Hamstring Muscle Injury


  1. Anatomy
  2. The injuries and their causes
  3. Exam and symptoms
  4. Treatment
  5. Prevention


Hamstring muscle injuries occur frequently among athletes. The risk of sustaining injury to this muscle group is very high for both anatomical and functional reasons.



There are three hamstring muscles: semitendinosus, semimembranosus, biceps femoris. They are two-jointed muscles, which means that they function at the hip joint and the knee joint. This increases the risk of injury. Injuries usually occur where the muscles join with the tendons (proximal part of the thigh, closer to the buttocks).


The injuries and their causes

Hamstring muscle injuries are common in disciplines which require fast acceleration, kicking and jumping. The main cause is said to be a coefficient of extensor and flexor strength that is lower than 0.6 or higher than 10 of hamstring muscle imbalance in the left and right limb. What is more, factors such as not warming up properly, insufficient muscle flexibility, and the transverse abdominal muscle and the gluteus maximus not working properly increase the risk and in the worst case scenario cause injury.


Exam and symptoms

Minor hamstring strains may not cause symptoms. However, more serious tears can be associated with extensive bruising, swelling, sensitivity, and sometimes even palpable muscle loss. Most hamstring injuries are serious and cause sudden pain at the back of the thigh when exercising. 

Depending on the severity of the damage, different symptoms can occur:

  • grade 1: a feeling of tightness/cramps at the back of the thigh, discomfort when walking, possible slight swelling
  • grade 2: pain when bending and stretching the muscles, difficulty walking, also possible: limping, unable to straighten, swelling
  • grade 3: severe pain and swelling, constant pain, difficulty walking, sometimes impossible to walk



In the first 24-28 hours we use P.R.I.C.E. therapy. When an area is inflamed you need to aim to gain full range of motion in the knee and hips. We also recommend strengthening the following muscles: the gluteus maximus, thigh muscle, the transverse abdominal muscle, and the abdominal internal oblique muscle. In the first stages of rehabilitation, training involves isometric exercises. After, we add concentric and then eccentric exercises.



As previously mentioned, strength imbalance, lack of suppleness, improper warm-ups and over training in general play a significant role in preventing hamstring injuries. This is why these aspects should be incorporated when thinking about prevention.

 As in the case of any injury, it is better to prevent than cure. Starting off training with the appropriate warm-up and stretching exercises is very important in preventing hamstring and other injuries. However, if we do sustain this kind of injury, the above procedures will help us to treat it. It is important to remember to go to a specialist for advice, as self-treatment often causes more damage than good. 


dr Jan Paradowski ©
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