Share this on:Copied!

Your hamstring muscles run down the back of your leg. These big muscles help you bend your knee and extend your hip. They also allow you to walk, run, squat, bend, lift, and climb stairs.

Hence, every step can be challenging when you have a hamstring strain.

The hamstring muscle group is second to your quadriceps in terms of strength (quadriceps run down the front of your leg). But hamstrings are also one of your most vulnerable muscle groups.

Athletes are especially at risk for hamstring injuries, which can range from a simple pulled hamstring to a complete tear.

What do you do for a pulled hamstring? Can a hamstring strain heal on its own? UPMC orthopaedic doctors answer these questions every day. Here are some of the key things to know.

What Is a Hamstring Strain?

You have three big hamstring muscles that run from the bottom of your pelvis to below your knee. Tendons then connect the muscle fibers to your bones.

If you stretch the muscle more than it can handle, it can become strained. A strain usually occurs when the muscle experiences loading, which means that weight and/or force is working on it.

For example, you might strain a hamstring while sprinting. Your body weight and the force you create load the muscle.

You might also strain a hamstring while doing an exercise such as a deadlift. In that case, the weight of the bar or dumbbell is loading the hamstrings.

What are the grades of hamstring strains?

You can strain either the hamstring muscles or the tendons. There are three grades:

• Grade 1 hamstring strain — This is a mild strain. It may hurt, but you’re still able to move around. With rest, these mild strains can heal quickly.
• Grade 2 hamstring strain — You have a partial tear in a hamstring. You likely  will experience moderate pain, have a limited range of motion and need a course of rehabilitation to recover.
• Grade 3 hamstring strain — This severe strain is usually a complete tear. You’ll probably have intense pain, won’t be able to move it and have difficulty weight bearing. You will need a course of rehabilitation to recover and rarely may need surgery.

What are the symptoms of a pulled hamstring?

How do you know if you have a hamstring strain? Some people describe it as a pop or a snap, but most people have a pretty good idea if they’ve pulled a hamstring.

If it happens while you’re running, you’ll feel a sharp pain. It’s sudden and causes you to stop moving immediately.

It may not be quite so dramatic with milder strains. You may feel pain or tenderness after the fact.

Other common symptoms of a pulled hamstring include:

• Pain in the back of your thigh when walking or bending over.
• Tenderness and swelling in the area.
• Bruising (not all strains have bruising).
• Difficulty putting weight on the affected leg.

How Are Hamstring Strains Treated?

How to treat a hamstring strain depends on its severity. Sports medicine doctors can diagnose hamstring strains fairly easily. An x-ray may be the first test but it will not show a tear. You may need an MRI or ultrasound to show the tear if your injury is complicated or not healing as it should.

For a mild strain, you may not even need imaging. Your doctor may be able to diagnose the condition by asking about your symptoms and testing your range of motion.

Only rarely, severe hamstring strains require surgery, and this is when they have significant retraction (torn hamstring is pulled away from its attachment).

RICE method for initial recovery

For tears in the muscle itself, there are many things you can do to encourage healing. The first is RICE:

• Rest — Rest the injury. Take a break from the activity that caused it. You might need crutches to keep weight off the leg.
• Ice — Ice your hamstring for 20 minutes on, 20 minutes off. Do this as much as possible for the first 24 to 48 hours.
• Compression — Wrap the injury with tape or an ACE bandage. This helps with swelling.
• Elevation — Prop up your leg, keeping it higher than your heart.

You can also take over-the-counter anti-inflammatory medicine to help with pain and inflammation. This includes ibuprofen and naproxen. Avoid these medications if you have any kidney or bleeding issues, including if you are on blood thinners. Acetaminophen may be a safer option for those who can’t take anti-inflammatories as long as there are no liver issues.

The recovery time for hamstring strains depends on the severity of the injury. A mild strain can heal within a few weeks, while a severe one may take months.

What Exercises Can Help Rehab an Injured Hamstring?

You want to avoid re-injuring your hamstring while it heals. Let the swelling go down before trying to exercise.

Working with a physical therapist is a great way to learn safe stretches and exercises. Ideally, you want a balance with movements that stretch the hamstrings with strength exercises.

Here are a few exercises you can try on your own.

Toe touch stretch

Sit on the floor with your legs long in front of you. Hinge forward at your hips, reaching toward your toes. Hold for five to 10 seconds, then repeat a few times.

Keep your back as flat as you can as you reach forward. Don’t push more than you’re able.

Legs up the wall stretch

Lie flat on your back, with your butt as close to a wall as possible. Extend your legs up the wall, resting them against the wall.

It can be a little tricky to get into this position, and it requires scooting. However, you can also do this stretch without a wall. Just lie on your back and extend your legs toward the ceiling.

Good mornings

Stand with feet flat with knees slightly bent. Reach your hands behind your head, cradling it.

Keeping your back straight, push your butt back. Your chest will wind up parallel to the floor. Think about using the strength of your hamstrings to return to a standing position.

Try a set of 10 to start.

Hip bridges

Lie with knees bent and feet flat, hip distance apart. You can adjust how close you move your heels in. The farther away your heels are, the more challenging the move is.

Tuck your tailbone and start peeling your lower back off the floor. Think about using the strength of your hamstrings to lift. Hold for a second at the top, then return to the starting position.

Start with a set of 10 and add from there. To add a challenge, you can place a weight on your hips.

You can also try hip bridges with one leg. To do that, lift one leg toward the ceiling. Lift and lower your body while the leg is in the air; do a set and repeat on the other side.

Remember that UPMC sports medicine and orthopaedic specialists are always here to help you strengthen and stay healthy.