Hamstring Injury

A hamstring injury is a muscle strain that affects the hamstring muscles at the back of your thigh. It’s one of the most common sports injuries. Hamstring injuries are also known as hamstring strains, pulled hamstrings or torn hamstrings.

Your hamstrings are a group of three muscles on each leg. They’re some of your biggest thigh muscles. You use your hamstrings to do most movements and motions with your legs. Your hamstrings use (and absorb) a lot of force when you run, jump or squat. This makes them more injury-prone than many other muscles.

Hamstring injury grades

Healthcare providers grade hamstring strains based on how much the injury tears your muscles. There are three grades that range from mild to severe:

• Grade 1. A mild strain with very little torn muscle
• Grade 2. A moderate strain with some muscle tearing (a partial tear)
• Grade 3. A severe strain where your muscles are completely torn

Pulled hamstring symptoms

The most common hamstring muscle injury symptoms include:

• A bump or knot in your muscle that you can see or feel
• Bruising
• Feeling or hearing a pop (more common with higher-grade injuries)
• Muscle spasms
• Muscle stiffness
• Pain on the back of your thigh (especially when you move or use your leg)
• Pain where your hamstring meets your butt when you’re sitting down (you may feel better when you lean your weight off that side)
• Swelling
• Tenderness
• Trouble moving your leg

The pain from a hamstring injury may spread (radiate) from the back of your leg into your groin, butt or other parts of your leg.

Higher grade strains will cause more severe and noticeable symptoms. Grade 2 and Grade 3 strains usually cause a loss of strength in your affected hamstring.

Hamstring injury causes

Anything that puts too much force on your hamstrings can cause an injury. Your muscles are made of lots of small fibers woven together. Strains happen when something puts too much force on them and pulls them further than they can stretch. It’s usually a sports injury that stretches your muscles too far. But it can happen anytime something puts more force on your hamstrings than they’re able to tolerate. Higher-grade hamstring injuries can happen when you slip and fall. Sliding on ice or wet ground can make you do “the splits” as you land and tear your hamstring muscles.

Risk factors for hamstring muscle injuries

Suddenly increasing your physical activity level is one of the most common causes of hamstring injuries. You’ll have a higher chance of injuring your hamstrings if you:

• Exert yourself much more than usual
• Have low flexibility and don’t stretch or warm up
• Ramp up your workout or training routine too quickly
• Start a new sport without the right training or equipment

Try to increase your physical activity gradually. Increase how much you’re lifting, running or training over time as you build up your strength and flexibility.

Anyone can strain a hamstring, but it’s more common among athletes, especially if you:

• Jump
• Play contact sports
• Play sports that require you to move suddenly or explosively
• Run

How doctors diagnose hamstring injuries

A healthcare provider can usually diagnose a hamstring injury with a physical exam. Imaging tests can show more about the injury.

Your provider will ask about the symptoms you’re experiencing and when they started. If you know the injury happened during a specific sport or activity, tell them what you were doing. Tell your provider if you were able to keep moving or playing, or if the injury made it too painful to walk.

Your provider may use a few tests to see the damage around your hamstring and to help diagnose and grade the injury. An X-ray will show any damage on your bones where your hamstring connects. Some hamstring injuries happen alongside broken bones. You may need an MRI or ultrasound to show how injured your hamstring is.

What are pulled hamstring treatments?

You can probably treat most low-grade (grade 1) hamstring injuries at home. But higher-grade injuries (grades 2 and 3) need more treatment. Your healthcare provider will suggest ways to manage symptoms and help your torn hamstring heal. Treatments may include:

• The MEAT method. MEAT stands for Movement, Exercise, Analgesia and Therapy.
• The RICE method. RICE stands for Rest, Ice, Compression and Elevation.
• Physical therapy (PT). You might need some PT before it’s safe to resume training or other physical activities. It’s more common to need PT for higher-grade injuries. A physical therapist will give you a customized recovery plan to help your hamstring regain its strength and flexibility.
• Hamstring surgery. You’ll probably only need surgery if you have a severe (grade 3) hamstring tear. See a provider right away if you can’t walk and have a lot of swelling and bruising.

When should I see my healthcare provider?

Visit a healthcare provider if you have hamstring injury symptoms that last for more than few days. Go to the emergency room if you experience severe pain or can’t move or use your leg at all.

Tell your provider if symptoms return or get worse after you’ve started treatment for a pulled hamstring.

You might want to ask your provider a few questions like:

• What can I do to prevent another injury in the future?
• What kinds of activities are safe to do while I’m recovering?
• Which treatment is best for me, MEAT or RICE?
• When will it be safe to resume sports or other physical activities?

How long does it take a hamstring injury to heal?

It depends on how severe the original injury is. Lower-grade hamstring tears will heal faster than more severe injuries. If you have a grade 1 injury, you might need less than a week to feel better. Grade 2 and grade 3 injuries will take longer to heal. It can take up to several months. Your recovery will be longer if you needed surgery.

Talk to your healthcare provider about what you can expect. You’ll be able to resume some activities gradually while you recover. Your provider or physical therapist will help you safely resume training and other activities. They’ll tell you when it’s safe to start walking, running, working out or practicing again. Don’t ramp up your activity level before your provider says it’s OK. If you put too much stress on your hamstrings before they’ve healed, you can reinjure them (or make the original injury worse). Injured hamstrings usually tighten up as they heal. It will be important to focus on your flexibility. Make sure you’re warming up and cooling down after any physical activity.