You just started your sprint towards the ball or next rep in your running interval workout when suddenly, you feel a sharp pain in your hamstring that turns your sprint to a limp.
You’ve incurred the dreaded hamstring strain – a common injury among athletes who participate in a sport that requires sprinting with sudden stops and starts.
A hamstring strain has three grades of severity, from Level 1 (a mild strain) to Level 3 (a severe strain). Even mild strains require at least three weeks of rest and ice for an athlete to recover.
If an athlete does not add massage, stretching, and strengthening exercises to their hamstring strain rehab once their condition begins to improve, they are at great risk of reinjury.
Do you think you’ve suffered a hamstring strain? Read on to learn about the symptoms, levels of severity, and a treatment plan that will have you returning to sport with strong and healthy hamstrings.
Symptoms of a Hamstring Strain
Hamstring strains typically occur suddenly right at the beginning or ending of a sprint or other movement that stresses the hamstring. Symptoms of a hamstring strain include:
- Sudden pain in the hamstring that might occur with a “popping” sound
- Loss of stability (athletes usually limp after the strain occurs)
- Pain in the hamstring that worsens with walking, straightening the leg, or bending over
- Swelling/bruising in the injured area
- Tenderness in the injured area
Levels of Severity
The amount of rest you’ll need from hamstring-aggravating activities will depend on the level of severity of your hamstring strain. There are three levels of severity:
Level 1: Mild Strain
A mild strain refers to a hamstring that was overstretched but did not incur tears in the muscle fibers. Symptoms typically include:
- Tenderness/tightness in hamstring that doesn’t impact mobility
- Tenderness/tightness that worsens with certain hamstring stretches
- Pain that can occur with sitting, walking uphill, or going upstairs
- Mild swelling
- An inability to run at full speed due to tightness and discomfort in the hamstring
Level 2: Moderate Strain
A moderate strain is characterized by a partial tear in the muscle that significantly effects movement. Symptoms typically include:
- A loss in the hamstring’s strength and flexibility
- Limping and sharp pain with certain movements, such as walking
- Pain that worsens when bending the knee against resistance or straightening the knee
- Tightness with or without movement and tender to the touch
- Mild swelling
- Bruising that occurs a few days post-injury
Level 3: Severe Strain
A severe strain involves severe or complete tear in the muscle. This type of strain requires immediate care from a healthcare professional to heal properly. Symptoms typically include:
- Sharp pain where the injury occurred
- Swelling that begins within 24 hours of injury
- Bruising that occurs a few days post-injury
- Pain with walking that may make it impossible to walk without assistance
- May require surgery and costly medical care, especially if not treated immediately
While Level 1 strains can usually heal from proper home-treatment, Level 2 and 3 strains require treatment from a healthcare professional or they may worsen and contribute to costly medical expenses.
Hamstring Strain Treatment
There are two phases to hamstring strain treatment.
Phase 1 is the immediate care phase, where treatment will focus primarily on reducing swelling and resting the injury so that it does not worsen. Phase 2 will include specific stretching and strengthening exercises to repair the muscle tissue and prevent reinjury upon return to sport.
Phase 1: Immediate Care
It is crucial to care for all levels of hamstring strains immediately or else the injury can quickly escalate. For 72 hours, you should follow the R.I.C.E and NO HARM protocols, which are as follows:
This protocol stands for “Rest,” “Ice,” “Compression,” and “Elevation.”
Rest: Do not perform any activities that further aggravate the injury. Avoid walking and running.
Ice: While you are awake, ice your hamstring with a cold pack at least once per hour for 72 hours. This will greatly reduce the swelling.
Compression: When not sleeping, icing, or elevating, it is important to compress the hamstring to further decrease swelling. A compression sleeve, compression shorts, or wrapping the hamstring in sports wrap can help keep the hamstring compressed and warmed.
Elevation: Elevate the hamstring while you are resting. A good time to keep the hamstring elevated above your heart is while icing. Elevation will lessen the swelling by encouraging fluid to leave the injured area.
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It’s important to avoid anything that can irritate the hamstring or increase inflammation within 72 hours of injury.
A common mistake among athletes is to stretch, massage, or try strengthening exercises for the hamstring within 72 hours of the strain. These activities can help in phase 2 but will exacerbate the injury in phase 1.
No HARM stands for “No Heat, Alcohol, Running, or Massage” within 72 hours of the strain. After 72 hours, you may add some of these back in (based on how the hamstring feels) except for running.
Avoid running and other physical activities that irritate the hamstring for at least three weeks.
Phase 2: Treatment Plan to Build Strong, Healthy Hamstrings
After the appropriate immediate care outlined in phase 1, you will restore your hamstrings in phase 2 so that you can return to sport as soon as possible without the risk of reinjury.
The key to succeeding in phase 2 is to do everything gradually. You’ll start with very mild stretching, strengthening, massage, and aerobic exercises and increase the intensity and duration only if the hamstring does not bother you.
Hamstring specific strengthening exercises such as 3 sets x 10 reps of eccentric hamstring curls on a medicine ball will rebuild weakened muscle tissue. One of the best exercises is the Nordic Hamstring Curl. Watch this quick video to see if you’re ready to perform these and if you’ll benefit from them:
Light stretching of the hamstring (with warmed up muscles) will encourage flexibility and improve range of motion. Avoid deep stretching or quick stretching movements such as leg swings.
Massaging the injury will break up tight muscle tissue and increase blood flow to quicken healing.
To massage the injury, sit on a chair with a tennis ball placed under your hamstring and roll around in small circles while breathing deeply. If you cannot roll out the trigger point with the self-massage method, contact a physical therapist who performs manual treatment such as Active Release Technique or Myofascial Release.
After the 72-hour rest period, it is good to perform aerobic activities in phase 2 that won’t burden the hamstrings. Aerobic activities that don’t place too much stress on the hamstring include swimming, cycling on a stationary bike, and working out on an elliptical.
Staying active with aerobic activities and moving every thirty minutes will decrease muscle tension. Always start light and increase the duration and/or intensity of aerobic activities gradually.
Consider visiting a sports physical therapist to guide you through phase 2 of the treatment plan. Sports physical therapists can prescribe the best exercises and treatments for hamstring strains.
Many sports physical therapists also speed up healing by providing massage and manual therapy, which do a better job of targeting the trigger point than any self-massage techniques.
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Home treatment for hamstring strains is tricky. It is tough to determine why you suffered the strain to begin with, which exercises will help you the most, and how to resume sport without risking reinjury.
We will identify what caused your injury and will provide you with proven treatment plans, including massage and manual therapy, to get you back in the game ASAP with strong and healthy hamstrings.
Click here or give us a call at 877-758-9404 to inquire about our top-rated physical therapy clinic and book an appointment.