Hamstring Strain (Pulled Hamstring)

Pulled Hamstring strain

A hamstring strain or ‘pulled hamstring’ is a tear to one of the hamstring muscles. Sudden sharp pain is felt at the back of the thigh which can range from mild to severe. Here we explain the symptoms, causes, treatment and rehabilitation of a pulled hamstring.

Hamstring strain symptoms

Symptoms of a hamstring strain usually consist of a sudden sharp pain at the back of the thigh, either whilst sprinting or performing a fast stretching movement such as a high kick. Hamstring strains are graded 1, 2 or 3 depending on how bad they are.

  • A grade 1 hamstring strain is relatively mild. You may feel a twinge or tightness at the time of injury, with little or no swelling.
  • A grade 2 is more severe.
  • If you have a grade 2 strain you will feel a sudden sharp pain at the time of injury. Swelling is likely and you will be unable to continue playing or training.

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Other injuries causing posterior thigh pain:


What is a pulled hamstring?

A hamstring strain (pulled hamstring) is a tear to any one or more of the hamstring muscles at the back of the thigh.

Hamstring strain muscles image

The hamstring muscle group consists of three separate muscles:

  • Semitendinosus
  • Semimembranosus
  • Biceps femoris.

The muscles originate from the lower part of the pelvic bone (ischial tuberosity) and insert into the back of the shin bone (tibia). When they contract, they bend (flex) the knee and help extend the hip (move the leg backwards).


What causes a hamstring strain?

Hamstring strains usually occur in two different ways. They are either sprinting related or stretch related for example in martial arts, gymnastics or dancing.

Sprint related hamstring strains

  • During sprinting the hamstring muscles work extremely hard. In particular, at a point just before the foot strikes the ground they decelerate the tibia (shin) very quickly. It is at this point that the hamstring is most likely to tear.
  • Sprint related hamstring injuries usually occur lower down the biceps femoris muscle. More specifically, where the muscle joins to the tendon. They often feel worse initially, but recover more quickly.

Stretch related hamstring strains

  • Stretch related injuries usually occur higher up at the back of the thigh. Most commonly the in the tendon of the semimembranosus muscle.
  • These injuries may take longer to heal because the blood supply to the tendon is not as good.

Referred pain

  • Referred pain is caused by problems elsewhere such as the lower back and hip, but is felt at the back of the leg.
  • These may increase the likelihood of suffering a hamstring strain and should always be considered, particularly if you suffer from recurrent hamstring strains.

Hamstring strain treatment & rehabilitation

Treatment is divided into immediate first aid, then longer-term treatment which begins after the initial acute stage of healing. Go direct to our Hamstring strain rehabilitation program.

Immediate first aid

The acute phase of hamstring strain rehabilitation usually lasts 3 to 4 days depending on how bad your injury is. Complete rest is advised, with no running or playing active sport allowed and as little walking as possible. Apply the PRICE principles of protection, rest, ice, compression, and elevation.

  • Protection – protect your muscle from further injury. This means leaving the field of play or stopping exercise as soon as possible.
  • Rest – from anything that causes pain, both immediately after injury and longer term whilst your muscle strain is healing.
  • Ice – apply cold therapy for 15 minutes every hour in the early stages, or at least 3 or 4 times per day. Ice should not be applied directly to the skin as it may cause ice burns. Instead, wrap in a wet tea towel. Commercially available cold packs and wraps that are just as effective.
  • Compression – use a compression bandage or thigh support to apply compression. This can be worn all the time during the acute stage to help reduce swelling and support the muscle.
  • Elevation – elevate the limb as much as you can because this will help swelling and tissue fluids drain away.

Once the initial acute phase has passed you move into the subacute phase. The sportsinjuryclinic.net hamstring strain rehabilitation program takes you step by step through what is required to recover from and prevent recurrance of a pulled hamstring.

Go direct to: Hamstring strain rehabilitation program

Sports Massage

hamstring massage

Sports Massage or soft tissue massage can be used at this stage but the pressure must be very light and superficial, to begin with, but can gradually get deeper as the days/weeks pass.

Massage can help to break down any scar tissue that has formed and can help to relax tight muscles and stimulate blood flow to the area and all of this aids the healing process and may increase flexibility. Light massage can be applied daily initially but later on, as the techniques become deeper, more recovery time between sessions may be required.

Go to: hamstring massage video.


Hamstring strain exercises

Isometric hamstring exercises

Both stretching and strengthening exercises are important. After the initial acute stage, very gentle static stretching exercises can begin as long as they are pain-free. As your injury heals, dynamic stretching which involves movement is introduced and eventually sports-specific drills.

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Hamstring kinesiology taping

Kinesiology taping for the hamstring muscles

Kinesiology taping can be applied during the later stages of rehabilitation by encouraging activation of the muscle fibres.

Go to: Kinesiology taping video


Hamstring strain exercises

Isometric hamstring exercises

Both stretching and strengthening exercises are important. After the initial acute stage, very gentle static stretching exercises can begin as long as they are pain-free. As your injury heals, dynamic stretching which involves movement is introduced and eventually sports-specific drills.

Strengthening exercises also begin gently with isometric contractions and progress through to advanced hamstring exercises.

Read more on Hamstring exercises.


References


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