Hamstring injuries are a common occurrence in athletes and active individuals alike. These injuries can range from mild discomfort to severe pain, and understanding the severity of a hamstring strain and how to manage it appropriately is key to effective recovery. In this blog post, we’ll break down the different grades of hamstring strains, how to manage an acute hamstring strain, and how to progress to return to sport.
What Is a Hamstring Strain?
A hamstring strain occurs when the muscles of the hamstring group—located at the back of the thigh—are overstretched or torn. This type of injury often occurs during activities that require rapid muscle contraction or sudden acceleration, such as sprinting, jumping, or heavy lifting.
Grades of Hamstring Strains
Hamstring strains are classified into three grades based on their severity. Each grade has different implications for treatment, rehabilitation, and recovery time.
Grade 1 (Mild Strain)
- Symptoms: In a Grade 1 strain, only a few muscle fibers are damaged. There may be mild discomfort or tightness in the muscle, but typically no bruising or swelling is present and there is minimal, if any, decrease in function.
Grade 2 (Moderate Strain)
- Symptoms: A Grade 2 strain involves partial tearing of muscle fibers. This can result in more significant pain, swelling, and bruising. Walking and normal daily activities may be difficult due to pain. Pain is usually present when pressing on the muscle or when bending your knee.
Grade 3 (Severe Strain)
- Symptoms: A Grade 3 strain is a complete rupture of the muscle fibers, often causing severe pain, significant bruising, swelling, and difficulty walking. In some cases, surgery may be necessary to repair the muscle.
Managing an Acute Hamstring Strain
1. Gentle Loading and Mobility
Treatment for a hamstring strain in the past typically involved rest during the initial stages to reduce irritability/inflammation. However, research has shown that early light activation of the muscle is more beneficial. This means that gentle dynamic mobility and light strengthening exercises can be introduced the day after injury, as long as they do not produce pain greater than 3/10. It would be beneficial to be evaluated by a PT to determine if these exercises are appropriate for your individual case, however, the following exercises typically are foundational exercises that would be beneficial during the acute phase.
2. Avoid anti inflammatories
It was also previously thought that icing the hamstring for the first few days after a strain was beneficial, however, research has shown that avoiding ice and other anti inflammatories is actually more beneficial. The body’s inflammatory response is designed to promote healing and ice will only slow this process. Ice should only be used if pain is at an intolerable level.
3. Compression
Using an elastic bandage or compression wrap can help control swelling. Be careful not to wrap it too tightly, as it could impede circulation.
4. Elevation
Keep the injured leg elevated above the level of the heart to help reduce swelling. Use pillows or cushions to prop up the leg while resting.
Later Phases of Hamstring Strain Rehabilitation
After the hamstring strain has transitioned out of the acute phase, it is vital to regain strength. The hamstring functions to not only bend the knee, but also extend the hip, so it is important to ensure that you are performing exercises that target both motions. Eccentric strengthening will be a priority as you want to strengthen the muscle in its lengthened position, as this is likely the position the hamstring strain occurred in. We highly recommend consulting with one of our Physical Therapists at Fick PT and Performance in order to guide you through targeted rehab tailored to your individual case, however, the following exercises are common eccentric exercises used to strengthen your hamstring.
The final stage of hamstring rehabilitation is return to sport, and including plyometrics in your training will be essential in a seamless transition back to sport. Plyometrics help restore power, strength, and explosive movement patterns essential for athletic performance. After an injury, the muscle fibers need to regain their full capacity for quick, forceful contractions, which is where plyometric exercises come into play. These exercises simulate the dynamic and high-intensity movements that athletes frequently perform during sport, such as sprinting, jumping, or cutting. By gradually introducing plyometrics into a rehab program, it helps recondition the hamstring to withstand the demands of sports-specific movements while improving neuromuscular coordination and reducing the risk of re-injury.
Conclusion
Hamstring strains can range from mild discomfort to severe tears, but with proper understanding, treatment, and rehabilitation, recovery can be swift and effective. Consult with a physical therapist for tailored guidance and rehabilitation exercises based on the severity of the strain.
At Fick PT and Performance, our physical therapists are very experienced in diagnosing and treating hamstring strains. Contact us today at (720) 480-2866 if you’re experiencing a hamstring injury and we’ll provide you with a personalized treatment plan to allow for your return to sport as quickly and safely as possible!
Research and Resources
- Askling, C. M., Tengvar, M., Saartok, T., & Larsson, H. (2007). Acute hamstring injuries in Swedish elite soccer players: the importance of muscle strength and flexibility. The American Journal of Sports Medicine, 35(2), 204-210. doi:10.1177/0363546506294195
- Croisier, J. L., Forthomme, B., Namurois, M. H., Vanderthommen, M., & Crielaard, J. M. (2008). Hamstring muscle strain recurrence and strength performance disorders. The American Journal of Sports Medicine, 36(8), 1566-1573. doi:10.1177/0363546508315081
- Whiteley, R., & Wrigley, M. (2015). Hamstring injury rehabilitation: current concepts in treatment and prevention. Journal of Sport Rehabilitation, 24(2), 142-150. doi:10.1123/jsr.2014-0013