Hamstring injury

Diagnosis

To diagnose a hamstring injury, a healthcare professional does a physical to check for swelling and tenderness along the back of the thigh. Where the pain is and how bad it is can give useful information about the damage.

Moving the injured leg into different positions helps pinpoint which muscle is hurt and whether there is damage to ligaments or tendons.

Imaging tests

In severe hamstring injuries, the muscle can tear, or the muscle tendon can separate from the pelvis or shinbone. When this happens, a small piece of bone can be pulled away from the main bone. This is known as an avulsion fracture. X-rays can check for avulsion fractures, while ultrasound and MRIs can show tears in the muscles and tendons.

Treatment

The first goal of treatment is to reduce pain and swelling. A healthcare professional might suggest the following:

• Take a break from strenuous activities to allow the injury to heal.
• 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 the leg elevated above the level of the heart, if possible, to lessen swelling.
• Take pain medicine you can get without a prescription. Examples include ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others).

Physical therapy

Your healthcare professional or physical therapist can show you how to do gentle hamstring stretching and strengthening exercises. After the pain and swelling go down, your care team can show you how to do exercises to build more strength.

Surgery or other procedures

Most partial hamstring tears heal over time with physical therapy and do not require surgery. If the muscle tendons have pulled free from the pelvis or the shinbone, orthopedic surgeons can reattach them. Serious muscle tears also may need to be surgically repaired.

An emerging treatment option is platelet-rich plasma (PRP) therapy. This treatment involves taking a sample of your own blood and separating out the platelets and other healing factors. The solution of platelets and healing factors is then injected into the injured area. Researchers are still exploring the best way to use PRP, but it has shown promise in the treatment of muscle injuries.

Lifestyle and home remedies

To care for a minor hamstring injury yourself, try the R.I.C.E. approach:

• Rest. Take a break to rest your hamstring muscles and allow the damaged tissues to recover. Avoid any activity that causes pain, swelling or discomfort. If you have more than a minor muscle strain, your healthcare professional may recommend that you use crutches to keep weight off the injured leg.
• Ice. Ice the area as soon after the injury as you can. For the first few days after the injury, keep an ice pack on the injured area for 15 to 20 minutes every 2 to 3 hours while you are awake. Cold reduces pain and swelling. It also may slow bleeding if there is a tear. If you have vascular disease, diabetes or don't have much feeling in your leg, talk with your healthcare professional before icing.
• Compression. Wrap your leg with an elastic bandage until the swelling goes down. Be careful not to wrap too tightly. 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 raised while resting. If possible, raise your leg higher than your heart.

Pain medicine you can get without a prescription, such as ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others), also might help. After a few days, start using your injured leg gently. Over time, your leg should get better at supporting your weight and moving without pain.

Preparing for your appointment

You might first talk with your primary healthcare professional. You might be referred to an expert who practices sports medicine or does orthopedic surgery.

What you can do

Make a list that includes:

• Complete information about your symptoms and when they began.
• Information about medical issues you have had.
• All the medicines and supplements you take, including doses.
• Questions you want to ask the care team.

What to expect from your doctor

Your care team might ask some of the following questions:

• When did the injury occur and how did it happen?
• Did you feel a popping or tearing sensation?
• Do any movements or positions make the pain better or worse?