Hamstring Strain

Medically Reviewed by Shruthi N, MD on June 24, 2024
Written by Timothy Gower, Kristin Mitchell, WebMD Editorial Contributor
8 min read

Unfortunately, hamstring strains are both common and painful. They strike athletes of all sorts – including runners, skaters, and football, soccer, and basketball players.

But what is a hamstring? It isn't actually a single ”string.” It's a group of three muscles that run along the back of your thigh. They allow you to bend your leg at the knee.

During a hamstring strain, one or more of these muscles gets overloaded. The muscles might even start to tear. Such tears most often happen in the muscle fiber itself or at the point where the muscle attaches to the tendon, which connects to the bones in your pelvis, knee, and lower leg. You're likely to get a hamstring strain during activities that involve a lot of running and jumping or sudden stopping and starting.

Getting a hamstring strain is also more likely if:

  • You don't warm up before exercising.
  • The muscles in the front of your thigh (the quadriceps) are tight as they pull your pelvis forward and tighten the hamstrings.
  • Your glutes are weak. Glutes and hamstrings work together. If your glutes are weak, hamstrings can be overloaded and become strained. 

When you injure your hamstring, your doctor will examine the muscle and classify – or grade – the injury based on how severe the damage is. This will help guide your treatment.

  • Grade 1. A mild hamstring strain or pull
  • Grade 2. A partial tear of your hamstring
  • Grade 3. A complete tear of your hamstring

Mild hamstring strains may not hurt too much. But severe ones can be extremely painful, making it impossible to walk or even stand.

Other possible symptoms of a hamstring strain are:

  • Sudden and severe pain during exercise, along with a snapping or popping feeling
  • Pain in the back of the thigh and lower buttock when walking, straightening the leg, or bending over
  • Tenderness
  • Bruising

To diagnose a hamstring strain, your doctor or physical therapist will ask specific questions about how your leg was injured. You'll also have a physical exam of the injured muscle, which will include the following:

  • A visual exam to look for signs of bruising
  • A hands-on exam to identify areas of tenderness, weakness, pain, and swelling. This will allow your doctor to get an idea of how serious your injury is.

Your doctor may not be able to fully evaluate your injury with a physical exam alone. You may need imaging tests to get a complete picture. These tests include:

X-ray. This will show if the injured hamstring tendon has pulled away from part of the bone. This is called avulsion and is the most severe type of hamstring injury.

Magnetic resonance imaging (MRI). This uses magnets and radio waves to create a picture of your hamstring muscle and how badly damaged it may be.

Luckily, minor to moderate hamstring strains usually heal on their own. You just need to give them some time. To speed the healing, you can practice the RICE (rest, ice, compress, elevate) protocol:

  • Rest your leg. Avoid putting weight on your leg as best you can. If the pain is severe, you may need crutches until it goes away. Ask your doctor or physical therapist if they're needed.
  • Ice your leg. This reduces pain and swelling. Do it for 20-30 minutes every 3 to 4 hours for 2 to 3 days, or until the pain is gone. Don’t let the ice directly touch your skin.
  • Compress your leg. Wear an elastic bandage around your injured leg to keep down swelling.
  • Elevate your leg. Keep your leg up on a pillow when you're sitting or lying down so that your leg is higher than your heart.

The following also may help you feel better:

Anti-inflammatory painkillers. Over-the counter nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, will help with pain and swelling. But these drugs may have side effects, such as an increased risk of bleeding and ulcers. They should be used only short-term, unless your doctor specifically says otherwise.

Immobilization. You may need to wear a knee brace to keep your leg in a neutral position. This will help it heal.

Stretching and strengthening exercises (if your doctor or physical therapist recommends them). Strengthening your hamstrings is one way to protect against hamstring strain. Your doctor may recommend a physical therapy program once the swelling and pain have ended. You’ll learn and practice exercises that help restore range of motion and strength.

Surgery. In severe cases where the hamstring tendon is torn away from the bone, you may need surgery to reattach the tendon to the bone. Tears of the central part of the muscle itself don’t typically require surgery.

Exercise will be an important part of your recovery. It helps you to regain strength and range of motion. Your doctor may recommend some gentle stretches and exercises, such as walking, or prescribe a physical therapy program. Start slowly, and gradually increase your activities as your hamstring begins to feel better and stronger. Check with your doctor before exercising on your own to reduce your risk of making your injury worse.

Here are some examples of hamstring strain exercises your doctor or physical therapist may recommend:

Hamstring set

Sit on the floor with your injured leg bent at the knee and your other leg straight. Press your heel on your injured side into the floor. Hold for 6 seconds then rest. Repeat eight to 12 times. Do this on the other leg as well.

Hamstring curl

Lie on your stomach with your legs straight. On your injured side, bend your knee and lift your foot toward your butt, then slowly lower it to the floor. If that hurts, try bending your knee less so that you don’t feel pain during the motion. Repeat eight to 12 times. Do this on the other leg as well. You can put a pillow under your stomach if you are uncomfortable while lying on the floor. You also can place a rolled-up cloth under your leg above your kneecap to reduce knee discomfort.

Hip extension

Stand facing a wall. Place your hands on the wall at about chest level and shoulder-width apart. Gently kick your injured leg back behind you while keeping it straight, then slowly return it to the starting position. Repeat eight to 12 times. Do this on the other leg as well.

Single leg balance

Stand on a flat surface, like a bare floor. Raise your arms to your sides so that your body forms a capital T. Lift your uninjured leg off the floor, bending it at the knee so your foot is behind you. Hold that position for up to 30 seconds while keeping your injured leg straight. Repeat eight to 12 times. Do this on the other leg as well. If you have trouble staying balanced that long, hold on to a counter or chair  or put your hand on a wall to steady yourself.

As you get stronger, you can make these exercises more challenging. For example, adding an elastic resistance band to the hip extension requires more effort to move your leg back. Standing on a pillow rather than a flat surface requires more effort to keep your balance.

Recovery time depends on how badly you injured the hamstring. Keep in mind that people heal at different rates. Typically, recovery from a grade 1 strain – the mildest injury – takes just a few days. More serious injuries – grades 2 and 3 – could require weeks, even months, to fully heal. 

While you get better, you should work the hamstring with a new activity that won't worsen the strain, with guidance from your doctor or physical therapist. For instance, runners could try doing laps in a pool.

Whatever you do, don't rush things. Don't even try to return to your old level of physical activity until:

  • You can move your injured leg as freely as your uninjured leg.
  • Your injured leg feels as strong as your uninjured leg.
  • You feel no pain in your injured leg when you walk, then jog, then sprint, then finally jump.

If you start pushing yourself before the hamstring strain is healed, you could re-injure the hamstring and develop permanent muscle problems.

As hamstring strains can be bad injuries, athletes should work hard to avoid them. After all, healing from a hamstring strain is much harder than preventing it. Here are some tips:

  • Warm up before and stretch after physical activity.
  • Boost the intensity of your physical activity slowly – no more than a 10% increase a week.
  • Stop exercising if you feel pain in the back of your thigh.
  • Stretch and strengthen your hamstrings as a preventive measure.
  • Make certain you do exercises using the proper form. Injuries, including hamstring strains, can happen when you do an exercise incorrectly.

 

A hamstring strain is one of the most common and bothersome injuries, especially among athletes who do sports that require sprinting, such as soccer, basketball, and track. Though painful, they frequently get better with minimal treatment. But serious hamstring injuries may need surgery.

What is the difference between a pulled and strained hamstring? Both terms often refer to a mild injury that typically heals quickly. Some experts consider a hamstring strain a category of injury that includes pulls, partial tears, and complete tears – the three grades of hamstring strain.

Is it OK to walk with a strained hamstring? Exercise, including walking, will be an important part of your recovery. But you should check with your doctor first. The severity of your injury will help determine when you’re ready to walk and how much walking you can safely do.

Is it OK to stretch a pulled hamstring? As with walking, get your doctor’s approval beforehand as well as some guidance on the right types of stretches. You don’t want to risk worsening your injury. If you need physical therapy, you’ll likely start with stretches to help you regain range of motion.