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Signs and symptoms of a hamstring injury include:

• A sudden, sharp pain in the back of your thigh during an activity
• A popping or tearing sensation in the muscle
• Swelling and tenderness within a few hours of the injury
• Bruising or discoloration along the back of your leg
• Muscle weakness or inability to put weight on your injured leg

When to see a doctor
Mild hamstring strains can be treated at home. But for more severe hamstring injuries, you should see a doctor if you:

• Can't bear any weight on your injured leg
• Can't walk more than four steps without significant pain
• Have numbness in any part of the injured area
• See redness or red streaks spreading out from the injury
• Have injured the same muscles in the past
• Aren't sure about how severe your injury is

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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The hamstring muscles are a group of three muscles that run along the back of your thigh from your hip to just below your knee. These muscles make it possible to extend your leg straight behind your body and to bend your knee.

When any one of these muscles stretches beyond its limit during physical activity, injury can result.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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Your chance of injuring a hamstring depends partly on your activities and partly on your physical characteristics. Some possible risk factors include:

• Sports participation. Sports that require sprinting or running, or activities such as dancing that might require extreme stretching, make a hamstring injury more likely.
• Prior hamstring injury. After you've had one hamstring injury, you're more likely to have another one, especially if you try to resume all your activities at pre-injury levels before your muscles have time to heal and rebuild strength.
• Poor flexibility. If you have poor flexibility, your muscles may not be able to bear the full force of the action required during certain activities.
• Muscle imbalance. Although not all experts agree, some suggest that a muscle imbalance may lead to hamstring injury. When the muscles along the front of your thigh — the quadriceps — become stronger and more developed than your hamstring muscles, you have a muscle imbalance, which means you're more likely to injure your hamstring muscles.

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Complications of hamstring injury may include:

• Re-injury of your hamstring muscles. Returning to strenuous activities before your hamstring muscles are completely healed might set you up to repeat the injury. In some cases, a recurrent hamstring injury may be more severe than the original injury.
• Permanent decrease in muscle strength. In some instances, you may never regain full muscle strength in your injured leg and may be unable to perform activities at the level you once did.

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While you may initially consult your family physician, he or she may refer you to a doctor who specializes in musculoskeletal medicine, sports medicine or orthopedic surgery.

What you can do
You may want to write a list that includes:

• Detailed descriptions of your symptoms
• Information about medical problems you've had
• Information about the medical problems of your parents and siblings
• All the medications and dietary supplements you take
• Questions you want to ask the doctor

What to expect from your doctor
During the physical exam, your doctor will check for swelling and points of tenderness along the back of your thigh. The location and intensity of your pain can help determine the extent and nature of the damage. Your doctor might also move your injured leg into a variety of positions to help pinpoint which muscle has been injured and whether you also have any ligament or tendon damage.

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During evaluation of your injury, you doctor may:

• Ask questions about your medical history. In particular, you doctor may want to know what you were doing when the injury occurred, what types of sports activities or exercise programs you regularly participate in and whether you've experienced past hamstring injuries.
• Perform a physical examination. During the exam, your doctor observes your walking or running gait to look for limping and other abnormalities. Your doctor will feel (palpate) along the back of your thigh for signs of bruising, tenderness and inflammation. Your doctor also might move your leg in certain ways to check your range of motion and muscle strength.
• Order imaging tests. An X-ray helps your doctor assess the extent of your muscle injury. X-rays also show whether your injured muscle still has stable attachments to your thigh bones. MRI can provide a more detailed image of soft tissues, such as the hamstring muscles and tendons.

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A hamstring injury may be:

• Mild. A mild injury strains your hamstring muscles and causes pain with minimal loss of muscle strength. You can expect to heal quickly without much downtime.
• Moderate. A moderate injury is a partial tear of one or more of your hamstring muscles. It causes pain and some loss of muscle strength.
• Severe. A severe injury is a complete tear of your hamstring muscles — either of the muscle fibers themselves or of the muscle from the bone (avulsion). You experience severe pain and significant loss of muscle strength. Severe injuries may take months to heal adequately. Complete hamstring avulsions may need surgical repair.

Initial therapy
The initial goal of treatment is to reduce pain and swelling. To accomplish this, your doctor may recommend that you do the following:

• Take a break from strenuous activities to allow the injury to heal.
• Use a cane or crutches to avoiding putting your full weight on your injured leg.
• 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 your leg elevated above the level of your heart, if possible, to improve drainage and minimize swelling.
• Take an over-the-counter pain medication such as ibuprofen (Advil, Motrin, others) or acetaminophen (Tylenol, others) to reduce pain and inflammation.

Severe injuries involving torn hamstring muscles may, in rare cases, require surgery. If needed, surgery is performed by an orthopedic surgeon.

Rehabilitation
After the initial pain and swelling of a hamstring injury subside, your doctor may recommend a program of rehabilitation exercises. The goals of rehabilitation are to:

• Improve range of motion of your leg and prevent muscle stiffness
• Restore muscle strength and flexibility
• Return you to your full activity level prior to injury

Your doctor or a physical therapist can set up an exercise schedule and show you how to perform specific exercises designed to rehabilitate your hamstring muscles. You may gradually increase the intensity level of the exercises as you regain strength and mobility. How long you'll continue these exercises depends on how severe your injury is, but standard rehabilitation exercise programs may last for several weeks, at least. A mild to moderate injury may take up to six weeks to heal; severe injuries can take several months to heal.

Rehabilitation exercises may be especially important for protecting your hamstring muscles from re-injury after you get back to your normal activity level.

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For immediate self-care of a hamstring injury, try the R.I.C.E. approach — rest, ice, compression, elevation. If your injury is worse than a minor muscle strain, you'll want your doctor and physical therapist to help you with this process:

• Rest. Take a break from strenuous activities to rest your hamstring muscles and allow the damaged tissues to repair. Avoid any activity that causes pain, swelling or discomfort. For a more extensive injury, your doctor may recommend that you use crutches so that you keep your weight off your injured leg.
• Ice. Even if you're seeking medical help, ice the area immediately. For the first few days after the injury, put an ice pack on the injured area or immerse the injured limb in ice water for 15 to 20 minutes every two to three hours while you're awake. Cold reduces pain, swelling and inflammation in injured muscles, joints and connective tissues. It may also slow bleeding if a tear has occurred. If your skin turns white when it's being iced, stop treatment immediately. If you have vascular disease, diabetes or decreased sensation, talk with your doctor before applying ice.
• Compression. Wrap your leg with an elastic compression bandage until the swelling goes down. Be careful not to wrap your leg too tightly or you may hinder circulation. 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 elevated while resting. If possible, elevate your leg higher than the level of your heart. Gravity helps reduce swelling by draining excess fluid.

Over-the-counter pain medications such as ibuprofen (Advil, Motrin, others) and acetaminophen (Tylenol, others) also can be helpful.

After a few days, gently begin to use the injured leg. You should notice a gradual, progressive improvement in your leg's ability to support your weight and your ability to move without pain.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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As part of an overall physical conditioning program, regular stretching and strengthening exercises can help to minimize your risk of hamstring injury. Try to be in shape to play your sport; don't play your sport to get in shape. If you have a physically demanding occupation, regular conditioning can help prevent injuries. Ask your doctor about appropriate conditioning exercises.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.