Hamstring syndrome (also due to a disproportion in muscle strength)

Hamstring syndrome (also due to a disproportion in muscle strength)

Hamstring syndrome (also due to a disproportion in muscle strength) 300 300 Aida

Hamstring syndrome or injury of the posterior thigh muscles is one of the most spread soft tissue injuries among people engaged in sports.

Are among you any athletes that have never felt any pain in the hamstring muscles? I guess not many.

Hamstring syndrome or hamstring pain


What are the scientific names of the posterior thigh muscles and what is their function?

The hamstring muscles are built of three muscles. They are positioned at the back side of your thigh between your hip and your knee. These muscles are m. semimembranosus, m. semitendinosus and m. biceps femoris.

Functions of the hamstring is bending the knee and extending the hip. In everyday life these muscles are very important. They are engaged when walking, running and jumping as well as when controlling certain movements of the torso. They also has the role of antagonist to slow the quadriceps down.

Who belongs to the risk group for a hamstring injury?

It is most likely to occur to people actively involved in athletics. These are sprinters, hurdlers, high jumpers and long jumpers, as well as in other sports. We are talking about sports where sudden accelerations and sprints are involved (like tennis, soccer, rugby, American football …).

Hamstring syndrome

Below you can find the most common factors for the hamstring syndrome:

  • tiredness,
  • decreased strength,
  • disturbed biomechanics of the lower extremity,
  • excessive muscle tension,
  • wrong running technique,
  • magnesium metabolism disorders.

Muscle pain of the posterior thigh occurs due to overload

Here we are talking about the areas in your body where muscle-tendon functional units are. It has very special characteristics and addresses a unique functional unit called myotensive apparatus. This is why:

  • It transmits the highest tension during muscle contractions,
  • Muscular force transmits all the way till its end,
  • Elasticity of the miotensive apparatus is lesser than muscle elasticity; within the apparatus are also the proprioceptive receptors/bodies.

Let’s repeat all of the above in a much simpler way. The cause for the hamstring syndrome to occur is either overload or overstretch of the back thigh muscles.

Hamstring recovery and physiotherapy

3 basic causes for hamstring syndrome:

  1. Imbalance between the power of back thigh muscles (hamstring) and front thigh muscles (quadriceps). For example, when bending the knee for 30º the ratio should be 1:1. With increasing angle the ratio changes and should be 2:1 in favor to the front side (quad) when bending for 60º.
  2. Imbalance between the hamstring power of the left and the right leg (when the difference exceeds 10%)
  3. Insufficient flexibility of the hamstrings

Clinical picture of hamstring syndrome

  • Constant pain in the lower part of the gluteal muscle, spreading down the posterior side of the thigh all the way to the popliteal area
  • Pain occurrence while quick and powerful movement in extension (sprint, jump over a hurdle)
  • Pain occurrence after a long time sitting
  • Palpatory pain on tuber ossis ischii

Hamstring pain is divided into 3 stages

Hamstring syndrome can also be classified or divided into 3 stages, depending on the severity of the injury.  

  • 1st stage overstretching: pain when moving, walking, palpatory pain, light muscle inflammation
  • 2nd stage overstretching: partial rupture, heavy pain and function loss of the knee joint 
  • 3rd stage overstretching: total rupture of the tendon/muscle, protective spasm, function loss

Physiotherapy of the hamstring syndrome

Different devices as supplements for faster recovery

When talking about prevention and healing of the hamstring syndrome, we suggest to go as per the R.I.C.E. rule: rest, ice, compression and elevation. All these actions help reducing local tissue’s reaction to the injury.

Applying cold compressions also reduces the inflammatory reaction. Furthermore, the compression spreads the hematoma over a bigger area due to better resorption.

Elevating the injured segment over the heart line helps maintaining the vein circulation and improves the lymphatic performance. 


Manual therapy is not enough to heal injuries as extensive as the hamstring syndrome. One of the better therapies available is the Tecar therapy.

Ever heard of Tecar therapy?

The Tecar machine works as a stimulator of the biological processes. It is an innovative therapy that triggers natural and restorative processes. What differentiates Tecar therapy from other approaches is that it works from within the body.

The machine transmits biocompatible radiative energies that intensely activate the affected area with stimulations of the affected biological tissues.


This is the best therapy to add to the manual treatments when recovering from the hamstring syndrome.

Other therapies used are also the ultrasound therapy (using higher frequencies), cupping therapy, IASTM, kinesiotherapy … 

Manual cross (transverse) friction for expanding muscle tissue in width

The manual method of transverse friction is very demanding and painful for the physiotherapist. However, everything pays off. Positive results after two weeks of therapy weights out every sweat drop and all the finger pain.

To be the most efficient with the technique, you have to do it in the exact time intervals. The physiotherapist works on restoring the injured fibers. This allows the patient to return to their everyday and sports life without pain. Also including all stressful situations, stretching and adding load. 

Sometimes we can use extracorporeal shockwave therapy (ESWT) instead of the manual transverse friction. The ESWT heals the hamstring injuries due to special working mechanisms.

Exercises, specialised for strengthening the muscles

The best exercises, when talking about hamstring injury, are isometric and eccentric exercises. This means the injured muscles are not moving and are in a certain position (isometric contraction). After we strengthen them with slow moves in the lengthening way (eccentric contraction).

If we work out with both legs we will diminish the hamstring muscle imbalance and reduce the possibility of a repeated injury.

Proper exercises for muscles


All of you, involved in sports, enter the new season carefully, wisely and slowly. Make sure you warm up before your activity and stretch after. If you feel any uncomfortable sensations in your hamstring look up professional help.