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Hamstring - Anatomy, Injury, Diagnosis, and Treatment

Published on Nov 03, 2022   -  7 min read


The hamstrings are responsible for walking, running, jumping, and many other physical activities. This article explains its anatomy, injury, and training.

What Is the Anatomy of the Hamstring Muscle?

The hamstrings are a group of muscles located in the thigh's posterior region. The biceps femoris, semitendinosus, and semimembranosus are large tendons near the back of the knee that produce significant tendons medially and laterally. These muscles work together to stretch the hip and flex the knee.

Muscles in the Posterior Compartment:

The muscles found in the thigh's posterior compartment are the biceps femoris, semitendinosus, and semimembranosus.

  • Biceps Femoris- The biceps femoris muscle, like the biceps brachii in the arm, contains two heads: a long head and a short head. The common tendon of the two heads can be felt laterally near the posterior knee, making it the most lateral of the muscles in the posterior thigh.

  • Semitendinosus - The semitendinosus muscle is mostly made up of tendons. It connects the biceps femoris to the semimembranosus and covers the majority of the semimembranosus.

  • Semimembranosus - The semimembranosus muscle has a broad and flattened appearance. It is found beneath the semitendinosus muscle.

What Are Hamstring Injuries?

Overuse injuries to the hamstrings are widespread in sports like soccer, football, basketball, and tennis, where quick starts and pauses are mixed with running. In activities like these, the long head of the biceps femoris is especially vulnerable to damage, likely because it exerts the most force compared to the other hamstring muscles.

What Is the Cause of Hamstring Injury?

The most common cause of hamstring muscle injury is muscle overuse. When a muscle is stretched past its ability or is suddenly loaded, this can happen.

What Are the Risk Factors for a Hamstring Injury?

Several variables can increase your chances of getting a muscle strain, including:

  • Muscle Tenseness- Tight muscles are more likely to be strained. Athletes should perform daily stretching exercises all year long.

  • Muscle Imbalance- A strain can occur when one muscle group is significantly stronger than the opposing muscle group. This is a common occurrence with the hamstring muscles. The quadriceps muscles in the front of the thigh are typically more powerful. The hamstrings may become exhausted faster than the quadriceps during high-speed movements. This exhaustion can result in strain.

  • Athletes who participate in sports like football, soccer, and basketball.

  • Older athletes whose exercise program is primarily walking.

  • Adolescent athletes who are still growing.

  • Runners or sprinters.

  • Dancers.

What Are the Symptoms of Hamstring Injury?

Sudden, intense pain in the back of your leg will occur if you strain your hamstring while sprinting in full stride. It will lead you to come to a halt and either hop or fall on your good leg.

Additional symptoms may include:

  • Swelling in the first few hours following an injury.

  • Over the first few days, you may see bruising or discoloration on the back of your leg below the knee.

  • Hamstring weakness that can last for several weeks.

How Is Hamstring Injury Diagnosed?

The following methods are used for diagnosis:

Patient History and Physical Examination-

People with hamstring strains frequently visit a doctor after experiencing abrupt pain in the back of the thigh while exercising. Your doctor will inquire about the injuries and examine your thigh for discomfort or bruises during the physical examination. He will palpate (push) the back of your leg to see whether there is any discomfort, weakness, swelling, or a more serious muscle injury.

Imaging Tests-

Imaging tests that may help your doctor confirm your diagnosis include:

  • X-rays are used only to rule out bony avulsions, but MRI and ultrasound are majorly used in teh diagnosis of hamstring injuries.
  • Magnetic resonance imaging (MRI).

  • Ultrasound - Ultrasound imaging plays a significant role in diagnosing hamstring injury. In addition, the most affected muscle is the biceps femoris, and ultrasound helps identify its injury. These imaging techniques also guide in assessing the severity of hamstring injuries and follow-up.

What Is the Treatment of Hamstring Injury?

Hamstring strain treatment varies depending on the type of injury, its severity, and your own needs and expectations. The goal of any treatment is to assist you in returning to all of your favorite activities. Following your doctor's treatment plan will help you regain your abilities faster and avoid future difficulties.

The following are the many forms of hamstring injury treatments-

Nonsurgical Treatment:

Most hamstring strains heal very well with simple, nonsurgical treatment.

  • RICE- Most sports-related injuries respond well to RICE therapy. Rest, ice, compression, and elevation (RICE) are acronyms for rest, ice, compression, and elevation.

  • Rest: Take a break from whatever was causing the stress. To avoid putting weight on your leg, your doctor may advise you to use crutches.

  • Ice: Several times a day, apply cold packs for 20 minutes. Ice should not be applied straight to the skin.

  • Compression: Wear an elastic compression bandage to avoid further swelling and blood loss.

  • Elevation: While resting, recline and raise your leg higher than your heart to decrease swelling.

  • Immobilization.

  • Physical therapy.

  • Flexibility is the primary priority in a therapy program. Your range of motion will be improved with gentle stretches. Strengthening activities will be gradually introduced to your regimen as your recovery develops. When it is safe to return to sports activity, your doctor will discuss it with you.

Surgical Treatment:

Tendon avulsion injuries, in which the tendon has been ripped completely away from the bone, are the most common reason for surgery.


To safeguard the repair, you will need to keep your weight off your leg after surgery. To enhance flexibility and range of motion, your physical therapy program will begin with mild stretches. Your strategy will eventually include strengthening workouts. Because of the severity of the injury, rehabilitation for a proximal hamstring reattachment usually takes at least six months. Before returning to sporting activity, distal hamstring reattachments require three months of therapy. Your doctor will advise you when it is safe to return to sports.

What Is Hamstring Injury Recovery Time?

Hamstring injuries can be classified into three categories. How long it takes you to heal will be determined by the severity of your injuries.

The three levels of hamstring injuries are as follows-

  • Grade 1 Hamstring Injury Recovery Time: This is the simplest injury, usually involving a muscular strain or pull. Recovery usually takes only a few days.

  • Grade 2 Hamstring Injury Recovery Time: This grade includes partial muscle tears. You will likely need to rest for a few weeks as your body heals.

  • Grade 3 Hamstring Injury Recovery Time: It is a total muscle tear. This is the most serious type of hamstring injury, and it usually takes months to heal.

If you are a regular athlete and suspect you have a hamstring injury, make an appointment with a sports medicine physician right away. It is critical that you give your hamstrings the rest they require to heal completely. Resuming exercising before the area has had time to heal adequately considerably raises the likelihood of recurrence.

What Are the Hamstring Injury Exercises for Recovery?

You might not be able to return to your typical workout regimen, but that does not mean you cannot help yourself recuperate. In fact, fully avoiding activity throughout your rehabilitation may cause your hamstring muscles to shrink and weaken. Starting a mild but consistent exercise plan can help maintain muscle strength and speed recovery.

Here are some hamstring recovery exercises:

  • Standing hamstring stretch.

  • Hamstring curl.

  • Hamstring wall stretch.

  • Standing-leg balance.

How to Train Hamstring Muscles?

The following exercises help to train the hamstring muscles:

Strengthening Exercises-

Walking, running, climbing, and descending stairs all contribute to improving the hamstring muscle group's functional fitness. In rehabilitation and bodybuilding, many isolations and compound exercises for the hamstrings can be used. Knee flexion and hip extension exercises are widely utilized to strengthen the hamstring muscles. Here are a few basic moves to practice:

  • Basic bridges.

  • Single-leg bridges.

  • Leg curls.

  • Squats.

  • Walking lunges.

Basic Stretches-

For runners, hamstring flexibility is vital because it can assist prevent injury and delayed onset muscular soreness (DOMS). When you straighten your knee, tight hamstrings might limit your range of motion. You may also experience a tightness in the back of your knee.

Hamstring stretches can be added to any stretching and flexibility practice. The hamstring stretches shown below can be done on a daily basis to increase flexibility, speed recovery, and prevent injury.

  • Seated stretch.

  • Supine stretch.

  • Standing stretch.


Because of the high occurrence and recurrence rates, hamstring injuries have long been the bane of athletes' sports participation, particularly among those who engage in sprinting and explosive movements. These injuries appear to cause subsequent weakening in the extended state of the muscle, putting the athlete at risk of further injury. Training the hamstring muscle is essential, but if any workouts cause significant pain, you should stop immediately. Make an appointment with a sports medicine physician for an evaluation of your injury as well as exercise advice. Remember that putting too much strain on your injury too soon may exacerbate the problem. Make sure you give your muscles the time they need to heal by being patient.

Frequently Asked Questions


Can a Person Train With a Hamstring Injury?

A hamstring injury occurs due to the stain or the tear of the tendons or the large muscles at the back of the thighs. It might be difficult for the person to train or perform strenuous exercises immediately after the injury. However, the rehabilitation must begin immediately after the injury. Trunk stabilization and lengthening exercises can be performed gently after the hamstring injury.


What Exercises Can Be Done After a Hamstring Injury?

Hamstring strain exercises must be done to recover from hamstring injuries.
The following exercises can be done after hamstring injuries:
- Straight leg hamstring stretches.
- Bent leg hamstring stretches.
- Dynamic hamstring stretches.
- Dynamic walk.
- Standing knee flexion.
- Bridge exercises.
- Seated hamstring curl.
- Single leg hip extensions.
- Lunge with the ball.
- Aerobic fitness exercises.


Can a Person With a Hamstring Injury Do Squats?

People with hamstring injuries must avoid squatting for days or weeks after the surgery. This is because squatting can cause certain problems. However, the person can do an isometric wall hold squat rather than a full-motion squat for a few days or weeks.


What Exercises Can Be Done After a Hamstring Injury?

A pulled hamstring does not mean the person cannot exercise cardio. The following cardio exercises can be easily done with pulled hamstrings:
- Swimming.
- Rowing ergometer.
- Stationary biking.
- Seated aerobics.
- Walking.


How Can I Differentiate Between a Torn and a Pulled Hamstring?

A hamstring tear or strain occurs when one or more of the muscles present at the back of the thighs get injured. The person will feel sharp severe pain and cannot do his activities. In contrast, a hamstring pull occurs when the muscles get stretched to the extent that they start tearing.


Can a Person Run With Hamstring Pain?

The hamstring pulls, or stains, are not severe enough to stop a person from running. So, a person with mild hamstring pain and soreness can run easily. However, if the hamstring pains while running or the injury is severe, he must refrain from running for a few days. Sometimes, running helps ease the symptoms of hamstring injury because it increases blood flow.


When Should a Patient Start Hamstring Rehabilitation?

The patient can start rehabilitation immediately after the hamstring injury. The rehabilitation, including arch trunk stabilization, agility, and lengthening exercises, can be started immediately after the hamstring injury. However, all the rehabilitation exercises must be done slowly.


Is It Okay to Massage a Pulled Hamstring?

After the acute healing phase, a pulled hamstring can be massaged, and the scar tissue formation is complete. This is because massaging in the early stage increases the chances of bleeding and tissue damage and prolongs recovery.


In How Many Days Do the Hamstring Tendons Heal?

Hamstring tears are serious and do not heal on their own. They require immediate medical care and attention. Generally, the healing gets completed in six weeks. However, the patient must avoid everything that activates the tendons for the first 48 hours.


How Can One Know if the Hamstring Injury Is Serious?

The patient usually feels a sharp, sudden pain after a hamstring injury.  Sometimes, the pain is accompanied by swelling and bruising at the back of the thighs. Serious or grade 3 hamstring injuries will be painful, swollen, and tender, making it difficult for the person to walk or stand.


What Are the Different Grades of Hamstring Injury?

Hamstring injuries are commonly seen in athletes and people involved in sports activities.
The different grades of hamstring injuries based on their severity are listed below:
- Grade 1 - A mild muscle strain or pull.
- Grade 2 - A partial tear of the muscles.
- Grade 3 - Complete tear of the muscles.


How Can One Heal a Pulled Hamstring in Two Days:

A pulled hamstring can be healed by following the below steps:
- Do not perform any physical activities that cause pain.
- Keep your leg still.
- Apply icepacks on your hamstrings for 15 to 20 minutes, two to three times daily. 
- A compression bandage helps reduce the swelling.
- Keep your leg elevated while sitting.


Can a Person Have Pain in His Hamstrings After Sitting for a Prolonged Period?

Some people tend to experience pain in their hamstrings after sitting for prolonged periods. This is because the hamstrings become tight, overworked, or overloaded, leading to pain. In addition, sometimes the hamstrings become tight due to injuries and pain when a person sits for a long time.

Article Resources

Last reviewed at:
03 Nov 2022  -  7 min read




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