Question
I first pulled my hamstring about a little over 2 1/2 yrs ago. I took a 2wk break from my activity & felt great when I returned to my activity; i pulled it the following day & plagued me all season long severely (at times I would feel a slight pain in my other hamstring)
A year following I continued to be plagued by my hamstrings pulling it only once, but continued to feel the strain in both legs.
This past year w/ a better knowledge of hamstring muscles for the 1st time (2010) I focused on strengthing my hamstrings & legs w/ good ROM in all lifts(stability ball leg curls worked best for me)  I would feel great soreness in my my hamstrings from overdoing some exercises; however when it was time to resume to activity I felt great for an initially 6 wk period running at around 75-85% spd tops w/ no feeling/memory of me having pain. The pain once again returned the last 6 wks of my activity & I developed once again strains/soreness & a knot in my right hamstring when stretching but no pulls (I did not strengthen hamstrings during 12 wks due to fear of recurring strain/soreness.) For the past 2 months since my activity ended I have not stretch or strenghen my hamstrings b/c I want to feel pain free & heal before I begin a wk-out/ rehab program, after taking hot showers the past 2 days I began slight stretching before going to bed & now feel the same tenderness/soreness the following mornings in my right hamstring.

My question is should I focus on strengthing my hamstrings & retaing my muscle/twitch  memory before I begin my stretching/flexibity regime? Is an MRI necessary? Seek physical therapist opinion?
I feel I have a good understanding of hamstring injuries from quad overpower,  bad lower back (which I have when running long distances), muscular fatigue..etc... b/c of the plenty of reasearch I've been doing the past 3 yrs trying to return to 100% sprinting form. Please help!!!! :(

Answer
Hi Joe,

First off: no more static stretching of your hamstrings!  If you're doing this, e.g. sticking your leg out and holding a static stretch for while, you are not doing yourself any good.  In fact, the research indicates that it will likely set you up for another hamstrings strain.   Dynamic lengthening activity is better.  Dynamic hamstring lengthening activity includes Frankenstein Walks and Good Morning exercise.  Strengthening and conditioning activities include alternating lunges, and with progression of doing lunges with your lead foot turned inward and then outward, and then lunges with your torso turned (twisted) to the left and to the right, and then with progression of lunging on to a balance pad or dome of a Bosu Ball.  I also like "Ham Bridges."  This is where you lay on your back an put your heels on the top of a physio-ball.   But start in a positon where your hips and knees are bent (not straight legs), and from this position, with arms and hands on floor, bridge your butt up off the floor while keeping your knees in the bent position and while holding the ball steady on the ground.     As for MRI: likely you don't need this unless you have relentless pain along the ischeal origin of the hamstring.  Look up my posting on "runners butt" and you can read all about this.  It sounds like you don't have this.    After tearing a hamstring in any way, there is a good chance you have scar tissue or adhesion formation.   The best ways to get rid of this include hands-on active myofascial release techniques and also Graston Technique (www.grastontechnique.com).   Recent research also demonstrated that sports chiropractic treatment can reduce hamstring issues (http://www.biomedcentral.com/1471-2474/11/64).  Go to www.acbsp.com to find a sports chirorpactor to dig out your myofascial lesions and get your joints to work better.  In the gym, focus on the dynamic activities and progressive lunging challenges, and also add squats, deads, and good-mornings to the mix.  

I hope this was helpful.

Dr. G'
www.drgillman.com