You’re engaged in your sport, playing hard, when you’re taken down by a sudden pain in the upper back of your leg. More than likely you just suffered a hamstring strain. Strains occur in muscles or tendons (as opposed to sprains, which occur in ligaments connecting bones to other bones).
If you’ve strained your hamstring, you know that it’s painful and that it’s keeping you from your sport. Understanding more about why the hamstring can be injured, the symptoms, treatment, and prevention will help get you back in the game.
Why Your Hamstring is Susceptible to Injury
Comprised of three muscles and their tendons and located in the back of the legs, the hamstrings cross two major joints, the hip and knee joints. They work with the quadriceps to perform a motion that becomes intense in many sports: extending and flexing the legs. The anatomy and mechanics of the hamstrings make them susceptible to injury.
If you’re a teenager, you are especially vulnerable to sustaining a strained hamstring. Adolescents are still growing. Bodies don’t grow evenly; instead, bones grow faster than muscles. This means that there are times when your growing bones stretch muscles that haven’t caught up. During these times, you go into training and games with hamstrings that are already tight. It doesn’t take much to overstretch or tear them.
Causes and Risk Factors of Hamstring Pulls
Clearly, a hamstring pull in sports is the result of intense action. Most hamstring injuries are due to overexertion, while some are due to direct blows. Contact sports and sports involving sudden, fast starts often strain the hamstrings.
The American Academy of Orthopaedic Surgeons names these sports and activities as particularly risky for hamstring strains:
- Long jump
The hamstrings can also be damaged through overuse and repetitive action. This usually results in a high hamstring strain, or hamstring tendinopathy. In contrast to pulls caused by overexertion, a high hamstring injury is a chronic injury, with pain developing over time.
Certain factors put you at particular risk for injuring your hamstring while playing sports. You might have a higher than usual chance of a hamstring strain if you experience any of the following conditions:
- Tight muscles—typically a result of insufficient stretching, warm-up, and cool-down
- Imbalance in strength—if one side of your body is more developed than the other, you increase your risk of injury on the weaker side
- Poor conditioning—without conditioning, your muscles remain weak and thus susceptible to injury
- Muscle fatigue—inadequate nutrition, hydration, and rest contribute to fatigue
Hamstring Strain Symptoms You Might Experience
An acute injury that happens in an instant of intense hamstring use results in sudden, sharp pain. According to both the Mayo Clinic and the American Academy of Orthopaedic Surgeons, symptoms of hamstring pulls include
- A possible popping sensation (in more severe injuries) when the tear occurs
- Pain intensity that varies according to the severity of the injury
- Tenderness in the area, especially when touched
- Possible bruising or discoloration, again according to injury severity
- Muscle spasm
- Muscle weakness
- Swelling/inflammation within a few hours of the injury
How to Treat Your Pulled Hamstring
Knowing how to treat a pulled hamstring will reduce pain, help you regain full use of your leg, and decrease your risk of re-injury.
Your healing approach and time will depend on seriousness of your injury. Injuries to the hamstring are categorized into grades, or levels, according to the degree of severity.
- Level one strains are mild, requiring minimal healing time (typically ten days to three weeks).
- Level two strains are moderate. These can require more than one but less than six months.
- Level three is a fully torn hamstring. Often, the tendon tears completely off the bone. This injury can take up to six months to properly heal.
Unless you have a level three tear, you’ll probably be able to do pulled hamstring treatment at home. Most doctors and trainers recommend the RICE method for hamstring strain recovery: rest, ice, compression, and elevation.
- Rest involves minimal use of your injured leg until the pain diminishes. Use your pain as your guide so you don’t overexert yourself and thus reinjure your hamstring.
- Applying ice for the first few days will help decrease swelling. Never apply ice or an ice pack directly to the skin (use a towel to protect your skin from possible frost bite). Apply the ice for 20 minutes and then remove it for 20 minutes. Continue this pattern until inflammation is gone.
- Compress the muscles using a special wrap such as an ACE bandage. This also reduces swelling.
- Elevate your leg when lying down so your injured muscles are slightly above your heart. Elevating a hamstring isn’t as easy as elevating a knee or an ankle, so you’ll need to maneuver and get creative.
Taking a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen or naproxen can reduce both pain and inflammation. Don’t rely solely on painkillers as they don’t fully treat like the other methods do. They mask pain and can be dangerous to various organs in your body.
Physical therapy is often recommended as a treatment in level two and level three strains. In the most severe hamstring injuries, avulsion injuries, you may need surgery to reattach the tendon to the bone.
Be patient with yourself during your pulled hamstring recovery. With rest and time, you’ll be back into your sport and playing hard once again.
Preventing a Hamstring Injury
You can do more than hope you don’t strain your hamstring again. Follow these guidelines to keep yourself doing what you love:
- Ensure that you’re fully healed before jumping back into things
- Warm up before all practices and games
- Cool down after all practices and games
- Stretch every day, both during the season and in the off season
- Do strength and conditioning training year-round
- Make sure you are properly hydrated
- Eat nutritious foods
Sometimes, sudden pain in the back of your leg might take you out of the game. A strained hamstring won’t keep you away for good. Treat a hamstring pull and prevent another one, and you’ll be off and running.