Your Piriformis Muscle is found in your pelvis. It connects the end of your leg to your hips. Even though this muscle is miniscule, it’s still quite vital. The Piriformis Muscle is an external rotator muscle, which means that it permits your legs to twist outward.

Anyway, your Piriformis Muscle also actually is located right on top of your Sciatic Nerve. Your Sciatic Nerve is the largest nerve in your body and it runs from your back all the way down either leg and it ends in your feet. If your Pirifomris Muscle becomes too tight from either being over worked or under worked, it can begin to irritate the Sciatic Nerve.

If your Sciatic Nerve becomes irritated, then it is often said that you have a condition called “Sciatica.” Sciatica can be due to a large amount of different causes. A tense Piriformis is just one of the many things that may result in Sciatica. Other causes might be a hernated disk (see bulging disc symptoms) in your backbone, muscle disparities, or inflammation around the Sciatic Nerve.

Symptoms of Sciatica can manifest themselves in many varied ways. Occasionally they can be intense stabbing pain anywhere from your back to your feet. Other times, you may notice a numbness or fuzzy sensation as if part of your body fell asleep.

However if you’re like me, then your Piriformis Syndrome-induced Sciatica came as intense and excruciating sensations in your rear. In reality for me, it got sufficiently bad that I could hardly even walk.

I’m hoping your pain isn’t that bad.

Anyhow, now that you know what it is, what are you able to do about Piriformis Syndrome?

Well, here’s a quick stretching technique you can do to help relieve the stress in the Piriformis.

Begin sitting on the ground with your legs right in front of you. Bend your knees while keeping your feet flat on the ground.

Now, if the agony is on your right side, grab your right leg and cross it over your other leg. Make sure both of your hips are square on the ground, or at the very least as close to on the ground as it is easy to get.

Then cuddle your right knee close to your chest with your arms. You need to feel a good stretch in your right hip. This is your Piriformis Muscle.

Hold this stretch about 5 minutes, or so long as feels comfortable to you. You may feel quick relief, nonetheless it could also take 1 or 2 days or even weeks before it is possible to relieve the strain in your Piriformis. Do this exercise every day until you get the relief you want.

Piriformis Syndrome is agonizing, but if you can make an effort to do this stretch and loosen up your tense external rotator muscle in your pelvis, then you can end the pain and eventually get back to your regular life again.

If you found this helpful also check out herniated disc remedy and pain in sacrum.

The Piriformis Muscle also happens to be located on top of the Sciatic Nerve. If the Piriformis Muscle becomes too tight from either being over worked or under worked, it can start to irritate the Sciatic Nerve. The Sciatic Nerve is the largest nerve in the body and it runs from the lower back, down to either leg and ends in the feet.

If the Sciatic Nerve shortens or spasms due to trauma or overuse, it can compress or strangle the sciatic nerve beneath the muscle, then you have a condition called “Sciatica.” Diagnosis is often difficult due to few validated and standardized diagnostic tests, but one of the most important criteria is to exclude sciatica resulting from compression/irritation of spinal nerve roots, as by a herniated disc.

Symptoms of Sciatica can manifest themselves in many different ways. Sometimes, the Piriformis Syndrome-induced Sciatica, can be just pain sensation in the buttucks. Other times, they can be sharp stabbing pain anywhere from the lower back to the feet. You may even notice a numbness or tingling sensation as if part of the body had fallen asleep.

If the Piriformis Syndrome is due to a tight Piriformis muscle, there are a couple of stretching techniques you can do to relieve this tightness. If the pain is caused by a subluxation (misalignment of the spine) or bulging disc in the spine, chiropractic manipulation and Spinal Decompression can help relieve the pain. Piriformis Syndrome is painful, but if you take the time to do the stretches and get regular chiropractic care, you can end the pain and get back to your normal life again.

Discover the newest information about chiropractic. Visit New Century Spine Centers website to learn about spinal decompression treatment to get rid of back pain.

People with thoracic outlet syndrome show such wide variation in their symptoms and their signs and there is no clear follow up test to substantiate the diagnosis. This ensures diagnosis of this condition correctly is problematic and unclear. How many people suffer from this syndrome is consequently not certain although higher numbers of female patients present with poor posture and poor development of thoracic and shoulder muscles.

The neurovascular bundle, the rope of nerves and blood vessels, travels from the neck on its way to supply the arm and goes across three small spaces roughly triangular in shape. Any of these small spaces can contribute to compression problems and the spaces are small as the arm is rested by the side, narrowing even further if the arm is moved into certain postures. The positions which increase the tightness of the spaces are used as tests, as testing can indicate which structures are compressing and which being compressed. Physiotherapy and medical testing involves placement of the patient’s arm in a stressful posture and then to ask them to do a repeated action such as clenching and unclenching the fist. This causes an increased demand on the neurological and vascular systems.

The repetitive movement of the shoulder towards the ends of its ranges makes the onset of thoracic outlet syndrome more likely, increasingly so if shoulder abduction (moving the arm out to the side) and outward rotation are involved at end ranges. A common occurrence is for swimmers to complain of pain during their stroke and this should raise the suspicion of thoracic outlet problems. Repetitive shoulder movements towards the end of the available movement make this more likely to occur in many sports or activities. Symptoms may present as neurological difficulties or as problems connected with blood supply to the arm.

Thoracic outlet syndrome presents differently due to whether the compressed structures are the blood vessels, the nerves or both together. The level of pain and disability involved can vary from mild to severe, with symptoms continuous or intermittent. The normal presentation groups are one whose symptoms are not clear or specific, the vascular group and the neurological group. Compression of the main vein or artery in the arm does not occur commonly and perhaps most often in young athletes who perform excessive overhead throwing.

If the arterial flow is disrupted the arm can change colour, there can be pain on muscle use due to their not getting enough blood and an overall pain in the hand and the arm. Mild onset is typical as blood can often get round a blockage, but when the block is large patients attend for medical review independently. Thoracic outlet syndrome from neurological compression involves compression of some of the brachial plexus, a nerve crossroads in the neck which supplies the arms. Nerve compression does not usually occur alone but presents with awkwardness holding a ball or a racket and loss of muscle bulk in the small hand muscles.

Neurological compromise may also cause pins and needles or loss of feeling, with some reports of pain but this tends not to be a major issue. Overhead actions with the arm repetitively tend again to be the aggravating factors. The third group is the contentious one, with a large number of patients who complain of pain in the neck, shoulder blade and arm. Often starting after an accident of some type, this kind of pain is not well understood and there is little medical agreement as to whether this is thoracic outlet syndrome or not.

Jonathan Blood Smyth is the Superintendent of Physiotherapists at an NHS hospital in the South-West of the UK. He writes articles about back pain, neck pain, and injury management. If you are looking for London Physiotherapist visit his website.

Multiple sclerosis sufferers report they are sensitive to heat, even after a hot shower and often if they have to physically exert themselves in hot weather. How MS presents as a condition can be widely variable with patients complaining of poor coordination and balance, weakness on one side, weakness from the waist down, visual disturbance, depression and some with a preponderance of mental changes. If there is an ongoing illness at the same times such as an infection then this can worsen MS symptoms, with further negative effects also caused to a much lesser extent by stress and physical trauma.

Visual disturbance secondary to optic neuritis is a frequent symptom of onset as well as varying degrees of eye pain. The limbs can be the site of frequently reported tingling and numbness with varying levels of muscle weakness and sometimes leg or arm pain problems. Profound mental effects can also be present which can include depression and dementia and inappropriate actions or utterances with lability of emotions. Common urinary symptoms are retention (difficulty in passing water) and incontinence, with frequent disturbance of sexual function.

The identification and placing of the lesions responsible for multiple sclerosis can now be well imaged in MRI (magnetic resonance imaging) scanning of the brain and spinal cord. The nerve lesions frequent in MS are placed near the brain ventricles, the small cerebrospinal fluid reservoirs. These lesions occur in white matter, where the insulated nerves are packed together as they travel to their destinations. Inflammatory changes can be present in even what look like older lesions, which might still be expanding. More recent MRI studies may indicate involvement of the grey matter, which are the regions where the cell bodies reside, atrophy of which can lead to mental decline.

Even older looking lesions can have an area of inflammation around them indicating they may still be growing. The grey matter, the brain areas which house the nerve cell bodies, have also recently been suspected of involvement, which can result in decline of mental faculties.

Severe tiredness can be an important symptom in MS and can be treated to a degree with medications. Halting the disease’s progress is the overarching aim of medical treatment and this works best in the early disease stages where the condition is most responsive. With increasing disability levels patients suffer highly reduced quality of life and respond less well to drug therapy. Suicide risk is also raised, to a level 7.5 times that of the wider population and this effect is not wholly taken account of by the levels of depression. Drugs which moderate activity of the immune system are employed to retard disease progress and to cut the number of relapses.

To minimise the number of attacks a large arsenal of other drugs is used but these may have no more long term effect on the amount of disability or degree of neural degeneration. When an MS attack starts there is no highly effective way of treating it although steroids may limit the time until recovery occurs while having little effect on the level of recovery. It is not common to resort to surgery but division of nerve tracts for neuropathic pain and tendon release for contractures are two typical examples.

Jonathan Blood Smyth is the Superintendent of Physiotherapists at an NHS hospital in the South-West of the UK. He writes articles about back pain, neck pain, and injury management. If you are looking for Bristol Physiotherapist visit his website.

MRI scanning has allowed an important increase in the ability to confirm MS as a diagnosis as the lesions in the central nervous system show up in the scans. No triggering factor or agent for this disease has yet been found, although it is known to be better during pregnancy and worse in the period following birth of the child. MS may be brought on by a number of different factors but only a quarter of MS onsets can be linked to any kind of infection at the time.

There are several different forms of multiple sclerosis which have differing patterns and severities of disease. MS is more common in Caucasian populations and the incidence increases with increasing latitude, in other words how far to the north the individual lives. Genetic inheritance may be important in the risk of getting MS but the environment plays a role somewhere as it is known that moving to a higher risk area before the age of 15 years means you suffer the increased risk of the new area.

2.5 multiple sclerosis sufferers are estimated to be presently living in the world and due to the typical age being a younger group this is the cause of important levels of disability and disturbance of family and economic life. Death is not a direct consequence of multiple sclerosis but there is an estimated reduction in life years of between five and seven, possibly due to the consequences of immobility such as urinary infections. Northern Europe shows the highest incidence of this disease and women present from 1.6 to 2.1 times more often than men in general, although in younger (under fifteen) and older (over fifty) women the proportion is three to one.

Male patients are more likely to get the primary progressive form of the disease while females are more likely to get the relapsing form. Attacks of the disease manifest themselves in newly developed central nervous system symptoms, symptoms which vary in part of the body affected and are spread over a variable time. Typical examples can be a sudden weakness of one or more of the limbs, double vision from involvement of the optic nerve and loss of sensations in variable areas. There can also be a steady worsening in both the physical and mental abilities without obvious attacks.

The relapsing and remitting type of multiple sclerosis exhibits acute attacks with an improvement again afterwards, however most sufferers in this very common group will eventually become more steadily worse which is termed secondary progressive disease. If affected by the primary progressive type the patient typically undergoes a steady worsening in ability without remissions, with deterioration to complete paralysis. This type of disease responds less well to usual treatments and is more disabling. Relapsing and progressive disease occurs when the disability from attacks is not recovered in remissions.

While MS symptoms often spread themselves over a variety of functions in any particular person they can be focussed on more specific areas such as mostly affecting balance, vision or mental abilities. At some point in the course of the disease sufferers seem to reach a threshold where they worsen in a neurodegenerative pattern rather than secondary to inflammation. The complex nature of multiple sclerosis means that virtually any neurological system can be affected in minor ways, or the damage can be concentrated in one particular part of the system. Even without much evidence of nervous system lesions people can lose significant mental ability.

Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapy, back pain, orthopaedic conditions, neck pain, injury management and Physiotherapists in Manchester. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.

If a muscle shortens while it is contracting and doing work the contraction is said to be concentric and if the athlete can manage this well then they can move on to working the muscle eccentrically. Eccentric muscle activity exists when muscle contraction is proceeding during which time the muscle is extending in length rather that shortening. Since eccentric muscle work is maximally stressful for a muscle this type of rehabilitation should be closely supervised. The starting position is on the front with the lower leg flexed to ninety degrees with an ankle weight and then lowering the leg down to the floor with close control.

This process continues as long as the injured area is not painful until the affected leg can perform as strongly as the unaffected leg (within 10 percent or so) then the programme can be progressed to a more active and vigorous one. During the whole programme the hamstring is regularly stretched to promote healing in a lengthened position and return it to the same length as the unaffected side. The functional stage of hamstring healing is the time from roughly two weeks to six months from the time of the injury, depending on the severity of the initial damage. Patients should have no apparent pain, a normal gait pattern and the ability to walk quickly.

Fast walking can be encouraged as a treatment goal and when the patient can manage half an hour without problems short bursts of jogging can be added. Without pain problems developing once half an hour of jogging is achievable then faster running and short lengths of sprinting can be inserted into the treatment plan. Gradual increase in the force and length of the sprinting is allowed, adding quick halts, twists and sprinting again to reflect more accurately the real world manoeuvres which can gradually become more specific to the sport concerned. The physio may now add plyometric exercises to increase the muscle and tendon stresses and deliver the speed and power which is necessary.

Plyometric exercises are designed to increase the contractile power of a muscle by stretching it in the preparatory phase of the exercise before it contracts, with typical exercises involving bounding or jumping. A more powerful contraction can be developed in this way and the muscle trained to cope with increased forces in activity. A low stress plyometric exercise is jumping rope or skipping and physios will carefully progress this to sideways jumping over obstacles, jumping up and down differing levels and other varied work.

The athlete can return to their particular sport at very variable times from about 3 weeks after the event up to 6 months if the injury is severe. A physio will check out the athlete in detail to make sure that they do not exhibit any loss of power, tissue length, strength, balance and coordination which may not be visible on superficial testing. Prior to competitive play it is recommended that the athlete warms up well and stretches comprehensively although little scientific evidence is available to back up this advice. An injury to a small part of the muscle or a superficial injury to the muscle may allow someone to return to their sport in the shorter time period.

In a study it was found that athletes who required more than one day to be able to walk normally without pain were more likely to need a longer time of rehabilitation over the three week mark. Typical medications recommended are non-steroidal anti-inflammatory drugs to reduce the inflammatory reaction and potentially speed healing.

Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapist, back pain, orthopaedic conditions, neck pain, injury management and Sheffield Physiotherapist. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.

Juvenile idiopathic arthritis can be classified into three main types, one which affects a few joints (pauciarticular arthritis), one which affects many joints (polyarticular arthritis) and a more overall disease which is termed systemic juvenile arthritis. The disease is chronic, persisting over a long period with flare ups and then periods of remission, with treatments aimed at inducing remissions for as long as possible without toxic effects from medication. More recent biological treatment agents have greatly increased the treatment efficacy against many arthritic diseases.

The causative factors and how the arthritis develops is not clearly understood, but a trigger such as trauma or infection may start an autoimmune reaction against the joint tissues. This makes the synovial membrane lining the joint enlarge and develops a chronic inflammation, all of these things likely to occur in children who have a genetic susceptibility. Many genes are thought to be responsible for the onset of the disease and how it presents in each individual. There are wide ranges in the incidence of these conditions as the susceptibility to the disease varies along with the different population groups and exposure to environmental influences.

Around half of all sufferers from juvenile chronic arthritis have the oligoarticular or pauciarticular type where a small number of joints are affected, around a third have the polyarticular type with many joints affected and the remainder have the more systemic type. People suffering from juvenile chronic arthritis may develop other autoimmune disorders. Psychological side-effects are common due to the pain and functional problems which occur with this disease, causing depression, anxiety and behaviour problems. The few joint and many joint forms of the disease occur more commonly in girls at a ratio of 3 to 4.5 to one with the systemic type occurring equally in boys and girls.

The polyarticular or many affected joint form of arthritis has two peaks of incidence, one covering one to four years of age and another covering six to twelve years. The fewer joint type, the oligoarticular form, tends to occur in children who are two to four years old. The systemic type has no particular age of incidence. The disease pattern over the first six months determines which pattern the individual patient fits into. If four or fewer joints are affected during this period then the diagnosis is the oligoarticular or fewer joint group. More than five joints are symptomatic during the first six months this indicates the polyarticular or many joint diagnosis. Arthritis, rashes and a fever are the typical onset symptoms of the systemic form.

A six week period of arthritis in a joint is necessary for a diagnosis to be made of one of the forms of juvenile arthritis. Typically there is a complaint of morning stiffness and stiffness after other periods of the joint having been kept still for a while. Disease onset can be insidious, i.e. slow and sneaky, or very abrupt with all the symptoms coming on in a short space of time. These can include joint stiffness after immobility, pain in the joints during the day, limping and school absences, with in some cases the addition of inflammatory disease of the bowel. There may be few complaints from the child of pain in their joints, instead they may just stop using a joint with the consequent contracture or disuse atrophy.

In the systemic form of juvenile arthritis the child suffers from fevers which spike once or twice a day at around the same time, the temperature typically returning back to normal each time. This pattern is different from infections so helps to distinguish what the patient is suffering from. These patients usually show a short lasting rash over the trunk and limbs, joint pain often in the bigger joints and appear to be unwell.

Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapy, back pain, orthopaedic conditions, neck pain, injury management and Physiotherapists London. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.

With a larger number of joints affected, a minimum of five or more, the child has the many joint or polyarticular form of arthritis, with typically joints affected on both sides, a so called symmetrical involvement. A mild fever may be present and there can be significant muscle weakness and limitation of normal functioning if the joints have a severe limitation in their ranges of motion. A complete physical examination of the patient is vital to ensure that the diagnosis is juvenile arthritis, in what areas the physical limitations exist and which type of arthritis the patient is suffering from.

The definition of arthritis for the examination is the presence of swelling inside the joint (often called an effusion), along with limited joint motion and perhaps pain, warmth and redness of the joint area. It is not possible to determine swelling of some joints such as the hips but they do exhibit pains and limited ranges of movement. A definitive diagnosis may take time to establish as the arthritis may develop at the same time as the fever and the rash but can occur some months later. The lymph nodes and the liver may be enlarged and muscles may be tender to palpation. In the fewer joint form of juvenile arthritis there is often only one joint affected.

In the polyarticular form of arthritis where many joints are inflamed, it is common for there to be a symmetrical involvement of the weight bearing joints as well as smaller ones of the hand. The joint cartilage may be reduced in thickness with eroded areas and in some joints the formation of a fusion across them. With more chronic changes there can be thickened synovial membranes and joint effusions, subluxations (partial dislocations), joint contractures and stiffness, bony deformity (particularly the fingers) and bony enlargements. The joints can also lose bone mass and suffer narrowing of the joint spaces as the cartilage thins.

A reduction of extension in the neck may not produce any symptoms but it is important to identify this as it can indicate arthritic changes in the cervical spine which can lead to partial dislocation (subluxation) of the upper neck bones, a potentially dangerous situation. The neck bones can also fuse together along the posterior structures. The jaw joints, the tempero-mandibular joints, may also be affected and lead to reduced amount of growth in the lower jaw with inability to open the mouth as wide as normal. There may also be involvement of the eyes in the inflammatory process.

Juvenile arthritis and other complex conditions are best managed by a specialised multidisciplinary team due to the numerous problems which patients have to do with family and patient education and schooling, drug treatments, physiotherapy and occupational therapy. It is rarely if ever successful to give isolated treatments to this patient group. Reviewing patients at regular intervals allows the drug treatments to be fine tuned towards a reduction in the morning stiffness and towards fewer affected joints until no symptomatic joints remain. A typical team to manage these conditions may include a physiotherapist, occupational therapist, social workers, a paediatric rheumatologist and nurse.

These patients do not routinely require surgical care although steroid injections into some joints can be useful. Knee and hip arthritis in polyarticular arthritic patients may be managed by joint replacement once bone growth has ceased at skeletal maturity. Resting for long periods is unhelpful and patients should be encouraged to keep active for a better end result.

Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapy, back pain, orthopaedic conditions, neck pain, injury management and Local Croydon Physiotherapists. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.

The management of hamstring injuries can be divided into three initial phases: the acute, sub acute and remodelling phases, each with a different strategy of treatment and each for a different time since the injury. The acute phase incorporates the first week after injury and the treatment is targeted at reducing the inflammation, pain and swelling associated with a soft tissue injury. The principles of treatment follow the PRICE format: protection; rest; ice; compression; elevation. Protection involves reducing the likelihood of inappropriate stresses being applied to the injured area and for this purpose the knee may be braced in a bent position or the patient taught to use crutches to reduce the weight bearing through the leg.

Rest has an important protective function to limit the stresses through the injury and this is often difficult to impress on injured athletes. Ice is a first line treatment for tissue injury to give pain relief, applied for around twenty minutes to the area providing the skin remains healthy. Inflammation may also be reduced as the cold decreases the local metabolism of thereby the tendency to deliver more circulatory swelling. Compression is useful to control tissue swelling and may be more useful than the cooling effects of ice which physios often use. Wrapping the limb with elasticated bandages can give the required effect.

Elevation of the injured area is advised for many injuries and raising the area above heart level drains the limb and prevents tissue fluid build up. It is hard to do this with the situation of the typical injuries to the hamstrings and in these injuries may not be needed. Once the inflammation and pain have receded to some extent the physiotherapist can begin moving the limb passively and giving assisted movements into flexion. Stretching is avoided as this will increase tissue damage. A mostly minor injury should recover quickly but they still need to be managed carefully to avoid a recurrence and ensure good progress.

Soft tissue injuries take at least six weeks to heal, even minor ones, so once feeling much better athletes should be encouraged to ease slowly into doing more stressful activities and should pay attention to strengthening muscles, stretching and balance to reduce the likelihood of the injury recurring. In the sub acute phase, which lasts until about three weeks after injury, the pain and inflammation of the acute injury should be reducing and so the physiotherapist can progress the treatment on to active range of motion exercises and then to muscle strengthening.

Prone performance of knee flexions with smaller ankle weights will be the initial process, with increased resistance applied provided the injury does not react. It is advisable to adopt a slow increase in resistance as too rapid a change may cause another injury or a chronic problem. Once the patient can perform strong concentric contractions, i.e. with the muscle shortening, then they should progress to eccentric contractions, where the muscle lengthens during the activity.

Active through range exercises begin in prone with light weight around the ankle and move to stronger resistance provided no injury pain is provoked. A conservative progression of resistance is advisable as too quick an increase could re-injure or develop chronicity. Once good strength work can be performed with the concentric contraction (muscle shortening in the action) then progression will be to eccentric contraction (muscle lengthening during the action).

Jonathan Blood Smyth is the Superintendent of Physiotherapists at an NHS hospital in the South-West of the UK. He writes articles about back pain, neck pain, and injury management. If you are looking for Physiotherapists Leeds visit his website.

Hamstring injuries are classified for ease of diagnosis and treatment into various grades of severity. The least serious injury with a number of damaged muscle fibres is a grade 1 injury, rated as a mild muscle strain. More serious involves a larger number of muscle fibres being damaged and a reduction of muscle strength which is obvious on testing and this is a grade 2 injury. In the most serious or grade 3 injury there is a rupture right through the substance of the tendon and muscle. Most injuries are located at the muscle and tendon junction and high up near the buttock, although the biceps femoris has a very long junction, most of its length.

The hamstring tendons originate from the ischial tuberosity, the area of bone often called “the bone in the bottom” or the bones we sit on. The tendon connections with this bony area can become pulled off, a so-called avulsion fracture, which may occur if a sudden, large movement into hip flexion occurs, moderately commonly seen in water skiers. Most commonly seen in patients who are between 16 and 25 years of age, hamstring injuries are typically the result of sprinting, field or contact sports such as football and rugby.

Starting at the ischial tuberosity insertion in the buttock, the hamstrings course down the posterior thigh and insert into the upper areas of the shin bone. If the hamstrings are loaded at the same time as they are lengthening (so called eccentric contraction), often occurring in rugby and running events, the risk of injury can be high. Contusions to the muscles can occur from direct blows while if a water skier falls forward suddenly with a straight knee then the hamstring origin can be damaged by avulsion. When a hamstring injury occurs, the patient often reports a clearly audible pop of the muscle and the onset is sudden.

Immediate pain is noticed in the posterior thigh area and people may be vulnerable early in the process before they are warmed up or later on when they may be becoming tired. If the damage is not severe then function can be preserved although with pain such as on stair climbing or walking up a hill. Examination of the back of the thigh may reveal little but it may well be painful if the patient is asked to bend their knee and the physiotherapist resists the movement. Rupture of one of the hamstrings may show by it balling up on contraction along with reduced strength on assessment.

Factors which increase the likelihood of a hamstring injury are thought to be a poor muscle balance between the quadriceps and the hamstrings, fatigue, lack of flexibility and poor warming up. If the patient has had a hamstring injury before this is a well known risk for a recurrence. The severity of the muscle injuries dictates the therapy and the speed of progression. In the case of a minor strain the physiotherapist might progress a patient quickly from gentle range of motion exercises on to resisted strength work, whilst major injuries such as ruptures may require surgical intervention.

The first aims of physiotherapy for an injury of a moderate level would be to limit the degree of local swelling and reduce the pain and inflammation from the soft tissue damage. Physios use the PRICE principles in these cases: Protection of the damaged tissues to prevent further damaging stresses being applied; Rest from normal activity and sport to allow the healing process to proceed; Ice in 20 minute bursts to control inflammation and pain; Compression over the damaged area with elastic wraps; Elevation of the part is not simple due to its location and that the patient wants to keep their knee bent.

Jonathan Blood Smyth is the Superintendent of Physiotherapists at an NHS hospital in the South-West of the UK. He writes articles about back pain, neck pain, and injury management. If you are looking for Physiotherapist Sheffield visit his website.