Hamstring strain - aftercare

There are 3 levels of hamstring strains:

• Grade 1 -- mild muscle strain or pull
• Grade 2 -- partial muscle tear
• Grade 3 -- complete muscle tear

The recovery time depends on the grade of the injury. A minor grade 1 injury can heal in a few days, while a grade 3 injury could take much longer to heal or need surgery. You may need surgery if the tear is near your buttock and the tendon is retracted.

You can expect swelling, tenderness, and pain after a hamstring strain. Walking may be painful.

To help your hamstring muscle heal, you may need:

• Crutches if you cannot put any weight on your leg
• A special bandage wrapped around your thigh (compression bandage)
• An injection can sometimes be done to help with recovery

Symptoms, such as pain and soreness, may last:

• 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 very close to the buttock or knee or there is a lot of bruising:

• It may mean the hamstring tendon 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.

Follow these steps for the first few days or weeks after your injury:

• 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.

For pain, you can use ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol). You can buy these pain medicines at the store.

• 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.

When your pain has decreased enough, you can begin light stretching and light physical activity. Make sure your provider knows what you are doing and agrees with your activity level.

Slowly increase your physical activity, such as walking. Follow the exercises your provider gave you. As your hamstring heals and gets stronger, you can add more stretches and exercises.

Take care not to push yourself too hard or too fast. A hamstring strain can recur, or your hamstring may tear.

Talk to your provider before returning to work or any physical activity. Returning to normal activity too early can cause reinjury.

Follow up with your provider 1 to 2 weeks after your injury. Based on your injury, your provider may want to see you more than once during the healing process.

Contact your provider if:

• You have sudden numbness or tingling.
• You notice a sudden increase in pain or swelling.
• Your injury does not seem to be healing as expected.

Pulled hamstring muscle; Sprain - hamstring

Cianca J, Mimbella P. Hamstring strain. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 68.

Hammond KE, Kneer LM. Hamstring injuries. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 86.

Reider B, Davies GJ, Provencher MT. Muscle strains about the hip and thigh. In: Reider B, Davies GJ, Provencher MT, eds. Orthopaedic Rehabilitation of the Athlete. Philadelphia, PA: Elsevier Saunders; 2015:chap 24.

Switzer JA, Bovard RS, Quinn RH. Wilderness orthopedics. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach's Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 22.

Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.