Hamstring Strain (Pulled Hamstring)

Overview

The hamstrings are three muscles running down the back of the thigh, from the sitting bone to just below the knee. They work hardest at the end of each running stride, slowing the leg down as it swings forward. A hamstring strain — often called a "pulled hamstring" — happens when the muscle is overstretched or overloaded at that moment and some of its fibres tear. People typically feel a sudden sharp pain or a "grab" at the back of the thigh mid-sprint and have to pull up.

Strains are graded by severity, from a mild strain with tightness and little loss of strength, to a larger tear with bruising, a limp and difficulty bending the knee against resistance. Recovery time varies widely with the size and location of the injury — tears involving the tendon tend to take longer than those in the muscle belly — and outcomes vary from person to person.

This is different from hamstring tendinopathy, which develops gradually at the sitting bone. Hamstring strains have a high re-injury rate when people return to sprinting too early, so the focus is a structured, staged return to full speed rather than waiting for the pain to disappear.

Causes and risk factors

• Sprinting, especially at top speed or late in a match when fatigued
• Kicking, high kicks in martial arts or dance, and slipping into the splits
• A previous hamstring strain — the strongest risk factor for another
• Hamstrings that are weak relative to the demands of sprinting, particularly in their lengthened position
• A sudden spike in sprint training or returning to sport after a break
• Inadequate warm-up before fast running
• Age — the risk rises from the late twenties onwards in sprinting sports

How we may be able to help

We start by confirming the diagnosis and estimating the severity: where the pain is, how much strength and range you have lost, and whether there are any signs that the tendon has pulled away from the sitting bone, which needs urgent imaging. We also check the lower back and pelvis, as these can contribute to hamstring overload.

Our physiotherapists guide a staged plan: protecting the muscle in the first days, then early gentle loading, progressing to strengthening in lengthened positions (such as Nordic curls and hip hinges), running drills, and finally graded sprinting and sport-specific work. Evidence suggests that starting appropriate loading early, rather than prolonged rest, may support recovery. We use clear criteria — strength, range and running tolerance — to guide your return to sport.

Kinesiology taping may offer comfort and support during the return-to-running phase, and interferential therapy may be used for short-term pain relief early on. Dry needling may help with tight, protective hamstring muscle in the later stages, once the tear has settled. If a more significant tear is suspected, an online private GP consultation can be arranged for imaging and a specialist referral.

What you can do at home

• Stop sprinting and kicking straight away; walk comfortably and avoid limping where you can
• Use a wrapped ice pack on the back of the thigh for 10–15 minutes several times a day in the first 48 hours
• Avoid hard stretching of the hamstring in the first week — gentle movement within comfort is fine
• Start gentle isometric holds (pressing the heel into the floor) as advised by your therapist
• Keep the rest of your body fit with upper-body work or cycling if it is comfortable
• Do not return to sprinting until you have completed a graded running programme