Hamstring Strain

Hamstring pain common running injury.

Bouncing Back Stronger Than Ever

Have you ever felt that frustrating twinge in the back of your pulled hamstring or thigh that seems to slow you down?

If so, you’re not alone. Hamstring strains are a common setback for many active individuals, causing pain, limited mobility, and a dent in your progress.

But fear not! In this blog post, we’ll unravel the mysteries behind hamstring strains and equip you with the knowledge to conquer this hurdle. Get ready to bounce back stronger than ever!

Understanding Hamstring Strain

A hamstring strain is a tear in one or more of the three hamstring muscles at the back of the thigh. This type of injury is common in sports and can vary from minor, causing some discomfort, to severe, where the muscle is completely torn or detached.

The three muscles involved are the semitendinosus, semimembranosus, and biceps femoris. They span from the lower part of the buttocks to the bones of the lower leg near the knee.

Overstretching or rapid contraction during activities like sprinting can lead to strains, commonly in the biceps femoris. Symptoms often include sudden pain, weakness, and sometimes bruising or swelling.

Causes of Hamstring Strain

Here are some causes:

1. Overuse and repetitive stress on the hamstring muscles: 

Pushing your body too hard without allowing sufficient recovery time from muscle injuries can lead to hamstring strains. Engaging in repetitive activities, such as running or jumping, without giving your muscles a chance to rest and repair can strain the hamstrings excessively.

2. Lack of proper warm-up and stretching: 

Skipping warm-up exercises and neglecting to stretch your hamstrings before physical activity increases the risk of strains. Adequate warm-up routines prepare your muscles for the demands ahead, while stretching helps improve flexibility and prevent muscle imbalances.

3. Muscle imbalances and weakness: 

When certain muscles in the leg, such as the quadriceps, become significantly stronger than the hamstrings, it creates an imbalance between hamstring muscle group. This imbalance stresses the hamstrings, making them more prone to strains. Strengthening and balancing all muscle groups is essential for injury prevention.

4. Previous hamstring injuries: 

Once you’ve experienced a previous hamstring injury or strain, the risk of re-injury becomes higher. Scar tissue and residual weakness from a previous strain can make the hamstrings more susceptible to future strains. Proper rehabilitation and strengthening exercises are crucial to minimize the likelihood of recurrence.

Other contributing factors: 

Several other factors can increase the risk of a hamstring injury or strain. These include inadequate rest between intense workouts, sudden training intensity or surface changes, poor running or jumping technique, and environmental factors such as cold weather or slippery surfaces.

By understanding these causes, you can take proactive steps to mitigate the risk and protect three muscles in your hamstrings from unnecessary strain and injury. Remember, prevention is always better than cure when staying active and injury-free!

Symptoms of Hamstring Strain

Here are the symptoms of a hamstring strain:

Sudden onset of pain in the back of the thigh

One of the hallmark signs of a hamstring strain is the sudden and sharp pain felt in the muscles at the back of the thigh. It often occurs during physical activity or movements involving hamstrings, such as sprinting or jumping.

Swelling and bruising

Inflammation and swelling are common responses to a hamstring strain muscle tear. The affected muscle injury area may appear swollen and tender to the touch. Bruising can also occur due to the rupture of blood vessels within the muscle tissue.

Reduced range of motion and flexibility

Hamstring strains can significantly impact your range of motion and flexibility. You may experience difficulty straightening the lower leg or bending the knee fully. Stretching the knee joint or performing activities that require a wide range of motion becomes challenging and uncomfortable.

Difficulty walking or running

The pain and discomfort from a hamstring strain can make walking or running a daunting task. Strains can cause a noticeable limp, and any weight-bearing activities that engage the hamstrings can be painful.

Severity levels and grading of hamstring strains

Hamstring strains are typically classified into different severity levels or grades. Grade 1 strains involve mild muscle fibre stretching or microscopic tears, resulting in minimal pain and functional limitations. 

Grade 2 strains indicate a partial muscle fibres tear, resulting in moderate to severe pain, swelling, and functional impairment. Grade 3 strains are severe, involving a complete muscle tear, leading to intense pain, significant swelling, and substantial loss of function.

Diagnosing Hamstring Strain

Medical evaluation and physical examination: 

When you suspect a hamstring strain, a medical evaluation is the first step toward diagnosis. A healthcare professional will discuss your symptoms, medical history, and the injury’s circumstances. 

They will also perform a physical examination to assess the affected area, including palpation, range of motion tests, and muscle strength assessments.

Diagnostic tests, such as imaging or MRI scans: 

In some cases, diagnostic tests may be necessary to confirm the diagnosis and assess the severity of the hamstring strain. Imaging techniques like ultrasound or magnetic resonance imaging (MRI) scans can provide detailed images of the muscle and soft tissues. 

These tests help identify the location and extent of the strain, ruling out other potential injuries or complications.

Differentiating between strains and other similar conditions: 

Certain conditions, such as muscle cramps, tendinitis, or nerve-related issues, can mimic the symptoms of a hamstring strain. Distinguishing between these conditions is crucial for accurate diagnosis and appropriate treatment. 

A skilled healthcare professional will utilize their expertise and the information gathered from the medical evaluation and diagnostic tests to differentiate between different injuries and conditions, ensuring you receive the most appropriate care.

Accurate diagnosis is vital in creating an effective treatment plan and ensuring a smooth recovery. If you suspect a hamstring strain, don’t hesitate to seek medical attention for a thorough evaluation. 

Recovery and Treatment

Rest and activity modification: 

Rest is crucial in most hamstring injuries and the early stages of hamstring strain recovery. It allows the injured muscle fibres to heal properly. It’s important to modify activities that aggravate the muscle strain and avoid high-impact exercises that strain the hamstrings excessively.

PRICE therapy (Protection, Rest, Ice, Compression, Elevation)

PRICE therapy is a well-established approach for treating acute injuries, including hamstring strains. Protect the injured area from further harm, rest to promote healing, apply ice packs to the muscle belly to reduce swelling and pain, use compression bandages to support and reduce swelling, and elevate the injured leg to minimize inflammation.

Pain management techniques

Managing pain is an integral part of the recovery process. A healthcare professional may recommend non-steroidal anti-inflammatory drugs (NSAIDs) to alleviate pain and reduce inflammation.

Also, techniques like heat therapy, gentle massage, or transcutaneous electrical nerve stimulation (TENS) can relieve and promote healing.

Rehabilitation exercises and stretching

Once the acute phase has passed, rehabilitation exercises and stretching become essential to restore strength and flexibility. A physiotherapist can guide you through a customized program that includes exercises targeting the hamstrings and surrounding muscles. 

These exercises aim to gradually rebuild strength, improve flexibility, and correct any muscle imbalances contributing to the strain.

Gradual return to physical activity and sports

A gradual return to physical activity and sports is recommended as you recover. It’s essential to follow a structured plan provided by a healthcare professional or physiotherapist to ensure a safe and successful return. 

This involves gradually increasing the intensity and duration of activities while closely monitoring signs of discomfort or strain. Remember, patience and adherence to the prescribed plan are key to preventing re-injury and returning to the activities you love.

Preventing Hamstring Strains

Proper warm-up routines: 

Before engaging in any physical activity, it’s crucial to prioritize a thorough warm-up routine. This should include dynamic movements that increase blood flow to the muscles and prepare them for exercise demands. Incorporate exercises targeting the hamstrings to activate and engage them before the workout.

Stretching and strengthening exercises: 

Regular stretching and strengthening exercises for the hamstrings are key in preventing strains. Incorporate static stretches after workouts to improve flexibility and elongate the muscles.

Additionally, include targeted strengthening exercises focusing on the hamstrings and the surrounding muscle groups to create a well-balanced and resilient lower body.

Correcting muscle imbalances: 

Muscle imbalances, such as having weak hamstrings compared to the quadriceps, can increase the risk of hamstring strains. Addressing these imbalances through targeted exercises is essential.

Work on strengthening the hamstrings while also balancing the strength of other muscle groups to ensure optimal function and reduce strain on the hamstrings.

Training modifications and gradual progression: 

One common cause of hamstring strains is overexertion or sudden increases in training intensity. Implementing gradual progression in your training routine is important to prevent strains. Gradually increase the intensity, duration, and frequency of your workouts, allowing your body time to adapt and strengthen without pushing it too far or too fast.

Listening to the body’s warning signs: 

Our bodies have an incredible ability to communicate with us. Pay attention to any warning signs or discomfort during exercise. If you feel tightness, pain, or unusual sensations in the hamstring area, take a step back and give yourself time to recover.

Ignoring these warning signs can lead to severe injury afterwards. Trust your body and make necessary modifications to your training plan when needed.


Understanding and preventing hamstring muscle strains are paramount in pursuing an active, injury-free lifestyle. We can significantly reduce the risk of hamstring strains by implementing proper warm-up routines, incorporating stretching and strengthening exercises, and correcting muscle imbalances.

However, if a strain does occur, timely diagnosis, appropriate physio treatment, and dedicated rehabilitation are key to a successful recovery from hamstring muscle strain. Let’s prioritize the well-being of our hamstrings, allowing us to stay strong, flexible, and resilient in our fitness journeys.

Stay proactive, stay mindful, and keep those hamstrings happy and healthy!

Kula Health

Diarmuid Hegarty

Diarmuid is the Principal Physiotherapist here at ReSync Physiotherapy. He has a wealth of experience in both private practice settings, in UK, Ireland, Australia and New Zealand. If you wish to book in with Diarmuid for an Assessment - Follow this link to Book Online Now.