Ask someone you know if they have ever pulled a hamstring and the chances are they will have experienced it, that’s how common hamstring injuries are. So what is the treatment? Well a wide variety of treatments are used and new treatments are being developed all the time.
As a chiropractor I will often manipulate the sacroiliac joint and low back and may encourage stretching of the hamstring, alongside exercises to strengthen core musculature to try and prevent injury recurrence. A GP or sports medicine practitioner may inject cortisone. The very latest interventions to be trialled are injections of substances like Actovegin and these substances act to increase oxygen flow to the injury site and reduce inflammation.
Recent research
A study published this month in the British Journal of Medicine http://bjsm.bmj.com/content/early/2011/10/28/bjsports-2011-090447 tried to compare these different treatment approaches and reach a consensus over which works best. However the study failed to come up with any firm conclusions and highlighted the need for further high quality studies to compare treatment modalities! Limited evidence was found in favour of stretching, agility and trunk stability exercises. Limited evidence was found that there is no effect of non-steroidal anti-inflammatory drugs. Likewise the same was found for manipulation of the sacroiliac joint.
What is means
The problem with studies like this is that very rarely does a chiropractor use only one of these treatment modalities. I personally will look at the latest evidence from scientific trials and integrate this with clinical experience learnt from treating patients. This may include joint manipulation, soft tissue therapies and exercises to develop strength and flexibility. It is very hard therefore to compare the effects of research studies carried out in strict, controlled conditions and the realities of practice where a multi-modal approach is common. Always a good idea to keep any eye on the research though!
