What is the most effective treatment for a hamstring strain?

Introduction

Hamstring strains remain the most prevalent injury across all sports (approximately 20% of all sporting injuries according to the latest studies!). Throughout my career in pro sport and private clinics, I've usually got at least one patient in my diary who's suffering with this common pathology. I've always been a stickler for the basics; lots of strengthening exercises and a phased return to running, based on progress. Despite success to date, stumbling across this study may encourage me to reconsider my approach- To the benefit of my patients! 

Background 

Published in June 2019, the study in question, set out to answer what is the most effective treatment. I must mention here that this is purely based on objective improvement over time and not necessarily the most cost effective way! This retrospective study compared conventional exercise-based rehabilitation vs shock-wave therapy + exercises (available at PhysioForm). As hamstrings are likely to re-occur, Outcome measures were assessed throughout the interventions and 12 months later. 

Results

They concluded that shock-wave therapy,  in combination with exercises, yielded the fast recovery from hamstring strains, in addition to the best reported outcomes 1 year later. Not only did their pain reduce quicker from the offset, but also their strength increased at a faster rate. The shock-wave therapy group were also less likely to suffer any recurrences in the future. 

 

Clinical Implications 

Previous to this, I'd rarely used shock-waved to treat hamstring strains. I understood how it could possibly work, but there wasn't any evidence to support it's use. It's also a relatively expensive treatment in comparison, at £60 per treatment vs £40 for conventional physiotherapy. My evaluation of these findings is that, if you're in a rush to recover from a hamstring strain and you'd like to return to sport quicker the extra £20 is certainly worth it!