Hamstring strains are one of the most common soft tissue injuries, particularly among athletes and individuals involved in activities that require sprinting, jumping, or sudden acceleration. The hamstrings—a group of three muscles (biceps femoris, semitendinosus, and semimembranosus) located at the back of the thigh—are responsible for knee flexion and hip extension. When these muscles are overstretched or subjected to excessive force, a strain or tear can occur, leading to pain, swelling, and impaired function.
At Adaptive Physiotherapy & Massage in Booragoon, we take an evidence-based approach to treating hamstring strains, incorporating manual therapy and structured exercise rehabilitation to restore strength, flexibility, and function.
Understanding Hamstring Strains
Hamstring strains occur when the muscle fibers are overloaded beyond their capacity, leading to microtears or complete ruptures. This injury is common in sports such as football, soccer, rugby, and athletics, where high-speed running, kicking, or rapid changes in direction place significant stress on the hamstring muscles.
Levels of Hamstring Strain
Hamstring strains are classified into three grades based on severity:
- Grade 1 (Mild Strain)
- Small microtears in the muscle fibers.
- Mild discomfort with minimal swelling.
- No significant loss of strength or mobility.
- Grade 2 (Moderate Strain)
- Partial tearing of the muscle fibers.
- Increased pain, swelling, and bruising.
- Difficulty extending the leg or bearing weight.
- Grade 3 (Severe Strain or Rupture)
- Complete tear of the hamstring muscle.
- Severe pain, swelling, and significant bruising.
- Possible “popping” sensation at the time of injury.
- Significant loss of strength and function.
At Adaptive Physiotherapy & Massage in Booragoon, our detailed assessment process helps determine the severity of the injury and the most appropriate rehabilitation strategy.
Evidence-Based Treatment for Hamstring Strains
Successful management of hamstring strains requires a structured, progressive rehabilitation approach. At Adaptive Physiotherapy & Massage in Booragoon, our treatment aims to reduce pain, restore strength, and prevent reinjury.
Manual Therapy for Hamstring Strains
Manual therapy plays a crucial role in reducing muscle tension, improving flexibility, and restoring proper movement mechanics. At Adaptive Physiotherapy & Massage in Booragoon, we use hands-on techniques to enhance recovery.
1. Soft Tissue Mobilization & Myofascial Release
- Helps reduce muscle tightness and prevent adhesions from forming within the healing muscle tissue.
- Releases excess tension in the hamstrings, glutes, and lower back, which often compensate for the injury.
2. Joint Mobilization
- Ensures proper hip, knee, and pelvic mobility, reducing unnecessary strain on the hamstrings.
- Improves biomechanical efficiency, allowing the muscles to function optimally.
3. Neuromuscular Re-education
- Enhances proprioception and muscle coordination, reducing the risk of reinjury.
- Focuses on restoring optimal movement patterns to avoid compensatory mechanics.
1. Early-Stage Management (Acute Phase)
In the first few days to a week, the primary focus is on reducing pain, inflammation, and preventing further damage. This phase is crucial in ensuring the injury does not worsen and that recovery starts on the right path.
Key Strategies:
- Activity Modification: Avoid excessive stretching or forceful contractions, as this can exacerbate microtears and delay healing.
- Pain and Swelling Reduction:
- Ice therapy, compression, and elevation can help manage acute inflammation.
- Gentle isometric contractions (muscle activation without movement) may help with pain modulation and maintain some muscle function.
- Gentle Range of Motion (ROM) Exercises:
- Controlled movements such as heel slides and seated knee extensions help maintain mobility without placing stress on the healing muscle fibers.
- Passive stretching should be avoided during this stage, as excessive elongation of the healing tissue may lead to further tearing.
2. Mid-Stage Rehabilitation (Subacute Phase)
Once pain levels decrease, swelling subsides, and basic movements become pain-free, the goal shifts towards restoring strength, flexibility, and functional mobility. This phase generally lasts 1 to 4 weeks, depending on the severity of the strain.
Key Strategies:
- Gradual Strengthening:
- Isolated hamstring exercises begin at low loads and progress slowly.
- Isometric holds (holding a contraction without movement) transition into eccentric exercises (muscle lengthening under load), which are key for tendon and muscle repair.
- Example exercises include:
- Seated hamstring curls with light resistance
- Isometric glute bridges
- Nordic hamstring curls (assisted at first)
- Controlled Range of Motion & Flexibility Training:
- Gentle dynamic stretches (not static) help restore mobility without excessive strain.
- Foam rolling the quadriceps, glutes, and hip flexors may reduce secondary tightness contributing to compensatory patterns.
- Neuromuscular Activation:
- Proprioception and balance exercises improve hamstring coordination and movement control.
- Example exercises:
- Single-leg balance drills
- Stability ball leg curls
3. Late-Stage Rehabilitation (Strength & Function Phase)
At this stage, the focus is on building muscle endurance, improving load tolerance, and restoring normal movement patterns. The timeframe for this phase varies, but it usually starts around 4-8 weeks post-injury.
Key Strategies:
- Progressive Strength Training:
- Eccentric loading is progressed to heavy slow resistance training, an approach proven to enhance tendon remodeling and prevent reinjury.
- Example exercises include:
- Nordic hamstring curls (progressively increasing difficulty)
- Romanian deadlifts (starting with body weight and progressing to resistance)
- Single-leg Romanian deadlifts for unilateral strength balance
- Dynamic Mobility & Flexibility:
- Full functional movement patterns are reintroduced, including agility work, explosive movements, and controlled flexibility exercises.
- Progressive hamstring stretching is incorporated, but only once strength has been restored to reduce reinjury risk.
- Sport-Specific Movements:
- Athletes returning to sports begin plyometric drills and progressive sprint work.
- Key drills:
- High-knee sprint mechanics
- Lateral bounds
- Acceleration drills
- Drop jumps for reactive strength
4. Return-to-Sport Phase (Performance & Reinjury Prevention)
This phase is crucial for ensuring the hamstring is fully capable of handling the demands of competition or high-intensity activity. The timeline depends on injury severity and rehab progression, but a gradual, monitored return is essential.
Key Strategies:
- Sprint Mechanics and Power Training:
- Acceleration and deceleration drills help mimic real-life sports movements.
- Example exercises:
- Resisted sprints (sled pulls, band-assisted drills)
- Agility ladder drills
- Plyometric & Explosive Strength Training:
- Emphasizes elastic loading of the hamstring for force absorption and power generation.
- Example exercises:
- Depth jumps
- Bounding drills
- Box jumps with controlled landings
- Ongoing Strength & Maintenance Training:
- Nordic curls, deadlifts, and eccentric training remain key elements to prevent reinjury.
- Monitoring muscle fatigue levels ensures proper recovery between high-load sessions.
At Adaptive Physiotherapy & Massage in Booragoon, we guide athletes and active individuals through evidence-based return-to-sport protocols, ensuring their hamstrings are resilient, strong, and ready for competition.
Additional Considerations for Hamstring Recovery
Preventing Reinjury
- Gradual return to activity is essential; reinjury rates are high when hamstrings are overloaded too soon.
- Maintaining hip and core strength prevents compensatory movement patterns.
Bracing and Taping
- In some cases, elastic therapeutic taping can support muscle activation and reduce strain.
- Functional bracing may be used for severe strains during return to sport.
Conclusion
Hamstring strains can be frustrating, but with structured rehabilitation, progressive strengthening, and proper biomechanical correction, individuals can fully recover and reduce the risk of reinjury. At Adaptive Physiotherapy & Massage in Booragoon, we combine manual therapy, neuromuscular retraining, progressive exercise therapy, and sport-specific drills to ensure a safe and efficient return to activity.
If you’re experiencing hamstring pain or have suffered a recent hamstring strain, contact Adaptive Physiotherapy & Massage in Booragoon for a tailored rehabilitation program that supports full recovery and long-term injury prevention.
References
- Askling, C. M., Tengvar, M., & Thorstensson, A. (2013). “Acute hamstring injuries in Swedish elite football: A prospective randomised controlled clinical trial comparing two rehabilitation protocols.” British Journal of Sports Medicine, 47(15), 953-959.
- Petersen, J., & Holmich, P. (2005). “Evidence-based prevention of hamstring injuries in sport.” British Journal of Sports Medicine, 39(6), 319-323.
- van Dyk, N., et al. (2017). “Preseason Strength and Flexibility Training Reduces the Risk of Hamstring Injury in Professional Soccer Players.” American Journal of Sports Medicine, 45(10), 2315-2321.
- Schmitt, B., Tyler, T. F., & McHugh, M. P. (2012). “Hamstring injury rehabilitation and prevention of reinjury using eccentric exercises.” Strength and Conditioning Journal, 34(5), 56-64.
- Timmins, R. G., et al. (2016). “Architectural adaptations of muscle to training and injury in athletes with a history of hamstring strain injuries.” Journal of Orthopaedic & Sports Physical Therapy, 46(7), 590-599.
