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What To Do When a Kid Pulls a Hammy

Rest, ice, compress, and elevate. Oh, and watch out for nasty avulsion fractures.

Perhaps your son goes from walking to jogging to running to sprinting to holding the back of his his thigh. Or maybe your daughter is in karate class, when an unplanned split leaves the back of her leg feeling weak. The likely diagnosis? Hamstring injury. These complaints are common among young athletes and, in all likelihood, nothing to worry about. But major muscles can occasionally be serious so it’s important to understand when medical attention is necessary and how much time is needed to heal.

Fatherly spoke with pediatric surgeon Dr. Jennifer Weiss of the American Academy of Orthopedic Surgeons, about this  injury—how to fix it, how to avoid it, and what exactly a “hamstring” is.

Blame Your Biceps Femoris (Usually)

Three muscles run behind your leg, between your thigh and your knee—the biceps femoris, semitendinosus, and semimembranosus. Together, they comprise the hamstring. The most common hamstring injury is a strain, which means one or more of these muscles stretches too far and begins to tear. We hate to name names and all, but the biceps femoris is usually the first to tear (hamstring injuries affect the biceps femoris about 75 percent of the time). This is most likely to happen after a “kick, or a split, or an overzealous sprint or hurdle,” Weiss says.

Hamstring tendinitis, or an inflammation of the hamstring tissue closest to the buttock or knee, is a bit less common in children and is usually the result of “overuse or repetitive activity,” she says. Meanwhile, the least common but most serious hamstring injury is known as an avulsion fracture, “a fracture off of the pelvis, in which the hamstring attachment pulls off a small piece of bone.” These can take much longer to heal, and they’re just about as unpleasant as they sound.

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You Probably Could Have Prevented It

Warming up is the best way to prevent hamstring injuries. Children who jog in place for a few minutes and then throw some stretches into the mix (holding each for about 30 seconds) are far less likely to get injured while playing sports. Regular exercise helps too—if this isn’t the first time your kid is sprinting or doing a split, it’s less likely to take their biceps femoris by surprise.

Crucially, don’t tell your kid to “walk it off”. First of all, the intense father on the sidelines who tells kids to be Spartans is a dad trope that needs to die. Second, pain is usually how the body conveys that it’s time to stop walking because something isn’t right. Listen to your kid’s body.

Sweep ‘Em Off Their Feet

Since hamstring injuries almost always heal on their own, Weiss suggests following a modified form of orthopedic medicine’s RICE formula: rest, ice, compress, and elevate—along with stretching and, if necessary, seeking physical therapy before returning to regular activities. If the pain is particularly intense, consider ibuprofen or another non-steroidal anti-inflammatory.

Even if you child has an avulsion fracture, he or she seldom needs anything besides rest. “Rest until the bone heals,” Weiss says. “These are painful, but they rarely, rarely need surgery.”

See A Doctor, Because You Can’t Handle This On Your Own

Even though treating a hamstring injury is usually straightforward, you’re likely to miss something if you insist on diagnosing your kid by yourself. Which is why it’s crucial that, if you suspect a hamstring injury, you take your child to the doctor for an assessment. Especially with vague pain in the back of the leg, it’s sometimes hard to know what’s wrong. Being able to rule out all of the other possible nightmares and settle on the relatively benign hamstring strain can be comforting. 

And identifying an avulsion fracture, however rare, early on can make all the difference. “If an avulsion is missed, healing could take a longer time,” Weiss says. “Or it might not happen at all.”