Have you ever felt a sharp pain shooting through the back of your thigh? This is when your leg gives way and you’re left hobbling and wondering if you’ll be able to make it up the stairs to your flat. If this scene sounds familiar, then you probably need therapy for hamstring strain.
Hamstring Strain Explained
Your hamstring is three muscles running down the back of your thigh from your bottom to below your knee. These muscles help you bend your knee and straighten your hip, which means you use them in nearly every movement from walking to running to simply sitting down. When you sprint or suddenly stretch these muscles too far, they can tear just like fabric that’s been pulled too tight.
Hamstring injuries comprise 10% of all injuries in field-based team sports, making them one of the most common sporting injuries sports physiotherapists treat. Young adults are particularly vulnerable, with studies showing hamstring injury peaks at 16 to 25 years of age.
These injuries come in three levels of severity. With a mild strain, you’ll feel pain but can usually still walk. A moderate tear brings more pain, some swelling and bruising, making walking uncomfortable. A severe tear can be so painful, causing swelling, bruising, and making it nearly impossible to put weight on your leg.
What to Do When Your Experience Hamstring Strain
Immediate Treatment (First 72 Hours)
Early therapy for hamstring strain starts with the RICE protocol:
- Rest your injured leg without complete immobilisation (gentle movement within pain-free ranges actually promotes healing)
- Ice the area for 15-20 minutes every few hours to reduce inflammation
- Compress with an elastic bandage to limit swelling
- Elevate your leg when possible
Over-the-counter anti-inflammatory medications can greatly help for pain management. However, use them judiciously as they may potentially slow aspects of early healing. Even in these early days of therapy for hamstring strain, gentle movement within pain-free ranges prevents stiffness and muscle atrophy. Simple ankle pumps and gentle knee bends while lying down maintain circulation without stressing the injured tissue.
For moderate to severe strains, you might need crutches at first. Seek medical attention promptly if you cannot bear weight, have severe pain or swelling, or experience numbness or tingling in your leg.
Early Rehabilitation Phase (Days 3-14)
Therapy for hamstring strain focuses on restoring normal movement while protecting healing tissue. Perform a gentle range of motion exercises. Lie on your back and use your other leg or a towel to assist the injured leg through pain-free knee bends. Then, introduce isometric contractions. Static muscle contractions without movement can be done by pressing your heel gently into the floor while seated.
Additionally, pay attention to your walking pattern. Aim for normal gait even if slower and avoid limping since this creates compensatory movements that can lead to secondary problems. Light stationary cycling with minimal resistance helps maintain fitness while promoting blood flow to the healing hamstring.
Your pain should gradually decrease as you regain the ability to walk normally. If pain persists or increases, scale back activities and consult your doctor or healthcare provider.
Intermediate Rehabilitation (Weeks 2-6)
During this phase, therapy for hamstring strain focuses on rebuilding strength and flexibility in a controlled manner. Begin progressive resistance training with lightweight hamstring curls, gradually increasing resistance as strength improves. Quality of movement matters more than resistance. Focus on smooth, controlled motions without compensation.
Introduce eccentric strengthening exercises that lengthen the muscle under tension. Start with assisted eccentric slides: Lie on your back with heels on sliders or towels, and slowly straighten and bend your knees to teach your hamstring to handle elongation forces safely.
Additionally, add balance exercises to restore your body’s position. It also helps to strengthen your core and gluteal muscles to support the hamstring and distribute load more effectively throughout the kinetic chain. When this phase of therapy for hamstring strain ends, you should have minimal pain with daily activities and perform controlled strengthening exercises with good form.
Advanced Rehabilitation (Weeks 6-12)
The last phase of therapy for hamstring strain prepares you for full return to previous activities by introducing more dynamic movements. Reintroduce specific movements required for your sport or regular activities, starting slowly and progressing in intensity. You can also add controlled jumping and hopping exercises to restore power and confidence.
Next, develop a structured running progression, starting with alternating short jogging intervals with walking recovery. Little by little, increase jogging duration and eventually add direction changes and sprinting when ready. Introduce high-speed eccentric training like Nordic hamstring lowers to build resilience against future injuries.
The reinjury rate for hamstring strains can be as high as 22-34%, which is why completing proper rehabilitation is absolutely essential before returning to full activity. Each reinjury typically results in more severe damage and longer recovery times.
Before concluding therapy for hamstring strain and returning to full activity, perform functional tests that mimic the demands of your sport to ensure readiness.You should achieve nearly full strength and flexibility, along with confidence in your hamstring’s ability to handle your demands after this phase.
Mental Wellbeing During Rehabilitation
Many patients experience frustration when they cannot participate in their regular activities. This feeling often intensifies around the two-week mark when initial improvement slows but complete recovery remains distant.
Setting small, achievable weekly goals helps maintain a positive outlook during recovery. Focus on celebrating minor achievements like walking without pain or completing new exercises.
Some patients also keep a recovery journal. This is beneficial for tracking improvements that might otherwise go unnoticed. Consider using this rehabilitation period to develop other skills while your hamstring heals. Working on upper body strength, trying meditation, or pursuing other interests can make the recovery journey feel more productive.
Common Setbacks You Might Encounter
Persistent Tightness
People with hamstring pain might report ongoing tightness even after pain subsides. This sensation of muscle tension can remain for months following the initial injury. Rather than aggressive stretching, which often worsens the problem, incorporate gentle, frequent movement throughout your day.
Heat therapy before light stretching typically works more effectively than stretching alone because warm muscles respond better to lengthening. If you sit for extended periods during work, stand and move gently every 30 minutes, as prolonged sitting particularly hampers hamstring recovery.
Returning Too Soon
The hamstring often feels recovered before it truly regains full strength and elasticity, particularly with moderate injuries.
Make sure you can complete all rehabilitation exercises with proper form and without pain before attempting to return to sport. Begin at approximately 50% intensity, increasing by 10-15% each week if no symptoms return. This reduces re-injury rates significantly, despite feeling slower than desired.
Compensatory Movement Patterns
After injury, your body naturally adapts to avoid stressing the injured area. Compensations such as shifting weight to your uninjured leg or altering your body mechanics can persist unconsciously even after healing. Such adaptations frequently create secondary issues in your knees, hips, or lower back.
Aside from therapy for hamstring strain, consider having your movement patterns assessed during exercise to identify these compensations. Focus on movement quality rather than quantity in every exercise. A physiotherapist can help identify and correct subtle compensations you might overlook.
How to Prevent More Injury
Warm-Up
Inadequate warm-up contributes to nearly half of all hamstring re-injuries. Your muscles need proper preparation before demanding activities. Holistic therapy for hamstring strain should include education about proper warm-up techniques that become lifelong habits.
Begin with 5-10 minutes of light cardiovascular exercise such as jogging or cycling to increase blood flow and muscle temperature. Follow with dynamic stretching that resembles the activities you plan to perform.
For example, controlled leg swings prepare your hamstrings for running more effectively than static stretches. Gradually increase activity intensity rather than immediately attempting maximum effort. A thorough warm-up requires about 15 minutes but significantly reduces re-injury risk.
Muscle Balance
Muscle imbalances frequently lead to hamstring injuries and often remain uncorrected after rehabilitation. Your hamstrings should maintain approximately 60-70% of your quadriceps strength for optimal function and injury prevention. Include hamstring-strengthening exercises like Nordic curls, Romanian deadlifts, and single-leg bridges in your regular fitness routine, especially if you spend considerable time sitting.
Movement Technique
Your movement patterns significantly impact hamstring injury prevention. For sports involving sprinting and direction changes, learning proper deceleration by lowering your hips and taking shorter steps reduces hamstring loading. In daily activities, practising hip-hinging movements rather than bending from the waist when lifting protects your hamstrings from unnecessary strain. These adjustments initially require conscious practice but eventually become automatic. This gives you protection against future injuries.
The Bottom Line
Recovery from a hamstring injury requires understanding your body and respecting the healing process. Successful therapy for hamstring strain addresses both the immediate injury and also the underlying factors that contributed to it. Contact us for a dedicated personalised rehabilitation plan for you.
