Dealing with Hamstring Strains

The hamstring muscles run down the back of the leg from the pelvis to the back of your knee. Hamstring injuries are common in sports involving sprinting, especially hockey and football. An injury can range from minor strains to total rupture of the muscle. Early treatment of a pulled hamstring can help to speed recovery and minimize the symptoms.


  • A sudden sharp pain at the back of the leg during exercise, most probably during sprinting.
  • Pain on stretching the muscle.
  • Pain on contracting the muscle against resistance.
  • Swelling and bruising.
  • If the rupture is severe a gap in the muscle may be felt.

Severity of a Pulled Hamstring:

Strains are graded 1, 2 or 3 depending on severity. Grade 1 consists of minor tears within the muscle. A grade 2 is a partial tear in the muscle and grade 3 is a severe or complete rupture of the muscle.

Grade 1: What does it feel like?

  • May have tightness in the back of the thigh.
  • Probably able to walk normally however will be aware of some discomfort.
  • Minimal swelling.
  • Little if any pain on resisted knee bending.

Grade 2: What does it feel like?

  • Walking will be affected, limp may be present.
  • Occasional sudden twinges of pain during activity.
  • May notice swelling.
  • Site of tear will feel tender to touch.
  • Flexing the knee against resistance causes pain.
  • Might be unable to fully straighten the knee.

Grade 3: What does it feel like?

  • Walking severely affected, may need walking aids such as crutches.
  • Severe pain particularly during activity such as knee flexion.
  • Noticeable swelling visible immediately.

Acute Management

It is vitally important that treatment for a pulled hamstring starts immediately following injury. The most important phase for treatment is the first 48 hours post-injury. Early management will have you back on the field faster. Suggestions for immediate treatment of a pulled hamstring include:

  • Stop your activity.
  • Rest the injured leg.
  • Use icepacks every two hours, applied for 15 minutes.
  • Bandage the thigh firmly with an elasticized bandage.
  • Elevate the leg above heart height whenever possible.
  • Avoid exercise, heat, alcohol and massage in the first 48 hours, as these can all exacerbate swelling.

Professional help

If the pain from a grade 1 hamstring tear that you are managing yourself has not improved after a day or so, or it is a more severe grade 2 or 3 tear, it is best to seek medical advice and consult with a physiotherapist or health care provider to get an accurate diagnosis of the injury and suggest the most appropriate treatment plan.

Physiotherapy provides rehabilitation and support

Physiotherapy treatment will depend upon the severity of the injury. Treatments may include:

  • Hands on therapy for damaged tissues. Soft tissue therapy is excellent for reducing inappropriate scar adhesions while promoting faster healing conditions.
  • Rehabilitation and strengthening exercises are used to rebuild the strength of the injured muscle in order to prevent re-injury.
  • A stretching program can be started as soon as the pain and swelling subsides to encourage full range of pain-free movement.
  • A core stability retraining program is highly recommended.
  • Correction of any predisposing biomechanical misalignments (e.g. excessive forward pelvic tilt) and muscle imbalances.
  • Provide mobility aids such as crutches

Preventing a pulled hamstring

Suggestions to prevent hamstring strains:

  • One of the most important methods of preventing a pulled hamstring is to warm up. This should consist of some light aerobic exercise followed by dynamic stretching (stretching while moving) and sports specific drills.
  • Consult your physiotherapist for hamstring strengthening exercises.
  • Include hamstring stretches in your workout routine.

This information is provided to Sutherland Shire Football Association by Jubilee Sports Physiotherapy as part of its commitment to Shire football and the SSFA.

Information Supplied by Jubilee Sports Physiotherapy

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