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What is a pulled hamstring?

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Hamstring strains are the most common injury in sports that involve high speed running and they have the potential to plague athletes and become a serious nuisance to people who engage in high levels of activity. There are 3 main types of strains. Grade 1 strains are represented by very small tear(s) in the muscle belly or the muscles tendon. These strains are usually accompanied by local tenderness, mild pain, inflammation and pain with stretching or flexing the muscle. Grade 2 strains are usually represented by larger tears, moderate pain, bruising, redness and pain with stretching/flexing the muscle. Grade 3 strains are the most severe strains and they are represented by a complete tear/rupture of the muscle tendon. In addition to the previously mention symptoms the person will experience severe pain, loss of muscle strength or even function of the hamstring.

Risk Factors

Typically athletes are more likely to develop hamstring strains; in particular athletes who are involved in sprinting such as a wide receiver or a soccer player. People who stretch for excessive periods of time or over stretch are also at greater risk of developing a hamstring strain, an example of this is a ballet dancer. People with muscle imbalances and insufficient core strength/stability are more likely to develop hamstring strains too. If the person has had a previous hamstring strain then they are at much greater risk (12-31%) to reinjure the hamstring.

Prognosis, Treatment

Typically a grade 1 strain will require RICE, which stands for resting the hamstring, icing, compressing and elevating the hamstring which reduces pain, inflammation and swelling. Grade 1 strains usually heal within 1 to 2 weeks. People with a grade 2 strain, athletes with a hamstring strain or an athletic person who suffers from reoccurring strains are most likely to benefit from physical therapy. Here the physical therapist will incorporate RICE, but they will also focus on first identifying any muscle imbalances and strengthening the hip and core musculature. As the hamstring begins to heal the therapist may incorporate activities that engage the hamstring such as biking, but the therapist will also focus on more balance and agility based exercises to help prevent re-injury. Once the patient is able to jog pain free and hamstring strength is equivalent on both sides the therapist will then begin exercises that focus on strengthening the hamstrings.

Grade 2 strains usually take 4 weeks on average to heal, but more severe grade 2 strains may take even longer. Grade 3 strains often require surgery because the actual tendon is torn. One of the more common questions a patient will have with this particular injury is when will they be able to return to their sport. The therapist will look at several factors including whether the hamstring is at full/equivalent strength without pain, if they have full range of motion of the hamstrings without pain and can the patient perform sport specific movements near maximal speed without pain (i.e. sprinting). For more information on physical therapy services visit

If you’re suffering with a painful hamstring don’t delay, call Total Performance Physical Therapy for a consultation today.



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