Hamstring Strain and Hamstring Injury Treatment

Discover the causes behind Hamstring Injury, and what you can do to treat it and prevent it.

by Brad Walker | First Published April 15, 2001 | Updated September 11, 2017

The hamstring muscles are very susceptible to tears, strains and other common sporting injuries. Athletes particularly vulnerable to hamstring injury are competitors involved in sports that require a high degree of speed, power and agility. Sports such as Track & Field (especially the sprinting events) and other sports such as soccer, basketball, tennis and football seem to have more than their fair share of hamstring injuries.

If you suffer from hamstring strain or are seeking to prevent its occurrence it is important to follow the information in this article. In addition, adding a few simple stretches to your fitness program will also help. To get started on a safe and effective stretching routine that’s just right for you, check out the Ultimate Guide to Stretching & Flexibility.

What is Hamstring Injury?

A hamstring injury or strain is an injury that results from a pulling action, which stretches or tears the hamstring muscles and/or tendons. (The term sPrain refers to an injury of the ligaments, as opposed to a sTrain, which refers to an injury of the muscle or tendon.) Remember; ligaments attach bone to bone, were as tendons attach muscle to bone.

Injuries to the muscles and tendons of the hamstrings are usually graded into three categories, and these injuries are referred to as: first; second; or third degree strains.

A first degree strain is the least severe. It is the result of some minor stretching of the muscles and tendons, and is accompanied by mild pain, some swelling and stiffness. There is usually very little loss of function as a result of a first degree strain.

A second degree strain is the result of both stretching and some tearing of the muscles and tendons. There is increased swelling and pain associated with a second degree strain, and a moderate loss of function.

A third degree strain is the most severe of the three. A third degree strain is the result of a complete tear or rupture of one or more of the muscles and tendons. A third degree strain will result in massive swelling, severe pain and gross instability.

Hamstring Anatomy

The hamstring group of muscles, located at the back of the upper leg, are actually a group of three separate muscles. The top of these muscles are attached to the lower part of the pelvis, and the bottom of the hamstring muscles are attached to the lower leg bone just below the knee joint.

The technical or anatomical names for the three hamstring muscles are semimembranosus, semitendinosus and biceps femoris.

The picture to the right shows the muscles located at the rear of the upper right leg. The three specific hamstring muscles can be seen on the picture, by looking for the anatomical names located half way down the right hand side.

Hamstring Muscle Group picture used from Principles of Anatomy and Physiology

What Causes Hamstring Injury?

Now that we know exactly what and where the hamstrings are, let’s take a look at some of the most common causes for hamstring injuries. By far the most common cause of hamstring injuries originates from an imbalance between the quadriceps muscles (located at the front of the upper leg) and the hamstring muscles.

The quadriceps are a very large, strong group of muscles that help to extend the leg. These muscles can become so strong that they overpower the hamstrings, putting a massive amount of tension on the hamstring muscles. Combine strong quadriceps with weak hamstrings and you have a hamstring injury waiting to happen.

Other factors that contribute to hamstring injuries are a lack of flexibility and poor strength of the hamstring muscles. Also, when the hamstrings become fatigued or tired they are more susceptible to injuries.

Treating Hamstring Injury

If you do happen to suffer from a hamstring injury, it’s important that correct first aid principles are applied immediately. The RICER regimen explains the correct treatment for all muscle strain injuries. RICER stands for Rest, Ice, Compression, Elevation, and then obtaining a Referral from a qualified sports doctor or physiotherapist. So, as soon as a hamstring injury occurs, rest the injured limb, apply ice to the affected area, apply a compression bandage and elevate the limb if possible.

This treatment needs to continue for at least 48 to 72 hours. This is the most critical time for the injured area; correct treatment now can mean the difference between an annoying injury and a permanent, re-occurring, debilitating injury.

After the first 72 hours obtain a referral from a qualified professional and start a comprehensive rehabilitation program. This should include a great deal of strength and hamstring stretching exercises, as well as other rehabilitation activities such as massage and ultra-sound.

Preventing Hamstring Injury

Mark my words, “Prevention is much better than Cure.” Anything you can do to prevent an injury from occurring is worth it. The prevention of hamstring injury comes down to the conditioning of the hamstring muscles and tendons, which ultimately involves both stretching and strengthening.

But don’t forget common injury prevention techniques like, warming up properly and using a bit of old-fashioned common-sense. Even if you don’t have a hamstring problem now, the following suggestions will be helpful.

  • A general warm up, followed by an activity specific warm up, will help reduce the likelihood of hamstring injury.
  • Reducing the frequency of, or stopping completely, any activities that aggravate the hamstring.
  • Completely rehabilitating a hamstring injury before returning to activity.
  • Rest in between training sessions or competition allows the body to heal the minor injuries and repair the muscles to be ready for the next round of activity. Rest is the time that the body uses to repair and rebuild.

The best preventative measures however, involve a consistent program of both stretching and strengthening exercises. Increasing flexibility, with regular hamstring stretches, will contribute greatly to the ability of the hamstring muscles to resist strains and injury. To follow are two very effective and very safe hamstring stretches.

Kneeling hamstring stretch

Kneeling Hamstring Stretch: Kneel down on one knee and place your other leg straight out in front with your heel on the ground. Keep your back straight. Make sure your toes are pointing straight up and gently reach towards your toes with one hand. Use your other arm for balance. Hold this stretch for about 20 to 30 seconds and repeat at least 2 to 3 times.

Standing leg up hamstring stretch

Standing Leg-up Hamstring Stretch: Stand with one foot raised onto a chair, fence railing or similar object. Keep your raised leg slightly bent, with your toes on the edge of the chair. Let your heel drop off the edge of the chair. Keep your back straight and gently move your chest towards your raised leg. As above, hold this stretch for about 20 to 30 seconds and repeat at least 2 to 3 times.

The Stretching Handbook, DVD & CD-ROMWhile the recommendations on this page are a good starting point, you'll get a lot more benefit when you include a wider variety of stretches.

To do away with stiff, tight muscles and joints, and become loose, limber and pain free, grab a copy of the Ultimate Stretching Video & Book Guide.

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Get back to the activities you love. Whether it’s enjoying your favorite sport, or walking the dog, or playing with the grand kids. Imagine getting out of bed in the morning with a spring in your step. Or being able to work in the garden or play your favorite sport without “paying-for-it” the next day.

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Brad Walker - AKA The Stretch CoachAbout the Author: Brad is often referred to as the "Stretch Coach" and has even been called the Stretching Guru. Magazines such as Runners World, Bicycling, Triathlete, Swimming & Fitness, and Triathlon Sports have all featured his work. Amazon has listed his books on five Best-Seller lists. Google cites over 100,000 references to him and his work on the internet. And satisfied customers from 122 countries have sent 100's of testimonials. If you want to know about stretching, flexibility or sports injury management, Brad Walker is the go-to-guy.