Pulled hamstring: Treatment, recovery, and causes

The hamstring is composed of three muscles located at the back of the thigh, referred to as the posterior muscle compartment as well. These three muscles are:

• semimembranosus
• semitendinosus
• long and short head of the bicep femoris

The hamstring muscles originate from the ischial tuberosity located at the base of the pelvis, before crossing the knee and terminating in the lower leg. They aid in stabilizing both the pelvis and knees and are crucial in daily activities. Their primary functions are hip extension and knee flexion, contributing to the intricate actions involved in standing, walking and running.

The quadriceps muscles, located at the front of the thigh, have an antagonistic relationshipTrusted Source with the hamstring muscles. This means that as one set of muscles contracts, the other set relaxes, facilitating the flexion and extension of the knee joint. Specifically, when the hamstring muscles contract, the knee joint undergoes flexion or bending, while when the quadriceps contract, the leg fully extends or straightens.

A hamstring strain can happen when the muscle is subjected to excessive stress beyond its capacity. This may happen if the muscle experiences an abrupt force that stretches it too far.

A sports injury, like sprinting or engaging in an activity that involves hamstring stretching, is typically the cause of a pulled hamstring. When running, for instance, the hamstring extends and bears the required force to propel the body forward. If the muscle’s ability to manage that force is surpassed, a pulled hamstring may be the result.

Hamstring strains were found to be the most prevalent form of muscle strain, as per a study published in Current Sports Medicine Reports. Furthermore, the likelihood of a hamstring injury recurring is considerably high.

The risk of developing a pulled hamstring increases when certain predisposing factors are present, although it can occur in anyone.

• participating in sports that require sudden running, sprinting, or stretching
• having a hamstring injury in the past
• poor flexibility in the hamstring
• muscle imbalance, such as having stronger quadriceps than hamstrings

Teens and young adult athletes frequently experience pulled hamstrings, with the incidence of hamstring injuries reaching its highest point between the ages of 16 and 25.

The signs of a strained hamstring could vary depending on how severe the damage is. Generally, there could be an unexpected and intense onset of pain accompanied by a popping or snapping sound. Furthermore, swelling and visible bruising may be apparent, and the affected region could be sensitive to touch.

To classify the severity of the strain, there are three grades of pulled hamstrings, which include:

• Grade 1: This grade of strain involves microscopic tears in the muscle fibers. Typically, an individual has mild symptoms and minimal limitations in their daily activities.
• Grade 2: This grade of strain or pull involves a partial tear of the muscle fibers that results in moderate pain. Swelling and bruising may also occur. The injury may interfere with activities such as running.
• Grade 3: This grade of injury involves a complete tear of the muscle fibers. Symptoms may include significant swelling and severe pain. The injury interferes with activities such as walking. Healing time can be a few months and may require surgery.

Diagnosis

As part of the physical examination, the healthcare professional investigates for any inflammation or sensitivity along the posterior aspect of the thigh. The location and severity of discomfort can provide valuable insight into the extent of the injury.

Shifting the position of the injured leg assists the healthcare provider in identifying the specific muscle that is injured and determining if there are any ligament or tendon injuries.

Imaging tests

In cases of serious hamstring injuries, the muscle may rupture or detach from either the pelvis or shinbone, which can result in a fragment of bone being dislodged from the main bone, called an avulsion fracture. Avulsion fractures can be detected through X-rays, whereas tears in the muscles and tendons can be visualized with the aid of ultrasound and MRI scans.

Reducing pain and swelling is the primary objective of the treatment. The healthcare professional might recommend 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

You can learn gentle hamstring stretching and strengthening exercises from either your health care provider or a physical therapist. Once the pain and swelling have subsided, your provider can demonstrate how to perform exercises that will increase your strength.

Surgery

With the aid of physical therapy, most hamstring injuries that cause muscle fibers to partially tear can heal naturally. However, in cases where the muscle has completely detached from the pelvic or shinbone, orthopedic surgeons are able to surgically reattach it. Additionally, significant muscle tears can be mended through medical intervention.

Lifestyle and home remedies

For self-treatment of a minor hamstring injury, consider using the R.I.C.E. method:

• 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.

Over-the-counter pain medication, including Advil, Motrin IB, Tylenol, and others, could provide relief. After a couple of days, carefully start using the wounded leg. As time passes, your leg’s capability to bear your weight and move without discomfort should improve.

Preparing for your appointment

Initially, it may be advisable to consult with your personal healthcare practitioner. They may suggest that you seek assistance from a sports medicine practitioner or an orthopedic surgeon.

What you can do

Create a list comprising of:

• 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

Some questions that your care provider may ask include:

• 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?