I think I pulled my hamstring…now what?
You’re outside, enjoying the weather, playing with your kids. Warmer days are finally here. School is almost done. Your summer vacation is on your mind. The kids are running around you, laughing, as you try to reach out and grab them as you sprint after them. That’s when you feel it.
Pain shoots up your leg, and you have to limp inside the house to get off your feet. Play time is over. The kids are disappointed. You’re in pain. Your summer vacation to the beach suddenly doesn’t sound so fun as you picture yourself limping through the sand.
You know you need to get your leg fixed QUICK. The problem is, you’re not sure what happened. You wonder…
How do I know if I have a hamstring strain?
Pulling a hamstring means that a portion of your hamstring muscle has torn. There are actually different grades of tears from micro tears (grade 1) to a complete tear (grade 3). Hamstring strains are most likely to occur when a person is sprinting, jumping, or kicking, but these activities might not be the sole source of your pain. Tears are the result of overuse, fatigue, poor technique, or simply lifting too much weight.
When a hamstring strain occurs, a person typically feels a sudden pop or tearing pain in the back of the thigh muscle. This makes walking and other basic daily activities extremely difficult. Within 24-48 hours after pulling a hamstring, you may notice swelling and even bruising around the site of the injury, which may last up to 1-2 weeks. You might also notice stiffness and weakness in your hamstring which prevents you from running or playing any kind of sport that requires sprinting or quick movements; this feeling of weakness can last for up to 3-4 weeks.
So, if you felt a pop and/or tear in the back of your thigh and find your leg weak, swollen, and bruised shortly after, you just might have a hamstring strain.
How long does it take for a hamstring injury to heal?
Most hamstring injuries resolve themselves within 5-6 weeks. After this point, you can go back to your favorite sports and recreational activities without any long-lasting issues. Keep in mind that everyone’s recovery time is different: pain levels at the time of injury, how tender the area is, and the number of days it takes to walk pain free after pulling your hamstring are good indicators as to how long it will take for a complete recovery.
How can I treat my hamstring injury?
Phase 1: RICE
- Rest the muscle as much as you can.
- Ice the muscle to decrease inflammation and pain.
- Compress the muscle by wearing compression gear or an ace bandage.
- Elevate your limb while resting.
Apply the ice for 20 minutes at a time, 3-4 times per day. I recommend also using an Ace wrap for compression and comfort while walking. You can use NSAID pain relievers, but check with your doctor first as to what medication is best for you, personally, to use for pain and swelling.
Phase 2: Strength, Stretching, and Core Activation
As your pain subsides, you will want to help your muscle heal. Massaging the area of the tear is helpful. Neural mobilization is what I recommend, but a manually trained physical therapist is needed for this. However, let’s stick with some exercises you can do at home, starting with what we call isometric exercises, and then progressing to eccentric exercises.
- Isometric Hamstring Bridge: Begin lying on your back with both knees bent at about a 20-degree angle with your feet resting on a chair or bench. Lift your buttocks off the floor while straightening your hips. Hold this for 5-10 seconds, and then slowly lower your back to the floor. Repeat. As you get stronger, try only having your injured leg up on the chair with your health leg lying on the floor.
- Eccentric Nordic Hamstring: Kneel on a soft surface with your body upright and hips straight. This exercise works best if you have someone to hold onto your ankles to steady you, but if you have something steady to hold your ankles, that works too. Keeping your spine straight, slowly lower your chest toward the floor. Use your arms to break your fall when you can no longer control the movement of your upper body. Use your arms to propel yourself back to the starting position. Perform 6-12 reps. Start with 1 set of reps, and then progress to 3 sets, completing them 2-3 times per week.
- Trunk Stability: Perform a lateral plank hold to increase your trunk stability thereby increasing hamstring stability. By working on both areas of the body, you will lessen the chance of re-injury. To perform a side plank, lie down on your side on the floor. With your arm directly under your shoulder, push your upper body and hips off the floor. Stack your feet on top of each other. Hold as long as you can. Repeat on the other side.
Phase 3: Agility Drills
Now that you’ve gained strength, it’s time to start introducing drills and sports with specific movements to help that hamstring heal. These drills are really anything that gets you up, moving, and running/jumping/kicking. An example would be: running backwards, an agility ladder, box jumps, etc.
Should I stretch after a hamstring injury?
Yes, but timing is everything here! Don’t start stretching until the pain in your thigh is mild or almost gone. A simple warm up on a stationary bike or going for a walk can allow your muscle to warm up, which will make stretching easier.
There are two types of stretching you should work on: static and dynamic. Static stretching is where you move gently into a stretch and hold it for thirty seconds. Repeat this about three times. A dynamic stretch is where you use active movement to stretch your muscles with activities such as leg kicks.
(image source: https://yurielkaim.com/dynamic-warm-up-exercises/)
What puts me at risk for a hamstring strain?
- Previous hamstring injury
- If you’re over the age of 23
- Previous ACL injury
- Calf strain
- Previous ankle or knee injuries
- Poor core strength
When can I return to my favorite sport or recreational activity after a hamstring strain?
The key here is DO NOT RUSH! Sometimes healing can take weeks, or even months. Slow and steady rehabilitation will increase your chances of returning to your favorite activities without changes of re-injury.
Before you get back to those activities make sure you have…
- NO pain
- Full movement of your leg
- Full strength
Should I see a physical therapist for my hamstring strain?
YES! By consulting with a specialist physical therapist, you can be confident that you are doing the exercises correctly while getting the hands-on manual therapy you need to get back to the activities you love doing, pain free without any worry about injuring yourself again.
At Move Empower Concierge Physical Therapy, our therapists specialize in the treatment of sports-related injuries, and we LOVE helping folks get back to their favorite activities.
Are you worried you might have pulled your hamstring?
Are you constantly frustrated by that nagging pain in the back of your thigh?
Are those exercises you found on YouTube no longer helping?
Take advantage of a FREE 20-minute phone consultation with a sports physical therapist to learn why you’re in pain, how to get rid of it, and how to make sure it does not happen again! Your summer vacation doesn’t have to be riddled with pain. We can work together to get you walking through the sand pain-free while chasing your kiddos again.