At a Glance
- Hamstring injuries feature in the top seven of sports related muscle injuries.
- These injuries may be mild, moderate or severe.
- Once healed there are ways to help prevent it from happening again.
Hamstring injuries are not the reserve of famous athletes and footballers, like Usain Bolt and Wayne Rooney. They can happen to anyone, whether your preference is to run, play football, basketball or tennis. Any exercise can lead to a hamstring injury.
How it does happen? What’s the best way to heal a hamstring? Let’s take a look at what these injuries are and how to heal them.
What Is a Hamstring?
The hamstrings are a group of tendons that attach the large muscles at the back of the thigh to the bone. The hamstring muscles are the large muscles that attach to this group of tendons, and stretch from the bottom of the pelvis to the knee. The hamstring muscles help you extend your leg straight back and to bend your knee.
What Is a Hamstring Injury?
A hamstring injury is when we strain or damage one or more of the muscles at the back of the thigh. This can be a pull, partial tear or complete tear.
They are graded depending on their severity as:
- Mild (first degree)—a strain or pull of the muscle fibers, hence the term pulled muscle.
- Moderate (second degree)—a strain or tear of the muscle fibers or tendons.
- Severe (third degree)—a tear across the whole of one of the muscles or tendons.
The length of time that it’ll take for these injuries to heal will vary depending on how badly you’ve injured the hamstring. Also your own personal rate of healing is a factor to consider. It can take anything from a few days to several weeks or months.
Some Causes of Hamstring Injuries
If you stretch a rubber band too far it’ll eventually lose elasticity and break. Our muscles work in much the same way, if we overstretch them too far they can tear. A hamstring strain happens when one or more of the muscles in the hamstring get overloaded.
This type of injury tends to occur during exercise that involves lots of running, jumping or sudden stops and starts. Think track, tennis, football, basketball, to name a few. It can even happen when you’re walking down stairs.
Some of the reasons they happen could be due to:
- Not stretching and warming up properly before exercising.
- Poor technique or posture when running.
- Weak or overworked muscles.
- Poor footwear.
- Recurrence of a previous injury that may not have healed properly.
Recognizing a Hamstring Injury
You may feel a sudden or severe pain when exercising; this can be accompanied by a snapping or popping feeling in your thigh.
You may feel tenderness in your hamstring. You may have pain at the back of your thigh and over your buttocks when walking. You may feel discomfort when straightening your leg or bending over. This can be accompanied by bruising.
If the strain is mild then you may just feel tightening and aching, but if the strain is severe it will be very painful and you won’t be able to walk.
Irrespective of how severe the stain you should always seek medical advice. The quicker you act the better. Don’t put it off till tomorrow thinking it’ll go away. It’s worth noting that as your sciatic nerve passes through your hamstring, a lower back injury or an injury that presses on your sciatic nerve can have similar effects as a hamstring strain. Another reason to seek medical advice is to make sure that you’re treating the right injury.
What Is the Best Way to Heal a Hamstring?
Mild and moderate hamstring injuries will normally heal on their own if you give them enough time. Sever strains may require medical intervention.
No matter what type of strain, the recovery takes three stages:
- Stage one decreases the inflammation.
- Stage two returns a normal blood supply to the muscle.
- Stage three begins the repair of the muscle.
Treatment for Stage One
During this stage of recovery your body is trying to protect you from further injury. Treatment for muscle injuries follows the RICE principle (rest, ice compression and elevation). This treatment should last for about five to seven days.
First and foremost it’s essential that you don’t do anything that makes your hamstring hurt during the first few days of recovery. It may be difficult to walk. This is because during walking the knee extends and straightens and the hamstring is stretched.
You may need to avoid weight bearing for a period of time and might even need crutches to walk. Even if you only feel mild discomfort you should walk as little as possible. You mind find it less painful if you take shorter strides.
While rest is important you should get moving as soon as you’re able to without feeling pain to prevent other problems developing. You should rest for two to three days post injury.
Apply ice to the affected area for about 15 to 20 minutes, every two to three hours for three to four days. This will help reduce pain, swelling and bruising. Make sure that you don’t apply ice directly to your skin and don’t apply it for longer than a maximum of 20 minutes. Use a barrier between yourself and the ice pack with a towel or something similar. You don’t want to end up with frostbite!
Don’t have an ice pack at home? This YouTube video will show how to make an ice pack, (and a heat pad which you’ll need later in the healing process).
A compressive (elasticized) bandage or elastic support may be applied to help reduce swelling and support the injury. This may also reduce pain as the injury begins to heal and lay down new scar tissue.
Make sure when applying a bandage or elastic support that it’s not too tight. It should support your injury but not restrict the blood flow.
For the first few days try and elevate the injury above the heart. This will help drain fluid from the injury site and help reduce swelling. You could do this by placing a pillow or a cushion under your knee. Be sensible, if it hurts then it’s not right for you.
You may consider whether to take non-steroidal anti-inflammatory (NSAID) painkillers, such as ibuprofen or naproxen, if absolutely necessary. These can help manage pain and reduce swelling.
These drugs should only be used short term and it’s advised that you consult with your doctor before taking them as some can interact with other drugs or have side effects. They may also antagonize pre-existing medical conditions.
Some Things to Avoid
During the first 48 hours after injury you should avoid:
- Heat—can increase swelling, so no hot baths or saunas!
- Alcohol–can increase swelling and bleeding, and delay healing.
- Massage–can increase swelling and aggravate damaged tissue, avoid massage for 48 to 72 hours post injury.
- Running or exercise—this will aggravate the injury.
Treatment for Stage Two
When you’re able to carry out daily activities and walk without feeling any pain, it’s time to move on to stage two of the healing process. Your body is now repairing the damage to the muscle.
You can begin to apply heat treatment to your injury to stimulate the blood flow and speed up healing. This will also help the muscle to relax.
In general terms, heat increases blood flow and cold reduces it so make sure you don’t use heat pads while there is still swelling or pain. You may want to alternate heat pads and ice packs.
Physiotherapists are trained experts in the field of soft tissue injuries may be able to help and advise you. Once pain and swelling have subsided a course of physical therapy may benefit your return to health.
The treatment they provide can:
- Reduce pain and inflammation.
- Bring the range of motion of your muscles back to normal.
- Strengthen your knees and hamstrings.
- Strengthen your pelvic and hip muscles.
- Strengthen the muscles in your lower limbs.
- Improve your running technique.
- Reduce your chance of re-injury.
As well as massage and exercise they may use electrotherapy such as ultrasound, TENS or laser to control pain. Ultrasound will also increase blood flow which can reduce inflammation.
Gentle Exercises That May Be Done During Stage Two
There are some gentle exercises that may be done once you’re walking pain free. Remember that if they cause you any pain you should not be doing them. Give yourself more healing time.
These exercises include.
- Hamstring stretches.
Here are a few hamstring stretches and exercises you can do:
Standing Hamstring Stretch
- Put the heel of your injured leg on a stool about 15 inches high.
- Keep your leg straight, bend forward at the hips.
- You should feel a slight stretch in the back of your thigh.
- Be careful not to bend at the waist or roll your shoulders or you’ll be stretching your back and not your thigh.
- Hold the stretch for up to 30 seconds and relax. Repeat three times.
- Sit relaxed on a chair and bend your head forward.
- Straighten your injured leg then move your foot toward you.
- Hold the stretch for up to 30 seconds and relax. Repeat twice.
- Lie face down with your legs out straight behind you.
- Bend your injured leg at the knee so your heel comes towards your backside.
- Hold for 5 seconds and relax.
- Put your foot back to the floor.
- Repeat 15 times and do two sets of repetitions.
Once this exercise becomes easier you could add some ankle weights.
Isometric Leg Curls
An isometric exercise is one that strengthens the muscle without shortening or lengthening it.
- Sit on a chair with your feet on the floor and your heels against the two front legs of the chair.
- Wrap your arms behind the chair keeping your back against it.
- Press your heels against the leg of the chair.
- Hold for 10 seconds and relax. Repeat five times.
You might be wondering what foam rolling is. Foam rolling is a form of self massage using a foam roller!
It can help get rid of internal scar tissue in your muscles and tissues. It helps increase blood flow to your muscles which can give you greater mobility. It also helps to stretch your muscles.
If you’ve never used one this YouTube video may help:
Treatment for Stage Three
Now that your hamstring has begun to repair itself you’re ready for rehabilitation.
You should hopefully be at a stage where you can jog without pain for at least five minutes. You should also have a normal range of movement in your injured leg.
Depending on the severity of the injury, you may reach this stage in about one to 10 days for a mild strain, two to three weeks for a moderate strain. A severe injury that involves a large tear may take many weeks and may need surgical intervention.
Your aim now will be to strengthen your hamstring and return to a full range of function and flexibility. This can be done through strengthening and exercising.
Exercises and Stretches
Once again, remember these exercises and stretches should be pain free during, afterwards and the next day. If you feel any pain, stop. Don’t forget your uninjured hamstring, this will benefit from exercise as well.
Standing Leg Curls
- Stand with your legs hip width apart.
- Raise your foot off the floor bending your knee and try and to touch your backside with your foot.
- Curl the leg as high as you’re able.
- Lower your leg back to the floor.
- Start with three sets of 10 repetitions building to four sets of 20 repetitions.
As you gain strength you could add ankle weights. You may need to use a wall or the back of a chair for balance during this exercise.
- Lie on your back with your knees slightly bent.
- Push your hips up off the floor and hold the position briefly.
- Lower your hips back to the floor again.
- Start with three sets of eight repetitions building to three sets of 12 repetitions.
Once you’ve gained strength you can progress to single leg bridges.
- Put one leg across your knee with the other leg slightly bent.
- Lift your hips off the floor, hold briefly and lower.
The aim with both of these exercises is to have a diagonal line from your knees to your shoulders, be careful not to arch your back.
Leg Lift Extension
- Kneel on all fours with your hands beneath your shoulders.
- Lift one leg off the floor and stretch it out behind you with the knee bent and toes pointed.
- Curl your leg towards your backside, hold briefly and lower.
- Start with one set of 10 repetitions building to three sets of 15 repetitions.
Returning to a Regular Routine
Thinking about getting back to your normal exercise routine?
- You can move your injured leg as easily and freely as your uninjured one.
- Your injured leg feels as strong as your uninjured one.
- You can walk, jog, run and then sprint with no pain.
If you push too hard too soon you risk re-injuring your hamstring or causing permanent damage. If you’re unsure consult your doctor or physiotherapist.
We’ve looked at the best way to heal a hamstring but prevention is always better than cure. In future make sure to:
- Warm up and stretch before exercising.
- Increase your level of exercise slowly, no more than 10 percent per week.
- If you feel any pain in the back of your thigh, stop exercising and act quickly to deal with it.
- Regularly stretch and strengthen your hamstrings to prevent further injury.
- Stay hydrated, cramps can increase the chance of muscle injury.
- Consider weight training to ensure all your leg muscles are exercised and not out of balance.
There’s no foolproof way to avoid injuries but paying attention to our muscle strength and flexibility can help minimize the risk.