Hamstring injury - Diagnosis and treatment (2024)

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Diagnosis

During the physical exam, a health care provider checks for swelling and tenderness along the back of the thigh. Where the pain is and how bad it is can give good information about the damage.

Moving the injured leg into different positions helps a provider pinpoint which muscle is hurt and whether there is damage to ligaments or tendons.

Imaging tests

In severe hamstring injuries, the muscle can tear or even separate from the pelvis or shinbone. When this happens, a small piece of bone can be pulled away from the main bone, known as an avulsion fracture. X-rays can check for avulsion fractures, while ultrasound and MRIs can show tears in the muscles and tendons.

More Information

  • MRI
  • Ultrasound
  • X-ray

Treatment

Hamstring stretch

Hamstring injury - Diagnosis and treatment (1)

Hamstring stretch

To stretch the hamstring muscles, extend one leg out in front. Then lean forward to feel the stretch in the back of the thigh. Repeat with the other leg. Don't bounce.

The first goal of treatment is to reduce pain and swelling. A health care provider might suggest the following:

  • Take a break from strenuous activities to allow the injury to heal.
  • Apply ice packs several times a day to relieve pain and reduce swelling.
  • Wrap the injured area with a compression bandage or wear compression shorts to minimize swelling.
  • Rest with the leg elevated above the level of the heart, if possible, to lessen swelling.
  • Take pain medicine you can get without a prescription. Examples include ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others).

Physical therapy

Your health care provider or a physical therapist can show you how to do gentle hamstring stretching and strengthening exercises. After the pain and swelling go down, your provider can show you how to do exercises to build more strength.

Surgery

Most hamstring injuries that involve partial tearing of the muscles heal over time and with physical therapy. If the muscle has pulled free from the pelvis or shinbone, orthopedic surgeons can reattach it. Severe muscle tears also can be repaired.

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Lifestyle and home remedies

To care for a minor hamstring injury yourself, try the R.I.C.E. approach:

  • Rest. Take a break to rest your hamstring muscles and allow the damaged tissues to repair. Avoid any activity that causes pain, swelling or discomfort. If you have more than a minor muscle strain, your health care provider may recommend that you use crutches to keep your weight off the injured leg.
  • Ice. Ice the area as soon after the injury as you can. For the first few days after the injury, keep an ice pack on the injured area for 15 to 20 minutes every 2 to 3 hours while you're awake. Cold reduces pain and swelling. It may also slow bleeding if there's a tear. If you have vascular disease, diabetes or can't feel much in your leg, talk with your care provider before icing.
  • Compression. Wrap your leg with an elastic bandage until the swelling goes down. Be careful not to wrap too tightly. Begin wrapping at the end farthest from your heart. Loosen the bandage if the pain increases, the area becomes numb or swelling occurs below the wrapped area.
  • Elevation. Sit or lie back with your leg raised while resting. If possible, raise your leg higher than your heart.

Pain medicine you can get without a prescription, such as ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others), also might help. After a few days, gently begin to use the injured leg. Your leg's ability to support your weight and your ability to move without pain should get better over time.

Preparing for your appointment

You might first talk to your own health care provider. You might be referred to a provider who practices sports medicine or does orthopedic surgery.

What you can do

Make a list that includes:

  • Complete information about your symptoms and when they began.
  • Information about medical problems you've had.
  • All the medicines and supplements you take, including doses.
  • Questions you want to ask the care provider.

What to expect from your doctor

Your care provider might ask some of the following questions:

  • When did the injury occur and how did it happen?
  • Did you feel a popping or tearing sensation?
  • Do any movements or positions make the pain better or worse?

By Mayo Clinic Staff

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Dec. 09, 2022

Print

  1. Miller M, et al. Hamstring injuries. In: DeLee, Drez, and Miller's Orthopaedic Sports Medicine: Principles and Practice. 5th ed. Elsevier; 2020. http://www.clinicalkey.com. Accessed Oct. 14, 2022.
  2. Fields KB, et al. Hamstring muscle and tendon injuries. https://www.uptodate.com/contents/search. Accessed Oct. 14, 2022.
  3. Hamstring muscle injuries. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/hamstring-muscle-injuries. Accessed Oct. 14, 2022.
  4. Silvers-Granelli HJ, et al. Hamstring muscle injury in the athlete: State of the art. Journal of ISAKOS. 2021; doi:10.1136/jisakos-2017-000145.

Hamstring injury

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Hamstring injury - Diagnosis and treatment (2024)

FAQs

What is the immediate treatment for hamstring injury? ›

Symptom Relief
  1. Rest. Stop any physical activity that causes pain. ...
  2. Ice. Put ice on your hamstring for about 20 minutes, 2 to 3 times a day. ...
  3. Compression. A compression bandage or wrap can reduce swelling and ease pain.
  4. Elevation. When sitting, keep your leg raised slightly to reduce swelling.

How to diagnose hamstring injury? ›

A physical examination is typically enough to diagnose a hamstring injury and often includes:
  1. Questions about the injury and the location of the pain.
  2. An examination of tenderness, swelling, and bruising.
  3. Range of motion and strength tests.

Is walking ok with a pulled hamstring? ›

Gentle exercises and stretches

To avoid this, you should start doing gentle hamstring stretches after a few days, when the pain has started to subside. This should be followed by a programme of gentle exercise, such as walking and cycling, and hamstring strengthening exercises.

How does a doctor fix a torn hamstring? ›

You will need surgery for a complete hamstring tear because it will not heal on its own. If the tear is in your proximal hamstring (the tendons that attach your hamstring to the pelvic bone), we will use sutures (stitches) to reattach the tendons to your pelvic bone where they tore away.

How do you tell if a hamstring is torn or pulled? ›

While a hamstring strain or pull is associated with duller pain that comes on gradually, a hamstring tear typically causes sudden, intense pain in the back of the thigh. Other symptoms include: Severe swelling and bruising. Significant tenderness when touched.

What can be mistaken for a hamstring injury? ›

Pain in the back of the leg is often diagnosed as sciatica and is characterised by a sharp, shooting pain down the leg or pins and needles further down towards the calf. Often this can be confused with a hamstring strain or tear. This can happen when we have not warmed up properly before doing activity.

What are the red flags for hamstring strain? ›

Pain. Tenderness. Loss of motion. Decreased strength on isometric contraction.

Should I stretch a pulled hamstring? ›

Gentle exercises and stretches

Returning to strenuous exercise too quickly could make your injury worse. But avoiding exercise for too long can cause your hamstring muscles to shrink and scar tissue to form around the tear. To avoid this, you should start doing gentle hamstring stretches after a few days.

Should I massage a pulled hamstring? ›

Is Massage Good for Pulled Hamstring? Yes. Once the acute phase of healing is over, sports massage can be of great benefit.

What is the fastest way to heal a hamstring? ›

Apply ice packs several times a day to relieve pain and reduce swelling. Wrap the injured area with a compression bandage or wear compression shorts to minimize swelling. Rest with the leg elevated above the level of the heart, if possible, to lessen swelling. Take pain medicine you can get without a prescription.

Is heat good for a pulled hamstring? ›

Hamstring strain rehab (3 – 7 days)

The heat should be applied for 10 – 15 minutes for the purpose of increasing circulation to the tissue and increasing extensibility of the muscle fibers. Immediately after the heat while the tissue is still warm and pliable, gentle massage can be given to the area.

Does a pulled hamstring ever fully heal? ›

Some very mild hamstring strains can resolve within a few days. But most injuries take weeks or months of recovery time to fully heal. In some cases, recovery could take as long as a year. Many patients with hamstring injuries ask me why the healing process tends to be so slow.

What happens if a torn hamstring goes untreated? ›

If treatment is delayed, a torn hamstring tendon may pull further away from the bone. This can result in a greater loss of power, the need for surgery, or a more serious condition in the lower back, buttock, calf, or posterior thigh.

What happens if you don't repair a torn hamstring? ›

Though many can heal on their own with time and rest, you may risk not being able to return to full function by skipping medical care.

What kind of doctor do you see for hamstring pain? ›

Your primary healthcare provider can diagnose a hamstring injury, talk to you about how to treat it and let you know when you can return to your normal activities. They might also refer you to a physiotherapist, sports medicine specialist or orthopedic (bone) healthcare provider if you need special help.

How do you get instant relief from hamstring pain? ›

Home remedies

Remember the acronym R.I.C.E.: rest, ice, compression and elevation. Stop your activity, or at least do fewer activities until the soreness is gone. Ice the area about 24 to 48 hours after your injury. Keep the ice on for 15 minutes, take it away for 15 minutes and repeat.

Should I go to urgent care for hamstring injury? ›

You may want to consider going to urgent care if: Pain isn't going away after a few days or getting worse. Symptoms include numbness or tingling. You heard a “pop” when the injury occurred.

What should you not do with a hamstring injury? ›

Take a break to rest your hamstring muscles and allow the damaged tissues to repair. Avoid any activity that causes pain, swelling or discomfort. If you have more than a minor muscle strain, your health care provider may recommend that you use crutches to keep your weight off the injured leg.

Should you massage a pulled hamstring? ›

Is Massage Good for Pulled Hamstring? Yes. Once the acute phase of healing is over, sports massage can be of great benefit.

References

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