Pulled Hamstring: The Dos and Don'ts

By: Andrew Stelter DPT, CSCS

With fall sports in full swing, it is likely you or someone you know is dealing with a pulled hamstring (AKA hamstring strain) and is sidelined for a few days, weeks or even longer. Not ideal when you train all summer for your sport and aren't able to play and perform at the level you expect!

Before we dive into what you should do if you pull your hamstring, let's talk about what a hamstring strain is...

The hamstrings are a group of 3 muscles that are on the back of your thigh and connect at your pelvis and below the back of your knee. Their main job is to help extend your hips and bend your knee and are crucial for running, jumping, cutting, squatting, and many other movements that happen when playing sports. 

Hamstring strains typically occur when sprinting at max effort, during changes of direction or quick accelerations or decelerations. You may feel a "pop" or tearing sensation and then have pain with stretching or trying to flex your hamstrings. It ay also be sore to touch the muscle and you may be walking with a limp as well. 

There are different types of strains and they are ranked based on how much of the muscle is involved:

• Grade 1 Strain: These are considered mild strains and only involve a small portion of the muscle being stretched or torn. Typically there are not losses in strength and range of motion. Pain and tenderness are the only symptoms. 
• Grade 2 Strain: These are considered moderate strains and involve about half the muscle fibers being stretched or torn. These have higher levels and pain compared to grade 1 strains and have swelling and mild decreases in strength and range of motion. 
• Grade 3 Strain: These are severe strains and involve the entire muscle belly being ruptured or it is torn in 2 separate locations. There is usually severe pain (although there may be no pain if completely torn), swelling, bruising, and a complete loss of function of the muscle. 

So what should you do if you pull your hamstring?

Depending on the severity and location of the strain, recovery may take anywhere from a few days to several months. Your first consideration should be to determine the severity of the strain. I would recommend going to see a physical therapist (PT) that focuses on sports and orthopedic VS going to your primary care provider. Getting in with a PT ASAP can get you on the road to recovery faster and get you back to competing in your sport. 

A physical therapist will assess your strength, range of motion, mechanics, and other relevant factors that are involved with the injury and provide you with appropriate treatment and exercises that are specific to you and your sport. They will be able to guide your recovery journey and make appropriate adjustment as needed. 

Treatment should include manual therapy and soft tissue mobilization (foam rolling, dry needling, etc.), strength exercises addressing the entire lower extremity and core, plyometric exercises, a return to running and cutting program, and relevant sport specific activities. 

I would recommend avoiding stretching your injured hamstring early on as that may actually make the the strain worse. Optional things you can do are icing for pain relief and swelling reduction earl yon in the healing process, sciatic nerve glides, and PRP injections. 

Ways to Decrease the Risk of a Pulled Hamstring: 

• Participate consistently in a well-rounded strength and conditioning program as well as mobility program. 
• Adequately warm up before training or sporting activities.
• Increase you activity volume and intensity at an appropriate rate (Don't go from sitting on the couch for months and then try and sprint as fast as you can in practice or a game)
• Maintain adequate hydration levels (at least 8 cups of water a day, but much more is recommended for athletes)

In summary: 

• Do see a PT if you have a pulled hamstring or any other injuries, reach out to us at Inspired Athletx!
• Do not just wait to see if it gets better on its own. 

If you need help with a tweaked hamstring or any other injuries, reach out to us here at Inspired Athletx and we will get you back in the game!

Good luck this season!
Dr. Andrew Stelter DPT, CSCS

References:

J Orthop Sports Phys Ther 2022;52(3):CPG1–CPG44. doi:10.2519/jospt.2022.0301