How to Treat a Pulled Hamstring Muscle

Exercises and tips to help your hamstring recover

Co-authored by Julian Arana, M.S.eD., NCSF-CPT

Last Updated: March 9, 2024

Even a minor strain on your hamstring should be treated immediately to reduce swelling and encourage the healing process as soon as possible. It can be tough for an athlete to accept the need to rest and return to exercises gradually, but pushing oneself too hard greatly increases the chance of re-injury. In most cases, the injured person is back to normal within a few weeks, but in severe cases surgery may be required.

Part 1

Part 1 of 3:

Immediate Treatment

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1
Call a doctor promptly for severe injuries. A severe injury may require surgical reattachment, and should be brought to a doctor's attention as soon as possible.^{[1]
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Research source} If any of the following symptoms match your condition, your hamstring muscle may be completely torn, or pulled off the bone:
- A popping sound of feeling at the time of injury.
- An injury very close to the buttock or knee.
- A large amount of bruising.
- Difficulty walking.
- Severe pain or weakness in injured leg.
- See Warnings, below, for symptoms that require medical attention at any point in the healing process.
2
Evaluate the injury. If the location of the injury is not obvious, gently press along the length and circumference of your thigh to locate it. Stretching injuries tend to involve the upper thigh, while sprinting is more likely to tear muscle near the knee.^{[2]
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- If there is no obvious injury site and there was no impact or fall that may have caused your hamstring to pull, the pain could be due to pelvis or back problems instead. Contact a doctor if you think this might be the case.
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Get off your feet as soon as you can after injury, even if you only feel mild twinges. Some pulled hamstrings, especially those in the upper thigh, involve damage to a tendon. These feel less painful than muscle injuries, but take longer to heal and still require rest. Walk as little as possible for the first few days, and avoid all running and leg exercises. If walking involves any pain at all, shorten your stride to a non-painful distance.^{[3]
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Trustworthy Source

Cleveland Clinic
Educational website from one of the world's leading hospitals

Go to source} If even a short stride causes pain, use a pair of crutches and visit a doctor.
4
Apply an ice pack once an hour. Use a cold pack, or wrap ice in a wet towel, and place it on the injury site. Leave this on for 10 to 15 minutes, then take it off. Repeat this once an hour during the day you pulled your hamstring.^{[4]
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Research source} Continue icing once every two or three hours for the next couple days after that.
- To avoid damage, do not apply ice directly to skin, and do not leave it on for more than 15 minutes.
- Do not use this treatment if you have Raynaud's phenomenon or other blood circulation issues.^{[5]
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5
Compress your leg. Wrap an elastic compression bandage or athletic tape around your thigh, starting above the knee and ending about 3 inches (7.5 cm) below the groin. When circling around your leg, make sure each new circle overlaps with about 50% of the last. The end result should be snug, but not uncomfortably tight or cutting off circulation.
- You can purchase a slip-on thigh wrap from a sporting goods store instead.
To reduce swelling, sit or lie down and prop your leg up on a tall object, so the site of the injury is higher than your heart. Do this as much as possible for the first 24 hours after the injury.^{[6]
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Take painkillers only if necessary. In order to manage pain and potentially reduce swelling, take an NSAID painkiller such as ibuprofen, naproxen, or acetaminophen.^{[7]
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Research source} These should only be used for short-term pain management in order to minimize side effects, unless you have a recommendation from a doctor. Some doctors discourage their use during this period, due to the possibility of slowed healing.
- Talk to a doctor first if you have high blood pressure, heart disease, or kidney disease, or if you have had stomach ulcers or internal bleeding issues in the past.^{[8]
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Avoid making it worse. Besides avoiding running and other exercise, stay away from the following for the next few days, until you can walk without pain:
- Avoid heat (take lukewarm baths or showers)
- Avoid alcohol
- Avoid massages
Until you can walk without pain or twinges, ice your injury once every two or three waking hours, for 10 to 15 minutes, and minimize the amount of activity involving your leg. This usually lasts for three or four days after the injury.^{[9]
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Continuing Treatment

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Switch to hot/cold treatment. At this point, instead of icing the injury, you can apply a hot pack for 3 minutes, then a cold pack for 1 minute. Repeat this six times, for a total of 24 minutes. Perform this treatment twice a day until your leg is recovered enough to jog for five minutes without pain.^{[10]
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Research source} Be aware that this treatment is not completely understood, and some doctors prefer to switch entirely to hot treatments.
- In general, cold treatment reduces blood flow, while heat increases it. Increased blood flow encourages healing but also increases swelling, so heat should not be used while the injury is still painful and significantly swollen.
2
Begin gentle stretching exercises. Cautiously begin using one or both of the following stretches, but stop or reduce the amount of stretching immediately if you feel pain at any point. The goal is to slightly stretch the injured area, not to increase your flexibility, so keep these stretches lighter than they normally would be.^{[11]
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Research source} To begin with, hold each stretch for no more than 10 seconds, relax, then repeat for a set of three to six stretches, depending on your comfort. Do this several times per day.^{[12]
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- Place your foot on a low table or a chair, and stretch forward from the hip into a comfortable, relaxed position with a gentle stretch at the back of your leg.
- Lie on your back and lift your leg vertically, or as high as is comfortable. Gently pull back on your thigh with your hands, with your knee slightly bent.
3
Perform muscle strengthening exercises. If you can stretch without pain, begin additional exercises to get your muscles back to full strength. Ideally, you should consult a doctor to learn which exercises will focus on your injured muscle with minimal risk of damage. If you do not have access to a doctor, try the following once every one to two days, but stop immediately if you experience pain:
- Lie on your back and bring your knee up to a slight angle. Contract your thigh muscle with about 50% of its maximum force, hold for thirty seconds, then relax and repeat several times. If still pain-free, repeat with your knee at a narrower angle, bringing your foot back up toward your hip.
- Sit on a wheeled chair or stool and place both heels on the floor, flexing your hamstrings to pull yourself forward. After a few days of this, try using just the heel of the injured leg.
After this stage is done, you should be able to jog for a few minutes without pain, and have an almost normal range of movement. A slight pulled hamstring can get through this stage in one to ten days, while a more significant injury can last two to three weeks. An injury that involves a massive tear and severe pain can take many weeks to heal, or may even require surgery.

Part 3

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Regaining Full Function

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Stretch dynamically and with full range of motion. Once the injury is essentially healed and you are trying to regain former flexibility, your stretching exercises should involve dynamic motion once every other day, with the leg swinging during the stretch. If you feel pain, stop and return to gentler stretches. Here are a couple examples, but consult a sports injury specialist for advice specific to your needs:^{[13]
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Trustworthy Source

PubMed Central
Journal archive from the U.S. National Institutes of Health

Go to source}
- Stand on your uninjured leg and gently swing the injured leg forward. The leg should stay relaxed, but swing out as far as is comfortable for you. Do this in three sets of ten reps.
- Lie on your back and bring your hips into the air, supported on your hands. Cycle your legs upside down.
2
Use more powerful strengthening exercises. There are many ways to strengthen your hamstrings, and a doctor or sports trainer can tell you which methods are best for your purpose. Try performing hamstring curls by lying on your back and lifting your ankle with ankle weights on, eventually progressing to seated hamstring curls, then standing hamstring curls.
- If you exercise your quadriceps, add these hamstring strengthening exercises to your regular routine. Quadriceps that are much stronger than your hamstring muscles increase the risk of another strain or tear.^{[14]
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To minimize the chance of re-injury, aim to increase the intensity or duration of your exercise routine by no more than 10% each week.^{[15]
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Be very careful when coming back into your activities. If you feel like something's wrong, stop immediately.

How Do You Recover From a Hamstring Injury?

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Question

How do you know if you pulled a hamstring?

Julian Arana, M.S.eD., NCSF-CPT
Certified Personal Trainer
Julian Arana is a Personal Trainer and the Founder of B-Fit Training Studios, a personal training and wellness set of studios based in Miami, Florida. Julian has over 12 years of personal training and coaching experience. He is a certified personal trainer (CPT) by the National Council on Strength and Fitness (NCSF). He has a BS in Exercise Physiology from Florida International University and an MS in Exercise Physiology specializing in strength and conditioning from the University of Miami.

Julian Arana, M.S.eD., NCSF-CPT

Certified Personal Trainer

Expert Answer

If you pull your hamstring, the first thing you should do is to get examined by an athletic trainer or a physical therapist to determine the severity of the injury. Then, follow the RICE method, which stands for rest, ice, compression, and elevation. Finally, rehabilitate the injury by doing exercises for both your entire body and for the affected area.

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Should I stretch my strained hamstring?

Kevin Stone, MD
Board Certified Orthopaedic Surgeon
Dr. Kevin Stone is an orthopaedic surgeon and the founder of The Stone Clinic, a leading orthopaedic surgery, sports medicine, and rehabilitation clinic in the San Francisco Bay Area. With over 30 years of experience, Dr. Stone specializes in knee, shoulder, and ankle repair, using biologic reconstruction and joint replacement. He holds a BS in Biology from Harvard University and a Doctor of Medicine (MD) from the University of North Carolina at Chapel Hill. Dr. Stone completed his residency in Internal Medicine and Orthopaedic Surgery at Harvard University and in General Surgery at Stanford University. He then completed a fellowship in Orthopaedic Research and Surgery at the Hospital for Special Surgery and Tahoe Orthopaedics. He lectures around the world as an expert in cartilage and meniscal growth, replacement, and repair and holds over 40 U.S. patents on novel inventions to improve healthcare. Dr. Stone is a physician for Smuin Ballet and has served as a physician for the U.S. Ski Team, the U.S. Pro Ski Tour, the United States Olympic Training Center, and World Pro Ski Tour.

Kevin Stone, MD

Board Certified Orthopaedic Surgeon

Expert Answer

Yes, gentle stretching can stimulate the body and help your muscles lay down new collagen.

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What do I do if my strained hamstring isn't healing?

Kevin Stone, MD
Board Certified Orthopaedic Surgeon
Dr. Kevin Stone is an orthopaedic surgeon and the founder of The Stone Clinic, a leading orthopaedic surgery, sports medicine, and rehabilitation clinic in the San Francisco Bay Area. With over 30 years of experience, Dr. Stone specializes in knee, shoulder, and ankle repair, using biologic reconstruction and joint replacement. He holds a BS in Biology from Harvard University and a Doctor of Medicine (MD) from the University of North Carolina at Chapel Hill. Dr. Stone completed his residency in Internal Medicine and Orthopaedic Surgery at Harvard University and in General Surgery at Stanford University. He then completed a fellowship in Orthopaedic Research and Surgery at the Hospital for Special Surgery and Tahoe Orthopaedics. He lectures around the world as an expert in cartilage and meniscal growth, replacement, and repair and holds over 40 U.S. patents on novel inventions to improve healthcare. Dr. Stone is a physician for Smuin Ballet and has served as a physician for the U.S. Ski Team, the U.S. Pro Ski Tour, the United States Olympic Training Center, and World Pro Ski Tour.

Kevin Stone, MD

Board Certified Orthopaedic Surgeon

Expert Answer

Talk to your doctor about treatment options. You may be a candidate for a PRP injection, which can help stimulate your body's healing response.

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Tips

The hamstring is actually three separate muscles: the semitendinosus, semimembranosus and biceps femoris.^{[16]
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Massage can cause harm in the first few days following the injury, but may help once the immediate pain is gone. Begin with very gentle, light massage, and avoid deep tissue massage for several weeks.

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Warnings

If your leg becomes more painful, more swollen, or more bruised, call a doctor.

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If you feel any tingling or numbness before your leg finishes healing, contact a doctor. This could be a sign of nerve damage.^{[17]
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