Rehabilitation of a Pulled Hamstring

• Rest as much as possible. Sit with the leg elevated when possible.
• Apply cold therapy for 15 minutes every 2-4 hours. Do not put ice directly onto skin as it might burn!
• Compress - using a tubular bandage or heat retainer.

• Alternate use of a hot and cold pack for 5 minutes each over a 20 -30 minute period. Finish on cold to reduce blood flow. Repeat 3 times a day.
• Begin static stretching (hold stretches for 30 sec's, 5 times a day).
• Knee extensions - in a sitting position straighten the knee as far as possible and return to the resting position. Repeat for 3-5 minutes. Do not hold and do not perform if painful
• From day three you can do pain free exercises for example standing hamstring curls and reverse straight leg raises.
• Strengthening of the hip and groin muscles using a resistance band or ankle weights (perform 3 sets of 20 reps every other day)
• Light sports massage may be used provided all bleeding has stopped.
• Treatment modalities such as TENS and ultrasound may be used to ease pain and reduce swelling.

• Use heat (hot pack or warm bath) for 10 minutes prior to rehabilitation exercises to help relax the hamstring muscles.
• Light leg curls on a hamstring weights machine or using a resistance band (3 sets of 20 reps at a light resistance three times a week).
• Perform bridging exercises by laying on the back with the knees bent and feet flat on the floor. Raise the hips off the ground as high as possible and hold for 3-5 seconds (3 sets of 20 reps every other day). Progress when this exercise feels easy, to performing on the injured leg only.
• Sports massage every other day.
• Swimming or cycling every other day.
• If all of these exercises are pain-free, jogging may be introduced at a slow speed for a few minutes at a time.

• Continue with static stretching as above.
• Continue to have deep massage on the hamstrings on a weekly basis or at least until all the lumps and bumps that the therapist will feel have gone.
• Introduce dynamic stretching exercises
• Continue with hamstring curl exercises, progress by increasing the weight and gradually decreasing the reps to 4 sets of 10.
• Introduce eccentric hamstring strengthening. Kneeling on the knees, the therapist or trainer stabilises the lower legs as the patient leans forwards as if going to lay on the front. It is important in this position to avoid any movement of the lower back or hips (sets of 10 reps initially once a week, progressing to twice).
• When you can run for 40 minutes with no problems begin speed work. An example session would be 10 x 60m striding at 50% effort. Two or three days later, 10 x 60m at 70% effort.

• You should seek medical attention immediately. R.I.C.E. (Rest, Ice, Compress, Elevate.) Use crutches.
• Follow any advice given to do by your doctor or consultant.
• Progress to full weight bearing as soon as possible.

• Heat with a hot water bottle, hot bath or ultrasound.
• Sports massage may be used providing all bleeding has stopped. This should be light initially and become deeper over time, as pain allows.
• Pain free static contractions (if it hurts don't do it). Use no weight and do 4 sets of 10 reps every day.
• Begin static stretches providing there is no pain. Hold for 30 seconds and repeat 5 times a day.
• Active hamstring range of motion exercises (pain-free!). Lie on the front and bend the knee towards the buttocks.
• Strengthening of the hip and groin muscles using a resistance band or ankle weights (perform 3 sets of 20 reps every other day)

• All of the above plus hamstring curls using a resistance band or light ankle weights (3 sets of 20 reps 3 times a week)
• Perform bridging exercises by laying on the back with the knees bent and feet flat on the floor. Raise the hips off the ground as high as possible and hold for 3-5 seconds (3 sets of 20 reps every other day). Progress when ready to performing on the injured leg only.
• Perform shallow squats (no weight) with the feet shoulder width apart (3 sets of 15-20 reps 3 times a week)
• Swimming every other day.
• Cycling if pain free.
  
  

• All of the above exercises, including gradually heavier resistance and increasing reps to 4 sets of 10.
• Start jogging provided it is not painful. An initial slow speed for 5 minutes can be increased gradually in time and pace.
• When you can run for 40 minutes with no problems begin speed work. An example session would be 10 x 60m striding at 50% effort. Two or three days later, 10 x 60m at 70% effort.
• Eccentric hamstring strengthening. Kneeling on the knees, the therapist or trainer stabilises the lower legs as the patient leans forwards as if going to lay on the front. It is important in this position to avoid any movement of the lower back or hips (sets of 10 reps initially once a week, progressing to twice).
• Introduce dynamic stretching exercises
  
  

Stretching >>