The Early Stage Hamstring Recovery Guide
Get back to running sooner with these tips and exercises
This feels good. My passes are strong, feet are moving quickly, and my shots are on. Flashbacks of high school and college basketball run through my mind. I’m trying old moves and running familiar plays.
I haven’t played basketball in a couple of months and for the first 30 minutes, it showed. But now I’m getting my touch back.
I steal the ball from my opponent and start to sprint towards the basket, then “pop”.
I see white and feel a sharp pain at the back of my thigh that brings me to the ground. It was like a rubber band snapped in my hamstring and rolled up to my glute. I couldn’t walk normally and knew that I strained my hamstring.
This was the beginning of my relentless search through research articles on the most effective ways to deal with hamstring strains.
Here’s what I found.
What is a hamstring strain?
A hamstring strain occurs when the muscle undergoes a stress that is too much for it. This leads to tearing and damage of some of the muscle fibers. There are three grades for hamstring strains.
- Grade 1: A few of the muscle fibers tear.
- Grade 2: Approximately half of the muscle fibers tear.
- Grade 3: Over half of the muscle fibers tear.
This article is going to look at what to do when experiencing a grade 1 or 2 strain as these are the most common. If you’re experiencing a grade 3 tear where the muscle is unable to perform any function at all, it’s advised to seek further medical attention.
Healing process for hamstring strain
There are three main steps in the healing process of a hamstring strain. An easy way to think about it is to compare a hamstring strain with scraping your knee as a kid.
What are the common signs of a hamstring strain?
A hamstring strain typically occurs in one of two ways:
- When a person is running and has their leg stretched out in front of them.
- In sports where there is a lot of lengthening of the hamstring such as high kicking in martial arts or slide tackling in soccer.
There can be bruising at the back of the leg and it is often tender to touch/pressure. Pain is common when stretching the hamstring muscle or contracting the muscle.
The hamstring muscles cross both the hip and the knee. This means it is put under the most amount of stress when the hip is flexed forward and the knee is completely straight. This position tends to be the most painful following a hamstring strain.
What to avoid with a hamstring strain
The biggest thing you want to avoid when first injuring your hamstring is stretching. Similar to how fully bending your knee will cause the scab to keep opening up and delay healing, the same occurs with a hamstring strain. Stretching places excess stress on the healing site and can cause more damage.
Instead of stretching, focus on moving the leg through its current range where the pain is less than 4/10. This will keep the scar formation mobile without damaging the tissue.
Watch out! — The first 4 weeks
Did you know that 33% of people who have a hamstring strain will reinjure it later that year? And the majority of these injuries occur within the first 4–6 weeks after the first injury.
Similar to how a scab is fragile and can easily open back up, the tissue that repairs the hamstring strain is very fragile for the first 4 weeks. It isn’t until the tissue transitions from type III collagen to type I that it is able to tolerate more stress.
If possible, avoid intense running or returning to sport for the first 4 weeks. This will greatly reduce your risk of reinjury. Instead, cross-train with biking or swimming to decrease the load on the tissue.
Exercises to perform right after a hamstring strain
Isometrics: 1x10–5 second holds 3x/day
Isometrics should be the first exercise after a hamstring strain. They have been shown to improve pain and increase blood flow to the area.
Start with the knee bent to 60 degrees, which will put the hamstring in a neutral position. Once this becomes easy, then perform isometrics in a shortened position with the knee bent >100 degrees. The last isometric to work on is with the knee relatively straight with only a 10-degree bend. This will put the hamstring on stretch and is more intense.
Once these three positions become pain-free to perform, progress to the exercises below.
Isotonics: 3x10 working up to 3x20 with 3 sec eccentric
Now it’s time to focus on restoring the strength of the hamstring muscle. These exercises can usually be started about three days after the injury. The key is to build up gradually. I usually recommend starting with heel slides and prone leg curls.
At no point should pain exceed a 4/10. If this means that you can only do partial range to begin, then that is okay. As it gets less painful, increase the range until you can do all exercises in a lengthened position.
Inhibition exercises
Although we do not want to stretch the hamstring muscle, we can help improve our motion by performing exercises that help calm down the hamstring muscle.
By performing exercises that contract the quad muscle, we are automatically helping to relax the hamstring musculature. Below is an inhibition exercise that can be performed. Make sure to stay within a relatively pain-free range. This is NOT a stretch, but rather working the muscle through its pain-free motion.
Conclusion: Slow and steady wins the race
If you’re not an in-season athlete, take your time and give yourself at least 4 weeks before trying to sprint or perform high-intensity exercises for the hamstring. This will greatly reduce your risk of reinjury.
In the next article, I will dive into what exercises are best for later stages of hamstring rehab recovery. Make sure to follow to read more.
In addition, I have created an app that will gradually run you through these recovery exercises. As they get easier, it will automatically progress you to the next exercise. To sign up for the app then fill out the google form here: https://forms.gle/sQ5654VY76kkzQu29
Thank you for reading! As always, feel free to reach out with any questions or article ideas. This content is for informational purposes only. Please consult your physician or other healthcare provider for specific medical advice.
