Treatment of a Torn Hamstring

Options for Rehab of a Pulled Hamstring

stretch hamstring
Stretching the hamstring muscles. Photo © Frank Herzog

Hamstring injuries are common sports-related problems.  A hamstring strain occurs when the muscle fibers of the hamstring muscle in the back of the thigh are stretched too far.  This can cause tearing of the muscle fibers.  Once the injury has been diagnosed, treatment should begin. 

Treatment of a torn hamstring is usually determined by the severity of the injury. Resting a pulled hamstring is the key to successful treatment.

As a general guide, if you have a hamstring strain, you can do activities that do not aggravate your recent injury. Rest until you are pain free giving time for the injured hamstring muscle to heal. Resting insufficiently may prolong your recovery.

The following are common treatments used for hamstring injuries:

  • Rest
    Allowing time for the muscle to rest is the first step in treatment of most hamstring injuries. Rest allows the swelling to subside and inflammation to settle down. In order to sufficiently rest the muscle, sometimes crutches are needed to relieve stress of the muscle.
  • Stretching
    Stretching can begin soon after the injury, but must not be done aggressively or the stretching may exacerbate the injury. Stretching should be gentle and not painful. Often a session or two with physical therapy can help an athlete develop a proper stretching program.  As healing progresses, the intensity of stretching can also progress, but should never be painful.
  • Physical Therapy
    Physical therapy can help guide an athlete with appropriate treatment. Many people find relief with modalities such as ultrasound, electrical stimulation, and therapeutic massage. Most athletes should begin therapeutic exercise as soon as possible. These types of exercises may include low-impact activities including cycling and pool workouts.
  • Ice the Injury
    Apply ice to the injured hamstring in the acute phase, and then after activities. Ice will help limit the swelling and inflammatory reaction and may help to stimulate blood flow to the injured area.  Ice can also be an effective pain relieving treatment for these types of muscle strains.
  • Heat Applications
    Before activities, heating the injured muscle can help loosen the tissue. Applying a heat pack to the hamstring prior to stretching or exercising may help to warm up the injured muscle. As a general rule, remember to heat before, and ice after.  Many patients also find benefit to contrast treatment where the muscle is alternately warmed, then iced, again in an effort to stimulate blood flow to the injured muscle.
  • Anti-inflammatory Medications
    Anti-inflammatory medications (such as Aleve, Motrin, or Ibuprofen) can help relieve pain and also calm the inflammatory response from the injury.

Surgical treatment is rarely necessary for treatment of a hamstring injury. When the injury occurs within the central part of the muscle, it is almost always best to treat these injuries non-surgically.

In some situations when the muscle attachment to the bone is pulled off, surgery may be necessary to reattach the muscle to its proper location.

Patients who have more severe symptoms of pain should be evaluated to determine if they might benefit from more invasive treatments.  Often an x-ray is obtained to evaluate if bone has been pulled off of the attachment of the hamstring, however this does not necessarily mean that surgery is a mandatory treatment. 

Sources:

Noonan TJ, and Garrett WE, "Muscle strain injury: diagnosis and treatment" J. Am. Acad. Ortho. Surg., Jul 1999; 7: 262 - 269.

Continue Reading