Questionable. Probable. Not practicing. Injured Reserve. Out. Are alerts like these causing you to stress out about your fantasy football team? Hamstring strains are a very common injury early in the season for skilled player positions. They can sideline your starting line-up quickly leaving you to scour the waiver wire looking for replacements. So the question becomes…just how long should you keep these players on your active roster before making the cut?
Over a ten year span, for players in the NFL, the dreaded hamstring strain injury was the 2nd most common injury, with knee sprains being the highest. Hamstring strains are most prevalent with high demand sprinting activities. The football position(s) most commonly suffering from a hamstring strain injury include defensive backs, wide receivers, and running backs because of the high-demand, explosive activity required. Hamstring injuries often occur during non-contact sprinting, with the classic “pulled a hammy” slow down following running a route. Individuals suffering from a hamstring strain often experience sudden onset of pain during sprinting. Sometimes they’ll report feeling a “pop” or “pulling sensation” resulting in severe pain and difficulty walking following injury. Upon examination, there is often significant tenderness along muscle belly. In some cases, there may be significant bruising and swelling that develops. Following the injury, there will be a reduction in strength and flexibility.
Essentially, a hamstring strain is an actual tear or micro-tearing of the hamstring muscle. Therefore, hamstring strains are often graded based on the severity of the tear. The grade of the tear often determines the expectations and timeline for return to sport. There are 3 grades used to classify hamstring strains:
Grade I: mild tears of muscle fibers (2-3 weeks recovery)
Grade II: moderate tear of the muscle fibers (3-6 weeks recovery)
Grade III: complete tear of the muscle, months of recovery, possible surgery.
The most troubling concern for fantasy-team owners is that one-third of hamstring injuries will reoccur, most commonly within two weeks of return to play, meaning that they are very stubborn injuries and recovery can be difficult. A study in 2007 noted (as demonstrated on MRI) that 20-55% of the injuries had not fully healed 6 weeks following injury. This lengthy recovery time often leads to players returning prior to hamstring being healed completely, and thus contributing to the 16.2% re-injury rate.
Following a hamstring injury, return to play is the goal of the rehabilitation process. However, there is a fine line in rehabilitation due to the high incidence of re-injury; therefore, the physical therapist should be continually adjusting the athletes program. Early treatment will address the symptoms and progress to addressing the presenting muscular weakness, decrease in flexibility, and assisting with graded return to a players’ high functional demands. Many factors go into determining the recovery time from a recent hamstring injury. The recovery time can be as short as a week, or depending on the grade, a season ending injury. That’s the fun of the game, you as the general manager get to decide when to make the cut.
Lui, H., Garrett, W., Moorman, C., Yu, B. Injury Rate, mechanism, and risk factors of hamstring strain injuries in sports: a review of the literature. J of Sport and Health Science 2012. 92-101.
Heiderscheit, B., Sherry M., Silder A., Chumanv, E., Thelen D. Hamstring strain injuries: Recommendations for diagnosis, rehabilitation, and injury prevention. JOSPT. 2010;40:67-79.
About the Author: Farren Holman, PT, DPT, Astym Cert. is a physical therapist in Wentzville, MO. She is a graduate from Washington University in St. Louis in 2011. An athlete herself, she takes great pride in helping others return to the things they love. She chose physical therapy as a way to help others stay active by incorporating movement into all of her treatment plans, including Astym treatment which promotes healing with motion.