Hamstring Injury

What is a hamstring injury?

A hamstring injury is a tear or strain (pulled muscle) in the group of muscles and tendons in the back of your thigh. It’s one of the most common and troublesome injuries seen mostly in athletes.

What is the hamstring? How does it normally work?

The hamstring connects the largest thigh muscle to your bone. The main job of your hamstring is to allow your leg to flex (bend) and extend (stretch). You use your hamstring the most when you:

• Lunge.
• Run.
• Climb.
• Sprint.
• Jump.
• Stretch too far.

What are the grades of a hamstring injury?

The grade describes the severity of your hamstring injury:

• Grade 1: A mild muscle pull/strain.
• Grade 2: A partial muscle tear.
• Grade 3: A complete muscle tear.

Who is most likely to injure their hamstring?

Athletes, especially those who jump, climb and lunge. You’re also more likely to have a hamstring injury if you’ve had one before.

Do hamstring injuries hurt?

Yes. The pain in your thigh may come on suddenly.

What causes a hamstring injury?

Hamstring injuries can occur in a number of ways, the most common is through overstretching. Other reasons include:

• Fatigue from training too hard.
• A direct blow to your thigh.
• Inadequately warming up.
• Inadequate pre-conditioning program.
• Previous hamstring injury.

What are the symptoms of a hamstring injury?

You may have different symptoms depending on how severe your injury is.

• Grade 1: Strain. Sudden, radiating pain in the back of your thigh. Your strength won’t be affected, but it’ll be hard to move your leg.
• Grade 2: Partial Tear. More painful than grade 1. You may have some swelling, bruising, and loss of strength in your leg.
• Grade 3: Severe tear. Worse pain, tenderness, swelling and bruising. You might have felt a popping sensation when the injury happened.

Additional symptoms include:

• Bump or knot in your thigh area.
• Spasms.
• Muscle stiffness especially after a cool-down period.

What makes a hamstring injury worse?

Your hamstring injury may be worse if you don’t follow the R.I.C.E. acronym after your injury. R.I.C.E. stands for rest, ice, compression and elevation.

How are hamstring injuries evaluated and diagnosed?

Your healthcare provider may be able to diagnose your hamstring injury based on the symptoms you report. They may test the tenderness and examine the swelling and bruising around your hamstring. Sometimes they may order a magnetic resonance imaging test (MRI).

What healthcare providers diagnose hamstring injuries?

Your primary healthcare provider can diagnose a hamstring injury, talk to you about how to treat it and let you know when you can return to your normal activities. They might also refer you to a physiotherapist, sports medicine specialist or orthopedic (bone) healthcare provider if you need special help.

What questions might a healthcare provider help to diagnose a hamstring injury?

It’s helpful to be prepared to answer questions your healthcare provider may ask. Possible questions include:

• What symptoms are you experiencing?
• Are you in pain?
• Where is the pain located?
• When did the injury occur?
• What were you doing when you were injured?
• What medications do you take?

How are hamstring injuries treated?

You can treat your hamstring injury at home, but some people may need physical therapy as well. Listen to your healthcare provider’s instructions and try:

Home remedies

• Remember the acronym R.I.C.E.: rest, ice, compression and elevation.
• Stop your activity, or at least do fewer activities until the soreness is gone.
• Ice the area about 24 to 48 hours after your injury. Keep the ice on for 15 minutes, take it away for 15 minutes and repeat.
• Use a compression wrap or elastic thigh sleeve. It should be worn whenever you’re not icing or showering.
• Do gentle range of motion exercises to maintain flexibility.
• Sit on a table with your injured leg hanging off. Gently raise and lower your leg during icing period. After icing, lie in a prone position on your stomach and continue to gently bend and straighten your leg.
• Take over-the-counter painkillers including pills, creams and/or gels.
• Use crutches if walking is too painful.

Physical therapy

• Strength exercises.
• Flexibility exercises.

Surgery

• Surgery is rare, and only needed if your hamstring is pulled away from your bone.

Could there be any complications of treatment for a hamstring injury?

Be aware that you can injure yourself further if you do your stretches and exercises too fast. Go slowly, and stay in touch with your healthcare provider regarding when it’s safe to return to normal activities.

How should I sleep with a hamstring injury?

There are no special ways to sleep that may help with a hamstring injury. However, be sure to wear your compression wrap or elastic thigh sleeve.

How soon after treatment will I feel better? How long does it take to recover?

The grade (severity) of your injury determines how long it will take you to recover. A grade 1 strain may take around three days. Grades 2 and 3 could take weeks to months.

How can I prevent a hamstring injury?

If you’re a runner or climber, there’s always a possibility that you could injure your hamstring. It’s less likely to happen if you:

• Warm up your body for at least 10 minutes before you exercise.
• Jog instead of run.
• Do easy calisthenics.
• Do stretch and flex exercises for three to five minutes before and after a sporting event.
• Maintain a good strength and conditioning program.
• Eat a well-balanced diet.

What’s the outlook for people with hamstring injuries?

The outlook is very positive. You should heal within days or weeks or, at most, months.

Can a hamstring injury just go away on its own?

No. You must follow your recovery plan. If you stay away from exercise for too long, your hamstring muscles may shrink. There may also be scar tissue.

When can I exercise again?

Follow your healthcare provider’s recommendations regarding exercise. Start off with very gentle stretching, then walking or cycling and strengthening exercises.

Can my hamstring get injured again?

A mildly strained hamstring that is not treated properly and allowed to heal sufficiently may result in recurring strains of that hamstring.

Can I live a normal life with a hamstring injury?

Yes, but you will be limited. You may need crutches to walk and you won’t be able to do your usual exercises. But, you should be able to continue other activities and maintain your quality of life.

When should I see my healthcare provider?

Your hamstring injury might just need to be treated at home. However, you should see your healthcare provider if:

• The injury is severe.
• Your symptoms worsen.
• Your injury isn’t healing.
• You have sudden tingling or numbness in your leg.
• The swelling suddenly gets worse.

When should I go to the emergency department?

If you think your injury is severe enough that you can’t wait to see your primary healthcare provider, don’t hesitate to go to the emergency department. There’s always the possibility that your hamstring actually disconnected from your bone.

What questions should I ask my healthcare provider about my hamstring injury?

• What grade of hamstring injury do I have?
• What’s the best treatment for me?
• What pain medicines work best?
• Do I need to see a specialist?

A note from Cleveland Clinic

The grouping of muscles and tendons in the back of your thigh helps your leg flex and stretch. If injured, the pain can be mild to severe, and there may be swelling and bruising. Do at-home treatments slowly at first, being careful to follow your healthcare provider’s recommendations. While it may take just a few days to a few months for you to heal, remember that you should take steps to prevent a hamstring injury from happening again. Don’t rush your healing.