About hamstring strain
The hamstrings are three muscles running down the back of the thigh from the sit bone to just below the knee. They bend the knee and extend the hip, and they work hardest when slowing the leg down during fast running. That is when most strains happen.
A hamstring strain can range from a mild overstretch of a few muscle fibers to a large tear of the muscle or its tendon. In rare cases, the tendon pulls completely off the sit bone, which is called an avulsion and usually happens with a forceful slip or split.
Hamstring injuries have a well-known habit of coming back, often because athletes return before the muscle has regained full strength and speed. A structured plan that ends with high-speed running is the best protection.
Common symptoms
- Sudden sharp pain in the back of the thigh during sprinting or kicking
- A pop or pulling sensation at the moment of injury
- Bruising down the back of the thigh in the days that follow
- Pain with walking, bending forward, or straightening the knee
- Weakness when bending the knee or pushing off
Common causes and risk factors
- Sprinting, especially at top speed or when tired
- Kicking, high kicks, or a sudden slip into a split position
- Previous hamstring injury
- Weak or fatigued hamstrings and glutes
- Rapid increases in speed work or inadequate warm-up
How we diagnose it
Our physicians examine the thigh for tenderness, strength, and flexibility, and ask exactly how the injury happened. Diagnostic ultrasound at the exam table lets us grade the injury by showing the location and size of the tear, bleeding within the muscle, and whether the tendon is still attached at the sit bone. When a tendon avulsion is suspected, we arrange an MRI promptly and coordinate a surgical evaluation, since repair works best when done early.
How Propel treats hamstring strain
Most hamstring strains are treated with a brief period of protected activity, then a progressive rehab program that restores motion, builds strength with exercises such as bridges and eccentric work, and gradually adds running. The final stage is a step-by-step return-to-sprint progression so the muscle is ready for full speed before returning to sport.
In selected cases, such as larger tears or injuries slow to recover, ultrasound-guided PRP may be considered alongside rehab. A complete tendon avulsion from the sit bone, especially with multiple tendons involved, usually needs surgical repair, and we move quickly to coordinate that referral.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about hamstring strain
- Should I stretch a pulled hamstring right away?
- Aggressive stretching early on can make the injury worse. Gentle movement is fine, but stretching and strength work should be added gradually as pain allows.
- Why do hamstring strains keep coming back?
- Returning to sport before strength, flexibility, and high-speed running are fully restored is a common reason. A structured return-to-sprint program and ongoing hamstring strengthening reduce the chance of another strain.
- When is a hamstring injury an emergency?
- Severe pain at the sit bone, large bruising, a visible gap, or difficulty walking after a forceful slip may mean the tendon has pulled off the bone. That should be evaluated within days, since surgical repair is most effective when done early.