set up the game winning field goal. Buffalo is now 4-2, including 3-0 at home, making Sean McDermott the first Bills head coach to start 3-0 at home. These Bills continue to impress, but key injuries may derail the good times.

Thankfully, the Bills injuries continue to occur at a minimum, but injuries in the secondary may be ill timed with the Oakland Raiders offense coming to life. CB E.J. Gaines suffered a hamstring injury during a tackle on DeSean Jackson early in the 3rd quarter. Gaines was able to walk off on his own power but was unable to return. As reports are minimal at best to avoid giving a competitive advantage to their opponents, Gaines has been listed day-to-day. Based on this report, he may have suffered a Grade 1 hamstring strain.

If you recall from my article on hamstrings, this is something that can be managed conservatively and is a week-to-week injury. It’s possible that he may be able to play in time for the Oakland game, but considering that Gaines had a hamstring injury in training camp and is just recently coming off a groin injury, this doesn’t bode well. Unfortunately, these are soft tissue injuries and while can be reduced, they are not fully preventable.

I would not hang the “injury-prone” tag on Gaines though at this time. During each time he has been injured, he has been going all out trying to make the play. I would rather have him go all out trying to make a play rather than a player taking it easy, such as CB Stephon Gilmore, who we dealt with for far too long last season. However, I believe based on all the previous history, he misses next week. As Brandon Beane has been known to do, he has been preemptive, signing CB Tony McRae and releasing WR Kaelin Clay with the uncertainty following the injury.

This signing was also made with the recent injury of S Jordan Poyer. His injury came on the last play of the game in which Tampa Bay attempted their pathetic imitation of the Music City Miracle. They were playing the Bills, you’re not going to fool them twice! Video of the play shows a player hitting Poyer low and Poyer reporting he felt a pop. Based on video, it appears he did injure his right knee, though the injury does not appear to be as severe as it could have been.

During the hit, Poyer was able to begin lifting his leg and turn his hip inward away from the hit, allowing him to deflect some of the force on the knee joint. As he was able to walk off with the trainers, this also indicates that this may be a Grade 1 MCL sprain. Thankfully, this MCL sprain is nowhere near the severity of the Charles Clay injury. I believe there is a better shot at Poyer playing Sunday than Gaines at the moment. This week’s practice will dictate how each player responds to the injury. I believe that the Bills could go without one of these players, but not both.

Finally, WR Jordan Matthews was able to suit up and play, recording 3 targets for 2 catches for 10 yards. While this is not the type of production the Bills had hoped for, this far exceeded expectations considering he is still coming off a broken thumb. It was a stretch that he was able to play this week, it appeared that he was used more as a decoy to help in allowing WR Deonte Thompson to make his mark after being signed off the street earlier last week. Having Matthews return to play gives Tyrod another weapon going into next week’s game against the Raiders.

Despite missing TE Charles Clay and using a less than effective Jordan Matthews, Tyrod Taylor was able to spread the ball around to Thompson, Logan Thomas, Nick O’Leary, LeSean McCoy, and even Zay Jones. Despite missing some top end talent on the roster, the Bills still benefit from the depth at each position which allows for a next man up mentality. I believe this is why the Bills have been able to stay in every game this season and win the close ones such as Sunday’s game. This formula will not work every week, but the Bills have to begin winning the close ones in order to have a shot at turning their years’ long misfortunes around.

The Bills aren’t losing anyone to season ending injuries, unlike many other teams in the league. Depth continues to be a concern, but it is not as though other teams lose their starting player and a Pro Bowl caliber replacement is warming the bench. I believe with this depth and team first mentality, the Bills can beat the Oakland Raiders and move to 5-2 on the season. The Raiders do have a talented offense lead by Derek Carr and Amari Cooper, but if the secondary can get healthy in time, this should limit the effectiveness of the passing game. With how the Bills defense has played this season, I expect McDermott and Frazier to draw up a defensive game plan to limit the Raiders offense.

I know that many Bills fans are still on the edge despite a 4-2 start. The Bills have been here several times in the past with poor finishes. This may be another year in which that’s the case. Experience, injuries, schedule all play a part in the rest of the season. Time will tell how the rest of the season plays out; I will continue to hope for the best, but prepare for moments that remind me why I am a Bills fan. Until then, I will continue to cheer and enjoy the moment. Thank you for your time and GO BILLS!!

Handling the Hamstrings

Educating on the all too common hamstring strain, levels of severity, and prevention.

As the Bills are on a bye this upcoming Sunday, this allows some deviation away from Bills injury talks to discuss general matters, my thoughts and opinions, and review ideas/thoughts that may get lost in the shuffle of the busy season filled with injuries. Already this season, we have seen Pro Bowl, All-Pro, and HOF caliber players go down with injuries that are potentially career ending, career altering, and just plain unfortunate. Over the next week, I will look to identify and explain general injuries that regularly occur and how to differentiate between injuries and their severity.

Today’s post will look at the all too common hamstring strain. This is an injury even the best conditioned athlete can sustain. This article will not focus on one specific player, but rather educate and inform what the hamstrings are, how they operate, why they’re injured, and prevention.

hamstrings-anatomy.jpg
Credit: myprotein.com

The hamstrings are made up of 3 muscles in the back of the thigh consisting of the biceps femoris on the outside and the semimembranosis and semitendonosis on the inside. Together these three muscles attach to parts of the upper femur and bottom of the hip which is called the ischial tuberosity . This is the bony part that everyone sits on when they are in a chair. At the other end, they connect to the top of the tibia and fibula, which is the lower leg bones. Due to the muscles crossing over two joints, they have different functions. Together, these muscles allow the leg to extend and drive the body forward, along with bending the knee. During running and blocking, these muscles cycle through the process of shortening and lengthening at regular intervals depending on the position of the leg.

453452733.jpg
Credit: livestrong.com

To help you envision the hamstring functioning, picture a sprinting athlete. Typically, one foot is in contact with the ground, the other in the air. During the foot that is in contact with the ground, the hamstrings with other muscles assist in extending the thigh to assist in moving the body forward. As the body moves forward and begins to push off, the other leg begins the process towards beginning to make contact with the ground. Once the original leg finishes pushing off, the knee begins to bend to assist in clearing the foot to bring the leg forward. Even during the portion where the leg makes contact with the ground, the hamstring is loading back up and eccentrically contracting which means that it is accepting a load while lengthening, which is the most taxing type of muscle contraction. While the hamstring does sound confusing, it can be, but know that without them, you’re not doing much walking without them

During times of injury, the muscle can be overworked, overstretched, or fatigued, leading to part of the muscle to become injured. Depending on the severity and location can dictate the recovery time. A strain is due to the injury to the muscle or the muscle bone attachment. Grade 1 tears are the least severe in which a small portion of the muscle tears during excessive activity. This can heal up rather quickly but several days of rest, stretching, and light exercise can remedy the muscle.

Grade 2 hamstring tear is where at a moderate portion of the muscle tears with a greater force, leading the player to limp and be unable to properly use the affected leg as intended. Typically, there is greater bruising and swelling with initial difficulty placing weight, keeping the player off it for some time. Bruising, poor functional control, and tenderness may occur during this time.

Grade 3 hamstring tear is where the muscle nearly or completely tears. It can also pull a chunk of the bone away from the bony attachment, most likely at the ischial tuberosity, known as an avulsion. This is due to this area being the anchor point, meaning the harder the muscle contracts, the harder it pulls on the anchor point, leading to eventual overload. At this level of injury, the muscle is quite weak and function is no longer normal.

muscle-tear-gradfes.jpg
Credit: physioprescription.com

These types of injuries occur when an athlete suddenly tries to decelerate and change direction, hurdling a player, or trying to push their body faster and faster. This can also occur during blocking, trying to maintain their ground as their being pushed forward and backwards, eventually the muscle gives out and the player becomes injured as a result. There are countless ways for the hamstring to be injured, these are just several of the more common mechanisms of injury.

While the injury is not fully preventable, there are certain steps that can be taken to reduce the incidence. Some preventable measures that can be taken is ensuring proper hydration, conditioning, stretching, and strengthening. Some things that can’t be controlled is previous hamstring injury and increased age. The best method to treat an injury is to prevent. However, I would be hard pressed to find an athlete that has not sustained some sort of hamstring injury during the course of their athletic endeavors.

As Bills fan, we have already seen several players deal with hamstring injuries this season with varying degrees of severity. As a PT, I am not concerned about the long term management of the injuries. I know these players need time to rest, recover, and not to rush back. I would expect to see these injuries increase as the season wears on and the bodies begin to break down. So far, several players on the Bills such as Marcell Dareus, E.J. Gaines, Matt Milano, Nick O’Leary, and Deon Lacey have all spent some time on the injury report this season due to this malady.

I hope this helped educate your understanding on the purpose of the hamstring, why it gets injured, and what it means when a Bills player or another player you follow goes down with the injury. Over the next week, I will continue to outline other common injuries or any specific injuries that occur. Thank you for your time; just doing my job one post at a time to help educate the fellow Bills fan and realize that not every injury is season ending or dashing the team’s success each year.