Sports medicine specialists have reported that 20% of athletes have missed a practice or game due to a hamstring injury. Of all hamstring injuries, nearly 18% were recurring injuries. Hamstring strains are one of the most common injuries that medical professionals treat. Today, we are going to discuss what the hamstring is, its causes and symptoms of injury, as well as common treatments.

What is a Hamstring?

The hamstring is made of the muscles that run along the back of the thigh. Three main muscles make up the hamstring: biceps femoris, semitendinosus, and semimembranosus. These muscles assist in bending the knee and extending the hip. The hamstring muscles are used the most with activities like running, jumping, and climbing.

What Causes Hamstring Injuries?

A hamstring strain, or tear, happens when there is a sudden, powerful movement that overextends the hamstring muscles. Although commonly associated with jumping and sprinting, a strain can occur with slower movements like stretching as well.

Once the hamstring has been injured, it becomes susceptible to future injuries. Other factors such as age, fatigue, and poor fitness also increase the risk of injury.

Symptoms of a Hamstring Injury

When diagnosing a hamstring injury, it is important to note that there are three grades of injury.

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  • Grade 1: Mild Muscle Strain
  • Grade 2: Partial Muscle Tear
  • Grade 3: Complete Muscle Tear

A partial tear is also known as an incomplete tear because the muscle is only slightly torn. A complete tear is when the muscle has been separated into two distinct pieces.

Symptoms can vary by grade, although there are symptoms that overlap.

Grade 1: Mild Muscle Strain

  • Sudden Back of Thigh Pain
  • Difficult to Move Leg

Grad 2: Partial Muscle Tear

  • Increased Pain
  • Swelling and Bruising
  • Loss of Strength in Leg

Grade 3: Complete Muscle Tear

  • Severe Pain
  • Tenderness
  • Swelling and Bruising
  • Popping Sensation when Injured

Some people may also experience a knot in the thigh area, muscle spasms, and muscle stiffness.

Diagnosing a Hamstring Injury

The first thing your medical professional will want to check for is swelling and tenderness along the back of the thigh. Diagnosing a hamstring injury is based on where the pain is located and how severe the pain is. Once the provider completes the physical exam they may put in orders for one of the following diagnostic tests.


X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs. This is a quick, painless test that is used to check for fractures.


Ultrasound diagnostics, or sonography, is an imaging method that uses sound waves to produce images of internal structures. It can also show tears in the tendons and muscles.

The ultrasound probe can be angled in different ways thus allowing doctors to evaluate each muscle at various angles. Ultrasounds are a great alternative diagnostic exam for people who can not undergo an MRI.


The last test is known as magnetic resonance imagining or MRI. This procedure uses a magnetic field and radio waves to form detailed images of the tendons and muscles. It is also able to see joint abnormalities, bone infections, and even tumors in the bone and tissues.

Treatment for a Hamstring Injury

Depending on the severity of the injury, will depend on which treatments your medical professional will want to begin. The first forty-eight hours post-injury are the most important. It is recommended to begin using the RICE therapy as soon as possible: rest, ice, compression, and elevation.

  • Rest – rest the leg as much as possible.
  • Ice – apply ice packs to the injured site in 20-minute increments.
  • Compression – use a compression bandage to limit swelling and movement. An elastic bandage can be found at the pharmacy.
  • Elevation – keep the leg raised and supported by a pillow as much as possible to help reduce swelling.

Home Remedies

Once you have started using RICE therapy there are a few other at-home remedies to try.

  • Take Anti-Inflammatory Drugs (NSAIDs)
  • Reduce Activities that Involve the Injured Site
  • Gentle Stretching and Range of Motion Exercises
  • Use Crutches

Physical Therapy and Surgery

The last two treatment options are physical therapy and surgery. If physical therapy is recommended then a physical therapist will work with you on stretching and strengthening exercises. It is important to practice gentle stretches when recovering from a pulled hamstring. These exercises will work to strengthen your muscles and reduce the likelihood of re-injury.

Surgery will always be a last resort. Typically, physical therapy can treat grade 1 and 2 injuries. However, if you have a grade 2 (partial tear) that physical therapy is not helping, then surgery may be needed. Most grade 3 (complete tears) tears require surgery to reconnect the muscles.

Hamstring Injury Prevention

There are a few ways to prevent recurring hamstring injuries. The best form of prevention is to warm up before and stretch after any physical activity. Also, when increasing the intensity of workouts, be sure to increase activity slowly. It is recommended to only increase workouts by 10% intensity each week.

Maintaining a healthy diet and workout routine is key to preventing injuries. If you are exercising and feel pain in a pre-injured hamstring, stop exercising immediately. The pain could be caused by the increased intensity or because there has been further damage made to the hamstring.

It is best to consult a medical professional before starting a new workout routine. If you are experiencing pain in an injury site, you will want to reach out to your physician to be evaluated.

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