• Hamstring strain


    Hamstring strain is inflammation and pain in the back of the thigh along the hamstring muscles. There are three muscles that make up the hamstring muscle group, going from the hip or upper thigh across the back of the knee to the leg. This structure is important for bending the knee, straightening the hip, and helping stabilize the knee. It is also important for running and jumping. These tendons feel like ropes in the back of the knee. This is the most common injury of the thigh.

    Hamstring strains are usually grade 1 or 2 strains. A grade 1 strain is a mild strain. There is a slight pull without obvious tearing (it is microscopic tearing). There is no loss of strength, and the muscle-tendon unit is the correct length. A grade 2 strain is a moderate strain. There is tearing of fibers within the substance of the muscle or tendon or where the tendon meets the bone or muscle. The length of the muscle-tendon unit may be increased, and there is usually decreased strength. A grade 3 strain is a complete rupture.

    Common signs and symptoms

    Notify a physician if any of these symptoms do not resolve or continue to worsen:

    • Pain, tenderness, swelling, warmth, or redness over the hamstring muscles at the back of the thigh
    • Pain that worsens during and after strenuous activity
    • "Pop" often heard in the area at the time of injury
    • Muscle spasm in the back of the thigh · Pain or weakness with running, jumping, or bending the knee against resistance
    • Crepitation (a crackling sound) when the tendon is moved or touched
    • Bruising in the thigh 48 hours following the injury
    • Loss of fullness of the muscle or area of muscle bulging with complete rupture


    Initial treatment consists of ice every two to three hours for 20 minutes to relieve the pain, stretching and strengthening exercises (primarily straightening the knee), and modification of the activity that initially caused the problem. These all can be carried out at home, although referral to an athletic trainer or physical therapist for further evaluation and treatment may be helpful.

    An elastic bandage or neoprene (made of swimsuit-like material) sleeve may help reduce swelling and keep the muscles warm, alleviating symptoms. Crutches may be recommended, if the strain is severe and the athlete is limping, until the pain and inflammation settle down, usually for the first 24 to 72 hours. Surgery is necessary to reattach muscle-tendon if it pulls off bone (uncommon). Suturing or sewing torn muscle is usually not successful.

    RICE Principle 

    With all acute injuries, follow the RICE principle to reduce swelling, pain and inflammation.

      R est- Walk with crutches if you cannot bear weight.

      I ce- Use an ice pack for 20 minutes every two to three hours during the first 72 hours.

      C ompression- Use an ace wrap. Start at the top of the calf and wrap to the top of the thigh.

      E levation- Keep the injured leg above the level of the heart when sitting or lying down.

    More on sports related injuries