Hamstring injury management--Part 2: Treatment.

The management of hamstring injuries can be described as vexed at best. One reason for this may be because of a lack of high-quality research into the methods of treatment, rehabilitation and prevention. As a result, an evidence-based approach to injury management does not exist. Management is based on clinical experience, anecdotal evidence and the knowledge of the biological basis of tissue repair. Previous hamstring injury is the most recognized risk factor for injury, which indicates that treatment approaches may be suboptimal under certain conditions. The identification of these risk factors and the methods best designed to manage them should be addressed with future research efforts. Much anecdotal and indirect evidence exists to suggest that several non-local factors contribute to injury. Despite the knowledge that these factors may exist, the literature appears almost devoid of research investigating their possible identification and treatment. Treatment has traditionally been in the form of altering the muscle repair process through the application of electrophysical therapy and various soft-tissue-based and exercise-based techniques. Little research has investigated the role of other forms of manual therapy particularly when directed at non-local structures. This paper will explore and speculate on this potential connection and offer some new contributive factors for hamstring injury management.