Premiership Physiotherapist Neal Reynolds has produced a step by step rehabilitation program based around healing or treatment, stretching, strengthening and maintaining aerobic fitness.
Aims of rehabilitation
The following guidelines are for information purposes only. We recommend seeking professional advice before attempting rehabilitation. The aims of this pulled hamstring rehab program are to reduce pain and inflammation, improve flexibility and muscle condition, increase the load through the hamstring muscle gradually to a level where the athlete can return to full fitness training and match play.
Hamstring rehabilitation explained
The hamstring strain rehab program is based around four elements or strands. The athlete will progress at different rates depending on the severity of the injury and the athlete themselves. The program is based on what a full time
professional footballer might do with all the time and resources available they need. Where the athlete starts along each stage will also depend on how old the injury is and how bad it is when beginning rehab.
Healing & treatment
This element is the treatment side of rehab and includes cold therapy or ice, electrotherapy such as ultrasound or laser, deep tissue sports massage and heat. Healing is split into three stages:
- Phase 1 is the acute stage and can last 3 to 4 days.
- Phase 2 is the sub acute stage lasting anything from 10 days to 2 weeks depending on severity.
- Phase 3 is the final stage returning back to full fitness.
- More on hamstring strain healing and treatment.
Hamstring stretching begins with very gentle static stretches initially moving onto more dynamic sports specific stretches as the injury heals. Different stretches will target the muscle in different ways depending on exactly where the muscle tear is. Some hamstring strains are nearer the knee and others may be higher up in the muscle.
See stretching for hamstring strains for more details and specific exercises.
Hamstring muscle strengthening is thought of in terms of gradually increasing the load on the muscle. Strengthening exercises should always be done pain free. If it hurts then it isn't helping. In the early stages of hamstring rehabilitation basic static exercises are done often using a therapist or partner to provide resistance. These will progress to more sports specific and demanding exercises as the muscle strengthens.
See hamstring strengthening exercises for more details and specific exercises.
When an athlete is injured it is important to maintain fitness as much as possible for physical as well as physiological reasons. With a hamstring strain it will be impossible to run so our progressive program starts with arm bikes for athletes with severe muscle strains and builds up.
Later in the rehab program timed shuttle runs and sprints like professional footballer would be expected to be able to do are included. It is important to progress this far before returning to competitive matches or re-injury is likely.
Visit our step by step aerobic fitness page for more details on aerobic exercise that can be done alongside a hamstring strain rehab program.