With any physical activity, there are moments of stress and fatigue that your body must overcome and adapt. Some hurdles are more manageable, like fatigue, muscle soreness and cramping.

However, some injuries like muscle strains can be a more intense, painful, and debilitating ailment to recover. Common muscle strains involve the hamstring muscle group, a group of three muscles located on the posterior thigh.

As this muscle group is a prominent source of movement, strains of these muscles can transition into long recovery times.

If you want to understand muscle strains, you need to know how they happen, how to prevent them, and how to recover from them.

READ: Triathlon Injury Guide: How To Deal with Triathlete Injuries

Understand the Anatomy

The hamstring complex consists of three large muscles on the posterior thigh. These muscles are the semitendinosus, semimembranosus, and biceps femoris. While located in different areas of the posterior thigh, these muscles work together to bend the knee during running, biking, weightlifting, etc.

For instance, both the semitendinosus and semimembranosus originate on the medial (inside) side of the thigh. On the other hand, the biceps femoris originates of the lateral (outside) side of the thigh.

Tear or Strain?

While you sometimes use the terms strain and tear interchangeably, they reflect different states of the muscle. When you strain a muscle, the tissue and its fibers are overstretched, usually without tearing.

A muscle tear involves a ripping of a muscle or tendon. While strains and tears can both cause discomfort for an individual, the severity of each is very clear cut. It is crucial to make this distinction between the two terms because of the sheer gravity of a muscle tear (and recovery).

Causes

Muscle strains are often the result of athletic injuries, poor flexibility, overuse, or a past hamstring injury. With any muscle strain, the muscle affected is often overloaded or overstretched during activity.

The load or stress placed upon the muscle is too much for the muscle to overcome. In this instance, the muscle fiber elongates, stretches and tears in more extreme cases.

Since you use the hamstring group in many movements during physical activity, it can commonly become strained and torn when overloaded.

How Does It Feel?

Symptoms of hamstring strains depend on the severity as well as the individual. The most common symptoms you can feel include:

  • Sudden or severe pain on the posterior thigh during activity or exercise
  • Intense pulling or “popping” sensation
  • Tender to touch
  • Moderate bruising (in severe cases)
  • Pain with weight-bearing activities
  • Weakness
  • Possible deformity of muscle (in severe cases)

Make the Grade

Hamstring strains, like most muscle strains, are measured or graded by severity. The severity of these strains are determined to be one of three grades:

  • Grade I: Mild strain of muscle or tendon, minimal stretching without tearing of muscle fibers. This grade of injury often causes mild discomfort, muscle tightness, and little to no loss in muscle strength or flexibility.
  • Grade II: Moderate strain of muscle or tendon, a partial tear of the muscle. This grade of injury causes more immediate pain and discomfort, pain to the touch, reduced strength, and flexibility.
  • Grade III: Most severe, complete tear or rupture of the muscle. This grade of injury causes a visible deformity within the muscle, sudden/sharp pain, large bruise is typically formed. Weight-bearing activities can cause severe pain, often leading to the need for surgical repair.

Recovery and Treatment

Initial treatment for a mild hamstring strain can be remedied with conservation treatment. This is traditionally called the RICE method:

  • Rest- Limited physical activity after initial strain, crutches, or canes can be used to help with gait. This is also the optimal time to take any pain medications, as you are removed from physical activity and trying to encourage repair and recovery to the hamstring.
  • Ice- Apply ice pack around the problem area. Typically left on for 15-20 minutes. It can be applied multiple times a day, depending on the severity of symptoms.
  • Compression- For moderate to severe swelling, a compression wrap or sleeve can be placed on the hamstring to reduce swelling
  • Elevation- Elevating the affected limb above the heart using pillows, cushions, blankets, and other soft items can also help reduce swelling. It will help the uncomfortable “pounding” feeling you may feel with a hamstring strain go away, as less blood flow is reaching the damaged area.

Physical Therapy

Seeing a doctor can help determine your plan of care and recovery. Once pain and discomfort subside, physical therapy can be prescribed. This plan will help regain strength, flexibility, and range of motion that you may have lost due to the injury.

As you become more robust and more flexible, introduce more hamstring exercises to further your recovery. Some of these exercises include:

  • Passive/active hamstring curls
  • Bridges
  • 4-way leg raises
  • Light-moderate hamstring stretch

Surgery May Be the Answer

In grade III strains or tears, there has been a complete tear within the muscle tissue. While the RICE method can help reduce pain, and small passive movements at the leg can reduce muscle tightness, they sometimes do not completely heal a partial or complete tear.

In these instances, a surgical intervention is the next possible course of action. These surgeries typically involve the stitching of the damaged tissue.

Prevention

Hamstring strains can be a very frustrating and debilitating injury for anyone to go through. To reduce the chances of these strains, you should take certain precautions. The best protocols for prevention of hamstring strains include:

  • Proper stretch routine - Stretching before and after physical activity can help muscles properly loosen up before an intense workout.
  • Self-myofascial release (SMR) - using foam rolls or tennis balls, this form of recovery can be used before or after activity. SMR is used to reduce the soreness of muscles while improving tissue recovery.
  • Listen to your body - Do not confuse soreness for pain and try to “fight through it.” Stopping activity the moment you feel discomfort can help reduce the likelihood of further damage to your muscles
  • Post-exercise recovery - After physical activity, muscle soreness and tightness can be common. Taking care of these symptoms through ice application, soft tissue massage, or pain medications helps reduces initial severity, while also working to prevent future discomfort.

Bottom Line

Hamstring strains can be very nasty injuries that can take weeks, even months, to recover. Making a habit of using proper prevention protocols, recovery techniques, and doctor’s guidance can greatly reduce the chances of these injuries and help you reach your fitness goals!