What can i do for a hamstring “pull”

August 31, 2009, Editor MCR,

Pulling one’s hamstring is one of the most common soccer injuries and the most common cause is the lack of proper stretching before playing. When one says that they pull their hamstring, what it means is that one has strained or slightly torn their hamstring. Most soccer players think that by just resting for about 2-4 weeks without playing is all that is required to recover. However, this is not true. If you do nothing about the strain, you are at a higher risk of sustaining the same injury.

48-4-8 Guide
Below are the recommended steps that you can take in a minor strain to aid in your recovery:

First 48hrs
Immediate post-injury

Remember RICER. The ice and compression will prevent severe bruising and swelling. Resting your leg will minimise the strain and prevent further aggravation.

After 48hrs – 4days
Using a compressive bandage would be advised to continue for this period.

1. Ice massage over the area of strain might improve the rate of healing. You may also want to try using contrast treatment (i.e. alternate hot and cold compress).

2. Gentle static stretches for your hamstring should be done. Never stretch into the pain. Stretching at this stage helps to mobilise the scar tissue and prevent it from stiffening.

4. Non-resisted hamstring curl should also be done during this period to speed up rate of recovery.

4 – 8 days
Start to strengthen your hamstring by doing a resisted hamstring curl. Begin with light resistance for about 15reps for 3 sets. Progress only when you feel the hamstring doesn’t feel achy after completing the 3 sets. Dynamic stretches should be done at least 3x/day. Light jogging can begin at about the 6th day post-injury. Normal activities should be able to be resumed after the 8th day.

Do i need to see a doctor?
Depending on the extent of the strain, one might need to seek a review with either a Sports Physician or a Sports Physiotherapist. The extent of the strain can only be diagnose through a real-time ultrasound imaging (RTUI), which can be done by an experienced Sports Physician. However, in some situation, an MRI might be ordered if the strain cannot be detected through the RTUI.

Moderate to severe hamstring strain will need a more extensive rehab and a longer period of recovery and a referral to a sports physiotherapist is highly recommended to get you back to sports as soon as possible.

Physiotherapy managment
In the acute stage of management, a sports physiotherapist would assess the site of strain and deep tissue mobilization might be required to break down the excessive scar tissues that have been laid down over the site of strain. A therapeutic ultrasound would also be used to speed up the rate of healing and manage the any swelling, if present. Gentle stretches, closely monitored by the sports physiotherapist, would be taught to help align the scar tissues. Kinesiotaping may also be done to aid the healing process.

Following the acute stage (about 1 week), your sports physiotherapist will start to progress your hamstring stretches to dynamic stretches and also to start you on resisted hamstring strengthening exercises. Before you’re able to return to sports, your sports physiotherapists will have put you through some form of agility drills to prepare your muscles for the gruelling demands of the game. This process may take about 2 – 4 weeks, depending on the extent of your injury.

Stretch to prevent a recurrence

The key to prevent a recurrence of this injury is to ensure that you adequately warm up your muscles with static and dynamic stretches before the start of your game and during the half-time break. You should ideally hold each stretch for 15-20 seconds for 3-6 repetitions for the static stretches, and at least 15-20 reps for the dynamic stretches. Read on here for static hamstring stretches.

Enjoy your game.

This work by Musculoskeletal Consumer Review is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 Singapore License. This article was contributed by Back2Sports - Sports Injury Management. In the spirit of promoting health education, you may copy, distribute and transmit the work under the conditions specified by the license. For articles re-printed with permission, copyright remains with the original copyright holder (author or publisher). MCR's Creative Commons License does not apply in such cases.