Diagnosis

During the physical exam, your doctor will check for swelling and points of tenderness along the back of your thigh. The location and intensity of your pain can help determine the extent and nature of the damage.

Your doctor might also move your injured leg into a variety of positions to help pinpoint which muscle has been injured and if you also have any ligament or tendon damage.

Imaging tests

In severe hamstring injuries, the muscle can tear or even detach from where it's connected to the pelvis or shinbone. Sometimes, a small piece of bone is pulled away (avulsion fracture) from the main bone when this detachment occurs. X-rays can check for avulsion fractures, while ultrasound and MRIs can visualize tears in your muscles and tendons.

Treatment

The initial goal of treatment is to reduce pain and swelling. To accomplish this, your doctor may recommend that you do the following:

  • Take a break from strenuous activities to allow the injury to heal.
  • Use a cane or crutches to avoiding putting your full weight on your injured leg.
  • Apply ice packs several times a day to relieve pain and reduce swelling.
  • Wrap the injured area with a compression bandage or wear compression shorts to minimize swelling.
  • Rest with your leg elevated above the level of your heart, if possible, to improve drainage and minimize swelling.
  • Take an over-the-counter pain medication, such as ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others), to reduce pain and inflammation.

Physical therapy

After the initial pain and swelling of a hamstring injury subside, your doctor or a physical therapist can show you how to perform specific exercises designed to improve flexibility and strengthen your hamstring muscles.

Surgery

If your muscle has pulled free from where it's connected to your pelvis or shinbone, orthopedic surgeons can reattach it. Severe muscle tears also can be repaired.

Lifestyle and home remedies

For immediate self-care of a hamstring injury, try the R.I.C.E. approach — rest, ice, compression, elevation. If your injury is worse than a minor muscle strain, you'll want your doctor and physical therapist to help you with this process:

  • Rest. Take a break from strenuous activities to rest your hamstring muscles and allow the damaged tissues to repair. Avoid any activity that causes pain, swelling or discomfort. For a more extensive injury, your doctor may recommend that you use crutches so that you keep your weight off your injured leg.
  • Ice. Even if you're seeking medical help, ice the area immediately. For the first few days after the injury, put an ice pack on the injured area for 15 to 20 minutes every two to three hours while you're awake.

    Cold reduces pain, swelling and inflammation in injured muscles, joints and connective tissues. It may also slow bleeding if a tear has occurred.

    If your skin turns white when it's being iced, stop treatment immediately. If you have vascular disease, diabetes or decreased sensation, talk with your doctor before applying ice.

  • Compression. Wrap your leg with an elastic compression bandage until the swelling goes down. Be careful not to wrap your leg too tightly for you may impair circulation.

    Begin wrapping at the end farthest from your heart. Loosen the bandage if the pain increases, the area becomes numb or swelling occurs below the wrapped area.

  • Elevation. Sit or lie back with your leg elevated while resting. If possible, elevate your leg higher than the level of your heart. Gravity helps reduce swelling by draining excess fluid.

Over-the-counter pain medications, such as ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others), also can be helpful. After a few days, gently begin to use the injured leg. You should notice a gradual, improvement in your leg's ability to support your weight and your ability to move without pain.

Preparing for your appointment

While you may initially consult your family physician, he or she may refer you to a doctor who specializes in musculoskeletal medicine, such as someone in sports medicine or orthopedic surgery.

What you can do

You may want to write a list that includes:

  • Detailed descriptions of your symptoms
  • Information about medical problems you've had
  • All the medications and dietary supplements you take
  • Questions you want to ask the doctor

What to expect from your doctor

Your doctor probably will ask some of the following questions:

  • When did the injury occur and how exactly did it happen?
  • Did you feel a popping or tearing sensation?
  • Does any particular motion or position ease or worsen the pain?
Oct. 03, 2015
References
  1. Alzahrani M, et al. Hamstring injuries in athletes: Diagnosis and treatment. The Journal of Bone and Joint Surgery. 2015;3:e5.
  2. DeLee JC, et al. Hamstring injuries. In: DeLee & Drez's Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed Sept. 13, 2015.
  3. Hay WW, et al. Sports medicine. In: Current Diagnosis & Treatment: Pediatrics. 22nd ed. New York, N.Y.: McGrawHill Education; 2014. http://www.accessmedicine.com. Accessed Sept. 13, 2015.
  4. Sprains and strains. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/health_info/sprains_strains/default.asp. Accessed Sept. 13, 2015.
  5. Fields KB, et al. Hamstring muscle and tendon injuries. http://www.uptodate.com/home. Accessed Sept. 13, 2015.