Hamstring Strain Treatment & Rehab

What is a hamstring strain?

Your hamstrings are three muscles that run down the back of the thigh, from the bottom of the pelvis to just below the knee. They bend the knee and help drive the hip backward, which makes them hard-working muscles in running, sprinting and kicking.

A hamstring strain — often called a pulled hamstring — happens when one or more of these muscles is stretched beyond what it can handle and some of its fibers tear. It's one of the most common injuries in sports that involve sprinting, and it has a frustrating habit of recurring if rehab is rushed.

Hamstring strain grades

Hamstring injuries are usually graded by severity:

1. Grade 1 (mild): overstretching with minor fiber damage. You can usually walk normally, but the back of the thigh feels tight and sore.
2. Grade 2 (moderate): a partial tear. Walking is often painful, and you may see swelling and bruising.
3. Grade 3 (severe): a complete or near-complete tear, sometimes with the tendon pulling away from the bone near the buttock. There's usually immediate severe pain, significant bruising and difficulty walking.

Your grade guides how quickly you can progress and when imaging or a specialist opinion is needed.

Pulled hamstring symptoms

• Sudden, sharp pain in the back of the thigh during sprinting, kicking or a big stretch, sometimes with a popping feeling
• Pain when walking, straightening the leg or bending the knee against resistance
• Swelling and tenderness over the muscle
• Bruising, which can appear a day or two later and track down toward the knee
• Weakness, or a feeling that you can't trust the leg to push off

Causes and risk factors for hamstring injury

Most hamstring strains happen during high-speed running, when the muscle is working hard while lengthening. Things that raise the risk include:

• A previous hamstring injury — the single biggest risk factor, especially if rehab was cut short
• Sprinting sports such as soccer, football, baseball, basketball and track, as well as dance
• Fatigue late in a game or training session
• Low hamstring strength, particularly compared with the quadriceps at the front of the thigh
• Limited flexibility and skipping a proper warm-up
• Lower back and pelvic stiffness that changes how the hamstrings are loaded

How we assess a hamstring injury

Your first visit includes a full orthopedic and neurological exam. We find exactly where the injury sits, test strength and flexibility, and check how your lower back and pelvis are moving. That last part matters: irritation of the sciatic nerve can feel a lot like a tight or strained hamstring, so we screen for it — see sciatica for more on how that pain behaves.

If your exam suggests a severe tear, particularly high up near the buttock, we'll refer you promptly for imaging and a specialist opinion.

Hamstring strain treatment at our clinics

Care is built into our sports injury treatment programs and follows the stage of recovery you're in.

Early phase (first few days): protect the muscle. That usually means relative rest, ice for 15 to 20 minutes at a time, compression and keeping the leg elevated. Avoid hard stretching while the injury is fresh. If you can't walk without a significant limp, crutches may help for a short time.

Recovery phase: once the initial pain settles, care may include:

• Gentle range-of-motion work and isometric exercises that load the muscle without straining it
• Soft-tissue therapy and massage therapy to ease the guarding and tightness around the injury
• Chiropractic adjustments where the lower back or pelvis is stiff and adding strain to the hamstring
• Progressive strengthening, building toward lengthening exercises such as bridges and controlled hamstring curls

Return to sport: the final stage brings back running, then sprinting, then sport-specific drills. Working with one of our trainers through personal training can help you rebuild strength and conditioning safely. We look for full strength, comfortable flexibility and pain-free sprinting before you go back to full play.

Our chiropractic treatment page explains how we build care plans more broadly.

Hamstring strain recovery time

Recovery time depends on the grade and location of the injury. Mild strains often improve within a few weeks, while more severe strains can take months. Injuries that involve the tendon tend to take longer than those in the middle of the muscle.

The biggest mistake is returning too soon. Feeling fine walking around doesn't mean the muscle is ready for a full sprint, and a re-injury usually means a longer layoff than the first one.

Preventing another pulled hamstring

• Keep doing hamstring strengthening, especially lengthening exercises, as part of your regular routine
• Warm up properly before sprinting, building gradually to full speed
• Build fitness before the season starts rather than using your sport to get in shape
• Pay attention to fatigue and avoid sudden jumps in training load

When to seek urgent medical care

Get prompt medical evaluation if you have:

• A loud pop at the time of injury with immediate, severe pain
• Large bruising, a visible gap or a bunched-up bulge in the muscle
• Difficulty walking or bearing weight on the leg
• Pain high up near the buttock after a forceful stretch, which can signal a tendon pulling off the bone
• Calf swelling, warmth or redness, or numbness and tingling down the leg

For the milder strain that's stopping you training, a chiropractic exam is a good first step. Hamstring injuries are among the many conditions we treat.