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​Hamstring pulls

​​​​​​​​​​​​​​​​​​​​Injuries to the hamstring muscle group are common during practice and competition. The hamstrings are a group of three muscles on the back of the upper leg: biceps femoris, semimembranosus and semitendinosus. Together they act to flex the knee and extend the hip.

Injury can occur to the hamstring muscle group when it is forced or stretched beyond its limits. Often this happens when the muscle is elongated (stretched) and a sudden load is placed on the muscle that results in a strain or “pull.” Strains can range from minor micro-tearing of the muscle fibers to complete tears of the muscle. Occasionally, the torn muscle can pull off a piece of the bone resulting in an avulsion fracture.

Several factors can increase risk o​f straining the hamstring:

  • Muscle tightness - Tight muscles can predispose you to injury because of decreased range of motion, increased load on muscles and poor mechanics.
  • Muscle imbalance - ​When one muscle group is significantly stronger or more flexible than its opposing muscle group or other connected muscle group; higher forces placed on the weaker or tighter muscle groups can result in injury.
  • Poor conditioning - Doing too much​ too soon or rushing into a sport or sport season can put weak or fatigued muscles at risk for injury.

Prevention of a hamstring strain begins with proper conditioning. This includes stretching, strengthening and a gradual increase in activity when beginning a training regimen. Listen to your body. If you are sore or feel pain after an activity or workout it is advisable to let your body rest.

Proper equipment also is important. Running in improper footwear or using the wrong equipment can lead to injury. If you are unsure of training techniques or how to begin, consult with a local fitness specialist or athletic trainer.

Hamstring strain signs include: a sudden or gradual increase in pain, swelling and bruising, or feeling a “pop,” “snap” or “tear” with decreased range of motion. All can result in limping or inability to bear weight.

If a hamstring strain is suspected, remove yourself from the sport, event or competition.

During the first 48 hours follow the Rest-Icing-Compression-Elevation (RICE) protocol:

  • Rest - allows your body to heal and not cause further injury.
  • Icing - decreases pain and prevents any further swelling in the area. If possible, ice for 20 minutes at a time every hour and a half or multiple times a day.
  • Compression – reduces swelling. An elastic wrap can be used to place compression on the area.
  • Elevation – helps to reduce swelling and bruising to the area. Elevating your leg at a 45-degree angle is enough. Non-steroidal anti-i​nflammatory drugs (NSAIDs), such as aspirin or ibuprofen, also may be used to manage pain and swelling.

Follow up with your health care provider to be evaluated and begin therapy so you can advance on your road to recovery.

Share comments or questions on this information. E-mail sports.medicine@marshfieldclinic.org​.