The hamstring muscle group consists of the following three muscles – the biceps femoris, the semitendinosus, and the semimembranosus, which originate from the ischial tuberosity with a common tendon.
Hamstring injuries most commonly occur to the biceps femoris, with the long head of the biceps femoris strained due to the high eccentric forces produced during sprinting or to the free proximal tendon of semimembranosus during activities that cause extensive lengthening of the hamstrings such as tackling or high kicking.
These injuries range in severity and can entail mild microscopic tears without loss of structural integrity or complete tearing of the muscle with full fibre disruption.
While describing the pathological changes involved in a hamstring injury, Ahmad et al. state that a simple injury constitutes damaged myofibrils which result in leakage of the cytoplasmic enzyme creatine kinase.
A severe hamstring injury comprises damage to the extracellular matrix and fascia which lead to the release of muscle enzymes, collagen, proteoglycan degradation and inflammation.
The factors which increase the probability of a hamstring injury have been listed as ageing, inadequate warm-up, muscle weakness, poor core stability and a previous history of hamstring injury.
Prevention and management of hamstring injuries are essential especially in sports because of the significant financial implications in addition to the loss of considerable training time and weak athletic performance.
Approaching treatment modalities from a biomechanical perspective involves reviewing the anatomical factors that can predispose an individual to hamstring injuries such as an excessive anterior pelvic tilt that can result from hyperpronation of the feet.
The early recognition of such biomechanical discrepancies can help in the prevention of hamstring injuries in the form of an orthotic intervention to eliminate any abnormal pelvic movements arising from an improper foot posture.
MASS4D® customised foot orthotics can also be included in rehabilitative programmes involving eccentric exercises to increase the strength of the hamstring muscles in the absorption of eccentric loads whilst training and to reduce any stress on the affected muscles for a speedy recovery and return of the athlete to the field.
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Repetitive plantarflexion can lead to pain and mechanical limitation in the posterior ankle joint which is known as posterior ankle impingement syndrome. This pathology commonly occurs in ballet dancers and football players.