What causes a hamstring strain?
Hamstring strain, also know as a hamstring injury, hamstring tear or pulled hamstring, can affect anyone, but is most common as a sports injury, where lunging, running or jumping creates a sudden strain or excessive stretch on the hamstring muscles. The resulting injury can range from a strain or minor tear to a complete rupture.

Re-injury is a high risk if there is a premature return to full use of the hamstring muscles, and this increases the chance of permanent damage.

Hamstring strain symptoms

A hamstring strain is a tear in the muscles at the back of the thigh. The symptoms are usually sudden pain and the person is unable to continue the activity. Sometimes a snap or pop is heard or felt at the time of the injury and the person may not be able to stand or support weight on the injured leg. There will be a tightness, tenderness and inflammation at the back of the thigh. There may also be muscle spasms and bruising will often show over time and may be swelling and bruising.

Treatment for a hamstring strain

The immediate response to any thigh pain or hamstring injury is to stop the activity and rest the leg.

Ice or a thigh ice wrap should be applied as soon as possible after the injury, and should be applied regularly (around 20 minutes every two hours) for the next 48 – 72 hours. The ice will constrict the blood vessels to reduce swelling, inflammation and bruising, and will provide pain relief by decreasing nerve conduction (and by reducing the pressure that the swelling is putting on the injury and surrounding tissue).

Elevation will also help reduce inflammation, but it is difficult, and usually impractical, to raise the thigh above heart height. Compression is often used for soft tissue injuries, but you must ensure that the compression does not restrict blood flow down the leg.

Any injury where the pain is severe, pain continues for more than a few days, there is tingling or numbness, or you are unable to support your weight should be referred to a doctor to determine the type of injury, the extent of the damage and a strategy for rehab.

The rehab for a hamstring strain will depend on the severity of the injury and may include self treatment, anti-inflammatory/pain relief, physiotherapy or surgery (usually only for a full rupture). Common to all approaches will be a RICS approach: 

  • Rest from the activities that led to the injury, or may aggravate it further. In some cases, your doctor or physio may crutches or splints to prevent over-use and provide additional support during recovery.
  • Ice the area with ice or a thigh ice wrap. Initially this should be frequent to bring down the inflammation and pain. After the swelling has come down, ice or a thigh ice wrap can be used after exercise or physio to keep down inflammation and pain. 
  • Careful stretching of the muscles. This should only be done after the acute inflammation has gone down and when pain permits. Applying heat or a thigh heat wrap can help warm and relax the muscles prior to the stretching.
  • Strengthen the surrounding muscles. This should be a gradual process that does not put a sudden strain on the hamstring – or other muscles. Do be aware that injury can lead to imbalance amongst muscles as your body adjusts to minimise damage or pain – e.g. the limping you do to reduce pain in your thigh can put a strain on the muscles and tendons in the knee, hip and calf of the same leg, and in all of the muscles of your other leg, as your body tries to compensate.

A physiotherapist will be able to guide on the stretching and exercises that can be done to strengthen and aid recovery, without aggravating the injury. A physio may also use other treatments such as massage and electrotherapy treatments such as ultrasound or laser.

Contact David Roberts Physiotherapy to see how we can help you recover from a thigh or hamstring injury

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