Hamstring Strain

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A hamstring strain can occur during an isolated athletic activity (acute) or result from persistent repetitive stress (chronic). Often an acute strain occurs as a result of a chronic condition which has rendered the muscle weak and vulnerable .

As in the case of the football player, hamstring strains often occur while sprinting. They also can occur during jumping and other activities where quick starts and stops are required. High risk sports for hamstring strains are: triathlon, rugby, tennis, basketball, and many track and field events. Runners are especially susceptible to chronic hamstring strains due to the repetitive nature of the sport.

Hamstring strain anatomy

Three muscles in the back of the thigh are collectively called the hamstrings: hurting these muscles leads to hamstring strain.

biceps femoris



The two general attachment sites for the hamstrings are the bony prominence felt under each “cheek” when sitting (ischeal tuberosity) and the back of the knee.

Contraction of the hamstring causes the knee to bend and the thigh to move backwards relative the trunk, although these actions usually do not occur simultaneously.

The hamstrings play a vital role in walking, running, jumping, and controlling movements of the trunk.

Most hamstring strains occur in the musculotendinous complex. This is the area where the muscles and tendons join. (Tendons are bands of tissue that connect muscles to bones.) The hamstring has a largemusculotendinous complex, which partly explains why hamstring strains are so common.


Hamstring strains are classified as either 1st, 2nd, or 3rd degree depending on the severity.

First Degree:

Excessive stretching or minor tearing of a few muscle fibres. The pain can often be localised with one finger. Some stiffness and weakness will also be present. If exercise is attempted, the pain and stiffness may decrease during the activity, but return after, often with much greater intensity.

Second Degree:

Covering a larger area than the 1st degree strain. Stiffness and weakness will be felt and the painful area may appear black and blue due to bleeding within the injured muscle. Significant limping may also occur when walking.covering a larger area than the 1st degree strain. Stiffness and weakness will be felt and the painful area may appear black and blue due to bleeding within the injured muscle. Significant limping may also occur when walking.

Third Degree:

A complete tear of the muscle. Wide-spread bruising will be present and a “balling up” of the muscle may be seen or felt with you hand. 3rd degree strains are a rare occurrence.


Hamstring strains treatment in the acute phase

When the hamstring is injured, the fibres of the muscles or tendon are actually torn. The body responds to the damage by producing enzymes and other body chemicals at the site of the injury. These chemicals produce the symptoms of swelling and pain.


Remember that many hamstring strains occur at contact phase of gait (when the foot hits the ground) due to increased biomechanical stress at this point. No amount of exercising will influence what happens at the point of heel strike, mid-stance and toe off phases of gait. It is therefore vital to improve your biomechanics with orthotics designed for your chosen sport.

Think you require treatment for your biomechanical problems?

Visit our Sports podiatry clinic directory pages for a clinic near you.

Golden rule- Don’t ignore the problem, it won’t go away!

The way we function biomechanically is predominantly controlled by genetics, its hereditary (runs in the family). The way you function is set and cannot be cured. What you can do however is control lower limb biomechanics by altering foot position during the contact phase of gait. This can only be done by wearing a good shoe (see our shoe guide) and with orthotics (foot beds).

This is the cheapest and most cost effective way for any athlete to reduce the risks of injury from occurring and from helping to prevent re-injury. Overall costs for the average athlete will run into pennies per mile/hour of sport. Orthotics are designed to alter the biomechanics during the time the foot is on the ground. They are also used to provide increased shock absorbency working in harmony with the sport shoe worn.

Returning to Activity

With calf strain, the goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity is determined by how soon your sesamoids recover, not by how many days or weeks it has been since your injury occurred.

After suffering from calf strain, you may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:

You have full range of motion in the injured foot compared to the uninjured foot.

You have full strength of the injured foot compared to the uninjured foot.

You can jog straight ahead without pain or limping.

You can sprint straight ahead without pain or limping.

You can do 45-degree cuts, first at half-speed, then at full-speed.

You can do 20-yard figures-of-eight, first at half-speed, then at full-speed.

You can do 90-degree cuts, first at half-speed, then at full-speed.

You can do 10-yard figures-of-eight, first at half-speed, then at full-speed.

Getting professional advice

If self treatment is not working or you are concerned regarding the severity of your condition it is always wise to gain a professional opinion. A good sports podiatrist is your best option preferably a clinic that is affiliated with other members of the multi- disciplinary team such as physios, sports rehab instructors etc.

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