What is a hamstring strain? - BulletProofRunner Blog

What is it?

A strain is a term used to describe when someone pulls their hamstring. Physiologically, this refers to the damaging of the muscle structure, which can involve either the muscle fibers alone or also affect the tendon structure. The muscle, which is the tangible and fleshy portion that can be touched and felt, attaches to the bone through the tendon at both ends. Additionally, there is an intramuscular tendon that runs within the muscle itself.

What terminology will I hear?

In general terms, hamstring injuries are classified as Grade 1, 2, or 3. Grade 1 denotes a less severe strain in terms of muscle damage. Grade 2 encompasses a wide range of muscle damage, spanning from approximately one per cent to 95-99 per cent. Consequently, this grading is imprecise when it comes to determining the extent of the damage. Grade 3 represents the most significant damage, involving a complete tear of the muscle and potential detachment of the hamstring tendon from its point of insertion on the bone. For athletes, this would necessitate surgery.

How does it happen?

Injuries to the hamstring commonly occur due to actions involving sprinting or acceleration. They are frequently associated with the final swing phase of running, which is characterized by the hip being flexed and the knee being extended while the leg is positioned ahead of you.

In the past, there have been instances of athletes experiencing hamstring strains from kicking, although it occurs less frequently. This discrepancy arises due to the significantly higher forces exerted on the hamstring muscle group during sprinting.

How painful is it?

The experience is unique to each person. The relevance of pain lies in its rating when the injury occurs, as it assists in predicting the prognosis. A person who experiences significant pain at the time of injury tends to have a slower recovery process. Similarly, we consider the duration it takes for an individual to walk without pain. If it takes them more days to achieve this, it usually translates to a lengthier rehabilitation period.

A full tear is undoubtedly the most excruciating scenario, frequently resulting in a player being carried off the field on a stretcher.

How long are you out of action?

The prognosis relies on various clinical factors, including your pain level during the injury and the duration it takes for you to walk without pain. Additionally, imaging such as scans or X-rays can provide some insight into the prognosis.

If the intramuscular tendon is affected, the time it takes to return to play is usually longer, particularly if the damage is extensive. This is why imaging is crucial as it offers more precise information. When assessing a person clinically, it is challenging to determine if the tendon is involved unless there is a complete rupture. In such cases, signs such as decreased muscle tension or muscle retraction may indicate tendon involvement.

On average, it takes about three weeks for someone to recover from a hamstring injury, but this can vary depending on factors such as clinical data, imaging results, individual characteristics, and previous injury history.

The minimum recovery time for a full avulsion is 16 weeks or longer.

What to Expect

After a hamstring strain, it is expected to experience swelling, tenderness, and pain. Pain may be felt while walking.

You may require assistance in healing your hamstring muscle.

Crutches if you cannot put any weight on your leg
A special bandage wrapped around your thigh (compression bandage)

Pain and soreness may persist as symptoms for a period of time.

Two to five days for a grade 1 injury
Up to a few weeks or a month for grade 2 or 3 injuries

If the injury is in close proximity to the buttock or knee or if there is extensive bruising:

It may mean the hamstring was pulled off the bone.
You will likely be referred to a sports medicine or bone (orthopedic) doctor.
You may need surgery to reattach the hamstring tendon.

Symptom Relief

For the initial days or weeks after your injury, adhere to these instructions.

Rest. Stop any physical activity that causes pain. Keep your leg as still as possible. You may need crutches when you have to move.
Ice. Put ice on your hamstring for about 20 minutes, 2 to 3 times a day. Do not apply ice directly to your skin.
Compression. A compression bandage or wrap can reduce swelling and ease pain.
Elevation. When sitting, keep your leg raised slightly to reduce swelling.

These pain medications, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and acetaminophen (Tylenol), are available for purchase at stores.

Talk with your health care provider before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past.
Do not take more than the amount recommended on the bottle or by your provider.

Getting Active Again

Let your provider know when your pain has sufficiently reduced so that you can safely commence gentle stretching and light physical activity.

Gradually enhance your level of physical activity, for example by engaging in walks. Adhere to the exercises recommended by your provider. As your hamstring heals and gains strength, you can incorporate additional stretches and exercises.

Be cautious not to overexert or rush yourself, as it may lead to the recurrence or tearing of your hamstring.

It is advisable to consult with your provider before resuming work or engaging in any physical activity to avoid the risk of reinjury.

Follow-up

After your injury, make sure to follow up with your provider within 1 to 2 weeks. Depending on the severity of your injury, it is possible that your provider may require multiple visits during the healing period.