The three muscles that run along the back of your thigh are called your hamstrings. Their function is to bend and straighten the knee. A hamstring strain is an injury caused by overloading one or more of these muscles, which can cause tearing in the muscle or at the point where it attaches to the tendon.
There are three grades of hamstring strain, depending on the severity of the injury. A grade 1 strain is a pulled muscle and is the most mild form of hamstring strain. A grade 2 injury is a partial tear of the hamstring, while a grade 3 injury is where you have completely torn your hamstring or if the tendon has pulled away from part of the bone (referred to as an avulsion). While a grade 1 strain may cause mild pain or discomfort, a grade 3 hamstring strain is extremely painful and you may find it impossible to walk or even stand with this type of injury.
Causes of hamstring strains
This type of injury often occurs in sports that involve a lot of running and jumping or sudden changes of direction. Athletes of all kinds are at risk, but hamstring strains are particularly common in sports like football, rugby and soccer, as well as any kind of running or jumping activities.
Symptoms of hamstring strains
The severity of symptoms may vary, depending on how badly you strain your hamstring. Typical symptoms include sudden or severe pain at the back of the thigh and lower buttocks which may worsen when you walk, bend or straighten your leg. You may experience a snapping or popping sensation and the affected area may be tender or bruised. If you have a severe strain, you may find it difficult to walk or even stand.
Diagnosing hamstring strains
If you suspect you may have strained your hamstrings, it’s important to seek medical advice. This will help to determine the extent of the injury and the best way to treat it. Your doctor will carry out a physical examination and check for signs of bruising, tenderness, swelling and pain. You may need an X-ray to ascertain if you have an avulsion (where the tendon has been torn away from the bone). An MRI scan may be used to determine the extent of any damage to the muscles.
Treating hamstring strains
Most mild hamstring strains heal by themselves without requiring surgery. The RICE method is recommended to speed your recovery. This involves:
- Rest – avoid putting any unnecessary weight on the affected leg. If you have a severe strain, you may need crutches to help you get around until it heals.
- Ice – use a bag of frozen peas or some ice cubes in a plastic bag to reduce pain and swelling. We recommend doing this for 20 minutes at a time every few hours but don’t apply ice directly to the skin.
- Compression – wearing an elasticated bandage can help to reduce swelling.
- Elevate your leg – when you are sitting or lying down, elevating your leg above the level of your heart also helps to bring down swelling.
Painkillers and anti-inflammatories can help you to manage the pain and discomfort and wearing a knee brace can help to keep your leg in a neutral position to avoid straining the muscles any more. A physiotherapist will recommend exercises to stretch out your hamstrings and build strength to support your recovery and prevent future injuries. You should start slowly and build up. Once you feel able to, gentle exercise such as walking can also help you to regain strength and mobility.
For the most severe hamstring strains, surgery may be needed to reattach the tendon to the bone. This involves making an incision along the buttock fold and fixing the end of the tendon or muscle back into place using stitches and bone anchors. After surgery, you will need to wear a brace to keep your knee in a bent position for up to six weeks. You may need to use a mobility scooter during this time as you will be unable to straighten your leg.
Recovering from hamstring strains
Most mild strains recover within a few days but more serious hamstring strains can take weeks or even months to fully heal. It is important not to try and rush your recovery as doing too much too soon can re-injure the hamstring and may result in more serious or long-term damage.
Preventing hamstring strains
If you participate in sport, it’s important to be aware of the risk of hamstring strains and to take steps to reduce your susceptibility. Always warm up properly before exercise, including doing stretching and strengthening exercises targeting your hamstrings. Build up the intensity of your workout gradually (around a 10% increase per week is ideal). Consider having professional coaching to ensure you are using good technique. Always stop exercising if you experience pain in the back of your thigh as continuing can result in a more severe strain.
We specialise in all types of sports-related injuries. Contact us for advice on diagnosing, treating and preventing hamstring strains.
