Have you strained your hamstring recently? Must read article!
This blog post is essential for those who have recently strained or "pulled" a hamstring muscle. Here we'll cover the common causes, types of strain, include what's to be expected and what needs to be accomplished in the early, mid and end stages of the rehabilitation process.
Causes/Mechanism of injury:
Hamstring strains are generally caused by an excessive load or stretch to the hamstring muscle. These mechanisms cause a high amount of stress placed through the hamstrings, resulting in damage to the muscular fibres.
Hamstring strains are common in sports involving jumping, quick decelerating and accelerating, kicking and sprinting.
Check out the hamstring anatomy picture below! Did you know there are in fact 3 different hamstring muscles?

Hamstring strains can generally be characterised into 3 grades:
Symptoms | Grade I | Grade II | Grade II |
Amount of fibres damaged | Few fibres damaged | Approx 1/2 the fibres have been damages/torn | More than 1/2 the fibres are ruptured/torn |
Gait | Potentially affected | Likely affected acutely | Highly likely affected |
Pain/discomfort | Pain may be present at the site of the strain at rest, and worse on palpation | Pain felt at the time of the injury. Likely pain at the site of the strain, worse on palpation and with gait. | Pain felt at the time of injury, pain at the side of the tear, worse on palpation, pain with gait |
Hamstring strength when being tested by a therapist | Likely to be weak and potentially causing pain to the site of strain | Moderate amounts of weakness and pain | Large amounts of weakness and pain |
Bruising | Potential (depending on the person) | Likely, but depends on the person | Highly likely + swelling |
Phase 1 - Early Management
Rehab Goals | Example |
Promote healing of the damaged tissue | Rest and appropriate loading of structures |
Reduce strength loss | Continue use of adjacent muscles |
Maintain range of motion | Continue use of adjacent joints |
Avoid dysfunctional gait pattern | Advice/education |
Avoid excessive lengthening of the hamstrings | Advice/education |
Phase 2 - Mid stage rehab
Rehab Goals | Examples |
Regain strength | Beginning with non-weight bearing isometric and eccentric exercises, such as: hamstring bridges/sliders, nordic hamstring curls. Progressing to weight bearing exercises such as: single leg deadlifts, split squats |
Regain range of motion | Sciatic nerve tensioning and hamstring mobility exercises. Hands-on soft tissue massage. |
Improve neuromuscular control in preparation for functional strength training | Isometric exercises where the focus is on time under tension. Hands-on soft tissue massage. |
Avoid end range lengthening | Advice/education |
Phase 3 - End stage rehab
Rehab Goals | Examples |
Restored concentric & eccentric strength through full range of motion | Advanced eccentric & concentric strengthening exercises through full range |
Restored high velocity contractions | Strength focus through different levels of speed - deceleration of the knee, aid in hip extension. Guided and progressively loading sprint & deceleration drills. |
Improved neuromuscular control of the pelvis | High level single leg balance and stability training |
Functional sport specific exercises | Plyometric training, such as: squat jumps, depth jumps, hops, bounds, leaps, "catch" bridges and hip extensions. |
Training symptom-free and bilateral strength capacity | Achieved with adequate and well rounded rehab |
Hopefully you've made it this far! :)
As you can see, there are lots of factors contributing to a successful return to sport post-hamstring strain. It will depend on the severity on the injury, nature of the injury, and whether you have successfully completed all stages of the rehab process or not.
Who is the best person to see for this condition:
If you've just recently injured your hamstring playing sport and need an accurate diagnose of your injury, the best person to see is a Sports Physiotherapist. They will be able to kick-start your healing process through manual therapy, and ensure you exercise rehabilitation is appropriate to your injury. Click below to read more!
If however, you have been suffering repeated hamstring strains, with unsuccessful return to sport, the best health professional to see is an Exercise Physiologist, who specialises at exercise rehab and mid-end stage return to sport treatment. Click below to clean more!
Want to read up on more hamstring-related blog posts?
Click here to read about chronic tight hamstrings
Click here to read about Hamstring Tendinopathy vs Hamstring Strains
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