• Hamstrings Strain

    (Pulled Hamstrings)


    A hamstring strain is an injury to the muscles in the back of the thigh. These muscles run from above the hip to the knee joint. A strain is a series of small tears in the muscle. The tendon attached to the muscle may also have some damage.
    Posterior Thigh Muscles
    Posterior Thigh Muscles
    Copyright © Nucleus Medical Media, Inc.


    A hamstring strain can be caused by:
    • Stretching the muscle too fast and/or too far
    • Suddenly putting stress on the muscles when they are not ready for the stress

    Risk Factors

    Factors that may increase your chance of getting hamstring strain include:
    • Participation in sports that require bursts of speed. This includes track sports like running, hurdles, or long jump. Other sports include basketball, soccer, football, or rugby.
    • Previous hamstring injury
    • Fatigue
    • Overexertion
    • Tight hamstrings
    • Imbalance of hamstring and opposing quadriceps muscle strength
    • A direct blow to the muscles


    Symptoms may include:
    • Pain and tenderness in the back of the thigh
    • Stiffness in the hamstrings
    • Weakness in the hamstrings
    • Bruising on the back of the thigh, if blood vessels are broken
    • Popping or snapping sensation as the muscle tears


    You will be asked about your symptoms and medical history. A physical exam will be done.
    Most hamstring strains can be diagnosed with a physical exam. Images may be needed if severe damage is suspected. Images may be taken with MRI scan .
    Muscle strains are graded according to their severity:
    • Grade 1—Some stretching with micro-tearing of muscle fibers
    • Grade 2—Partial tearing of muscle fibers
    • Grade 3—Complete tearing of muscle fibers; this may also be called a rupture or avulsion


    Talk with your doctor about the best treatment plan for you. Treatment depends on the severity of the strain. Recovery time ranges depending on the grade of your injury. Treatment steps may include:

    Supportive Care

    Your muscles will need time to heal. RICE is often the main part of treatment:
    • Rest—Activities will need to be restricted at first. Normal activities will be reintroduced gradually.
    • Ice—Ice therapy may help relieve swelling. Heat or cold may be advised throughout recovery if they provide benefits.
    • Compression—Used for a limited time, compression bandages can provide gentle pressure to help move fluids out of the area.
    • Elevation—Keeping the area elevated can help fluids drain out or prevent fluids from building up.
    Prescription or over-the-counter medications may be advised to reduce pain.


    To reduce the chance that you will strain your hamstrings:
    • Keep your hamstrings strong so they can absorb the energy of sudden physical stress.
    • Learn the proper technique for exercise and sporting activities. This will decrease stress on all your muscles, including your hamstrings.
    • Warm up and stretch before vigorous activity.


    American Council on Exercise http://www.acefitness.org

    Family Doctor—American Academy of Family Physicians http://www.familydoctor.org


    Health Canada http://www.hc-sc.gc.ca

    Healthy U http://www.healthyalberta.com


    Hamstring muscle injuries. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00408. Updated July 2009. Accessed March 10, 2015.

    Hamstring strain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated October 28, 2014. Accessed March 10, 2015.

    Heiderscheit BC, Sherry MA, et al. Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention. J Orthop Sports Phys Ther. 2010;40(2):67-81.

    Mendiguchia J, Brughelli M. A return-to-sport algorithm for acute hamstring injuries. Phys Ther Sport. 2011;12(1):2-14.

    Mendiguchia J, Alentorn-Geli E, Brughelli M. Hamstring strain injuries: are we heading in the right direction? Br J Sports Med. 2012;46(2):81-85.

    10/26/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

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