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Ultimate Guide to Hamstring Strains and Tears
Ultimate Guide to Hamstring Strains and Tears

Deep dive into hamstring strains and tears: signs and symptoms, self-diagnosis techniques and effective self-management strategies

Adrian D'Costa avatar
Written by Adrian D'Costa
Updated this week

Hamstring strains are a common and frustrating injury for runners of all levels. These injuries can sideline even the most dedicated athletes, disrupting training schedules and impacting performance. Understanding the causes, symptoms, and effective management strategies for hamstring strains is crucial for any runner looking to maintain peak performance and avoid recurrent issues. This blog will explore the intricacies of hamstring strains, including how they occur, how to self-diagnose and manage them, and how to safely return to running after an injury.

What Causes Hamstring Strains?

Hamstring strains typically occur due to excessive stress placed on the muscles at the back of the thigh. These muscles include the biceps femoris, semitendinosus, and semimembranosus. Several factors can contribute to hamstring strains, particularly in runners:

1. Speed and Intensity: Running at high speeds significantly increases the load on the hamstrings. The hamstrings are most vulnerable during the terminal swing phase of the running gait, where they work eccentrically (muscle contracts as it lengthens) to decelerate the leg and prepare it for ground contact. The faster you run, the greater the force the hamstrings must handle, increasing the risk of strain.

2. Muscle Imbalances: An imbalance between the strength and flexibility of the hamstrings and the quadriceps can predispose runners to strains. Additionally, research shows us that hamstrings that are both weak and lack flexibility have an increased risk of injury.

3. Fatigue and overtraining: Tired muscles are less capable of absorbing shock and are more prone to injury. As the hamstrings fatigue, their ability to effectively decelerate the leg and stabilise the knee decreases, making strains more likely. This is where monitoring your training load and periodically implementing deload weeks in your training is necessary.

4. Previous Injuries: The high recurrence rate of hamstring strains is often linked to incomplete rehabilitation. Without fully restoring the strength, flexibility, and functional capacity of the hamstrings, runners may return to their activities too soon, leading to repeated injuries and prolonged periods of running.

How to Self-Diagnose a Hamstring Strain

Recognising the symptoms of a hamstring strain can help runners take timely action to prevent further damage. Here are common signs to watch for:

  • Sudden Sharp Pain: A sudden, sharp pain at the back of the thigh during a run or sprint is a key indicator of a hamstring strain. The pain is usually immediate and can be severe.

  • Swelling and Bruising: In the hours and days following the injury, swelling and bruising may develop around the affected area.

  • Tenderness: The hamstring muscles may be tender to touch, particularly where the strain has occurred.

  • Weakness and Stiffness: Difficulty in extending the leg or walking without pain can indicate a significant strain. As well as difficulty performing a bridge (either single or double leg).

  • Running limitations: Inability to run at faster paces. Some low level strains might be able to tolerate easy running, however as the pace increases, this can result in a flare-up of symptoms.

IMPORTANT! It is essential that you seek a medical opinion on the diagnosis and management of your hamstrings injury to ensure you’re on the right track. Some strains might require further assessment in the form of an ultrasound or MRI scan. Additionally, Hamstrings strains are classified on a grading system which has a resulting time needed off one’s sport (i.e. running or types of runs).

Self-Management Strategies

Managing a hamstring strain effectively involves several stages, from initial rest to rehabilitation and finally, a structured return to running. Here’s a detailed guide:

1. Relative Rest and Initial Care

  • Reduce Running Load: Stop running or significantly reduce your mileage to prevent further injury. In Severe cases you may need to focus on low-impact activities that do not stress the hamstrings.

  • Ice: Apply ice to the affected area for 15-20 minutes every 2-3 hours during the first 48 hours to reduce pain.

  • Elevation: Elevate your leg when possible to decrease swelling.

2. Rehabilitation to Restore Strength and Power

  • Strengthening Exercises: Once pain allows, incorporate hamstring-strengthening exercises such as bridges, hamstring curls, and eccentric exercises like Nordic hamstring curls and Romanian deadlifts. Gradually increase the intensity as your strength improves.

  • Core and Glute Strengthening: Strengthen the core and gluteal muscles to improve overall stability and reduce the load on the hamstrings.

3. Return to Run Programming

  • Gradual Progression: Start with low-intensity running and gradually increase the duration and intensity. Monitor your symptoms closely and avoid any activities that cause pain.

  • Interval Training: Once you’re able to return to running at an easy pace and build volume with your weekly mileage. Look to incorporate interval training with a focus on gradually increasing speed and intensity as well as volume of speed/intensity.

  • Warm-Up appropriately: Prior to each run, perform dynamic movements to prime and activate the hamstrings and other muscles for activity. Include exercises like squats, split squats, high knees, and butt kicks to name a few.

  • Consistency and Patience: Adhere to your rehabilitation and return-to-run plan consistently. Patience is key to avoiding re-injury.

Hamstring strains are a common yet preventable injury among runners. Understanding the causes and recognising the symptoms early can significantly improve outcomes. Effective management, from initial rest to a structured rehabilitation and return-to-run programme, is essential for a full recovery and prevention of recurrence. By taking proactive steps and listening to your body, you can get back on track and continue enjoying your running journey without the setback of hamstring injuries.

Achieving optimal rehabilitation requires careful implementation of all the factors mentioned above, all working in harmony with each other. Remember, hamstrings strains don’t always play by the rules. Listen to your body, always seek professional guidance, and prioritise your rehabilitation.

For expert help and management please feel free to contact my team at The Running Room (www.therunningroom.net)

Adrian D’Costa

Running Physiotherapist

Founder of The Running Room

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