How to Treat Hamstring Strain Injury as a Sports Massage Therapist

Case Study: Managing Hamstring Strain Injury as a Sports Massage Therapist

Introduction

Hamstring strain injuries are common in sports requiring explosive movements like sprinting, jumping, or sudden direction changes. This case study outlines my diagnostic and therapeutic approach as a sports massage therapist to address a Grade 2 hamstring strain effectively.

Client Background

• Name: Zee Khan
• Age: 28
• Gender: Male
• Occupation: Amateur Football player
• Injury Context: The client experienced acute pain in the posterior thigh during a football match while sprinting. He reported immediate pain, swelling, and an inability to continue playing.

Assessment and Diagnosis

1. Initial Consultation:

The client described his pain as sharp  in the middle portion of the hamstring, rated as 7/10 on a pain scale. He also mentioned mild swelling and bruising.

2. Observation:
   • Visible swelling and slight bruising around the posterior thigh.
   • Guarding posture with limited weight-bearing on the affected leg.
3. Palpation:
   • Tenderness localized to the biceps femoris muscle.
   • No palpable gap, ruling out a Grade 3 rupture.
4. Range of Motion (ROM) Testing:
   • Reduced active knee flexion and passive hip flexion due to pain.
5. Strength Testing:
   • Weakness during resisted knee flexion, indicative of a Grade 2 strain.

Reference:

• Brukner, P., & Khan, K. (2017). Clinical Sports Medicine (5th ed.). McGraw-Hill Education.

Treatment Plan

Phase 1: Acute Stage (0–7 days)

Goals: Minimize swelling, manage pain, and prevent further damage.

• RICE Protocol: Reinforced rest, ice application, compression, and elevation.
• Gentle Massage: Applied light effleurage and lymphatic drainage techniques around the injury site to reduce swelling and promote circulation.
• Education: Advised the client on avoiding aggressive stretching or weight-bearing activities during this phase.

Reference:

• Bleakley, C. M., Glasgow, P., & MacAuley, D. C. (2012). PRICE needs updating, should we call the POLICE? British Journal of Sports Medicine, 46(4), 220–221.

Phase 2: Subacute Stage (7–21 days)

Goals: Restore mobility, reduce muscle tightness, and prevent scar tissue adhesions.

• Deep Tissue Massage: Focused on areas surrounding the hamstring to alleviate compensatory tension in the quadriceps and glutes. Used cross-fiber friction on the injury site to break down developing adhesions.
• Myofascial Release: Targeted the posterior chain to improve overall mobility and reduce stiffness.
• Assisted Stretching: Introduced gentle hamstring stretches within the pain-free range.
• Strengthening Exercises: Suggested isometric hamstring contractions progressing to eccentric exercises like Nordic curls.

Reference:

• Young, W. B., & Behm, D. G. (2020). Effects of eccentric strength training on hamstring injuries. Journal of Strength and Conditioning Research, 34(1), 134–143.

Phase 3: Remodeling Stage (21+ days)

Goals: Enhance muscle strength, flexibility, and prevent re-injury.

• Sports Massage Techniques: Integrated pre-event sports massage to prepare the muscle for progressive loading and activity.
• Trigger Point Therapy: Focused on trigger points in the glutes and hamstrings to relieve residual tightness.
• Active Stretching: Encouraged dynamic stretches, including leg swings and lunges, to improve functional range of motion.
• Functional Training: Advised gradual return to sports with sport-specific drills to rebuild confidence and prevent re-injury.

Reference:

• Petersen, J., & Holmich, P. (2005). Evidence based prevention of hamstring injuries in sport. British Journal of Sports Medicine, 39(6), 319–323.

Outcome

• By Week 6, the client achieved full, pain-free range of motion and strength comparable to the uninjured leg.
• He returned to light football training with no discomfort or compensatory movement patterns.
• Regular maintenance massages were scheduled monthly to reduce post-training tension and monitor for potential issues.

Discussion

This case highlights the effectiveness of a structured sports massage therapy protocol in managing a Grade 2 hamstring strain. Key takeaways include the importance of timely intervention, customized treatment plans, and collaboration with the client to ensure compliance with home care and rehabilitation exercises.

References:

• Brukner, P., & Khan, K. (2017). Clinical Sports Medicine (5th ed.). McGraw-Hill Education.
• Bleakley, C. M., Glasgow, P., & MacAuley, D. C. (2012). PRICE needs updating, should we call the POLICE? British Journal of Sports Medicine, 46(4), 220–221.
• Petersen, J., & Holmich, P. (2005). Evidence based prevention of hamstring injuries in sport. British Journal of Sports Medicine, 39(6), 319–323.
• Young, W. B., & Behm, D. G. (2020). Effects of eccentric strength training on hamstring injuries. Journal of Strength and Conditioning Research, 34(1), 134–143.

Conclusion

As a sports massage therapist, my role extends beyond pain relief to facilitating holistic recovery and preventing re-injury. This case emphasizes the importance of tailoring treatments to individual needs and leveraging evidence-based techniques to deliver optimal outcomes.