Hamstring Strains

The hamstring muscles are a muscle group at the back of the thigh. They work on both the hip and the knee joint. If they are overstretched they will tear. Hamstring strains are common in running and field sports. Like all muscles strains physiotherapists will classify them as first degree , second degree and third degree stains.

Chronic overuse of the hamstring muscle group can result in a tendinitis. With this the onset is more gradual and weakness may be less obvious. Activities such as sitting on a hard chair can provoke pain. This condition often takes 4-6 weeks to get symptom relief and up to 12 weeks to restore painfree function.

Risk factors for hamstring strains/ tendonitis/tendinopathy

  • Previous hamstring injury [approximately 1/3 of hamstring strains are recurrent.]
  • Muscle weakness [ if gluts and /or core muscles are weak this can cause hamstrings to be overloaded]
  • Muscle tightness
  • Poor core muscle strength
  • Poor warm up
  • Hill running
  • Sudden increase in kicking practice in footballers [ especially if done at end of a training session when the muscle may be tired to start with]
  • Muscle imbalances
  • Runners who “over stride”
  1. First degree hamstring strain. This is a mild tear with only a small level of discomfort, minimal swelling and bruising. It will get better with R.I.C.E. but may not regain full flexibility and strength without physiotherapy. Many first degree strains left untreated will become re-injured upon return to running.
  2. Second degree hamstring strain. This is a moderately severe tear of the muscle. There will be significant discomfort and noticeable weakness. Bruising can be quite dramatic. Physiotherapy is essential to restore muscle strength and flexibility.Most hamstring injuries we treat at swords physiotherapy are in this group.
  3. Third degree hamstring strain. This is a severe tear in the muscle . Patient will have significant pain and will be unable to walk. Fortunately these are uncommon. The patient will require significant time off sport and require lots of rehabilitation.

Until your injury has been assessed and for the first 48 hours you should follow the R.I.C.E. principle. This will minimise swelling and facilitate a speedier recovery with fewer complications.

  • REST: do not use the affected joint.
  • ICE: for 10 minutes at a time as often as possible especially in the first 24 hrs.
  • COMPRESSION: apply a firm bandage.
  • ELEVATION: raise the injured joint above the level of the heart (to help drain swelling).

In the acute [first 48 hours] stage AVOID – H.A.R.M.

Heat, Alcohol,Running, Massage

Physiotherapy will restore full pain-free stretch and strength in the injured muscle. Early treatment is vital because if bleeding is unchecked a large amount of swelling can occur, leading to a much more extensive area of scarred tissue (hard inflexible scab like tissue). This will then need to be treated prolonging recovery time considerably.

Initially physiotherapy treatment will aim to decrease pain and swelling using electrotherapy (ultrasound and interferential) and the R.I.C.E. principle. Once bleeding/swelling has stopped, stretching and strengthening exercises will be prescribed. A detailed assessment of care, strength, general flexibility and bio-mechanics will be made to identify any possible predisposing factors (e.g. flat feet, tight hamstrings, stiff back, weak core muscle groups). A comprehensive rehab program will then be devised.

Video analysis of running or kicking technique may be indicated and physiotherapist will liaise with coaches to ensure accurate movement analysis .

sports_injuries_web. download leaflet on physiotherapy and sports injuries here.

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