Pelvis > Hamstring Strain > Treatments

   R.I.C.E., Anti-Inflammatory Medication, Physical Therapy

Home Recovery

Non-surgical treatment usually can heal hamstring strains. Physicians typically prescribe a combination of R.I.C.E. (Rest, Ice, Compression, and Elevation), medication, and physical therapy. Depending on the severity of your hamstring injury, your physician may prescribe crutches to keep weight off your leg for up to three weeks. Immediately after you suffer a hamstring strain, you may want to follow the first-aid routine known as R.I.C.E.:

   Rest – your physician may suggest that you refrain from sports activities, and lie or sit down for a few hours at a time every day until your hamstring heals. Just the weight of your body puts pressure on the hamstring, and can lengthen recovery time.

   Ice – initially, your physician may recommend applying ice packs to the back of your leg for about 20 minutes at a time every three or four hours. You will probably need to do this for two or three days or until the pain subsides.

   Compression – wrapping your thigh with an elastic bandage can be used for compression during the first 48 to 72 hours. Your physician can teach you the proper thigh-wrapping technique.

   Elevation – raising the thigh to a level higher than the heart helps reduce swelling during the first 48 to 72 hours. Try to prop your ankle up on a couple of pillows when lying down or sleeping.

Most patients receive adequate pain relief from non-prescription anti-inflammatories like aspirin or ibuprofen.

After the first 48 hours of ice, heat therapy usually can begin in any convenient form. Physicians commonly prescribe over-the-counter heat packs you can warm up in the microwave. Physical therapists also have many different forms of heat therapy available, such as whirlpool baths. After the first seven to ten days after the injury, the usual routine is heat application, followed by stretching, followed by ice. Massage from a trained therapist can help relax and tone your hamstring muscles after an injury.

After most hamstring strains, you can expect to return to sports at full strength. Mild strains can usually be rehabilitated in two to ten days. Moderate strains may take between ten days and six weeks, and severe strains may require six to ten weeks of rehabilitation before you can competitively return to physical activities. Your physician will decide when it is appropriate to visit a physical therapist to begin stretching and strengthening exercises for the hamstring. Most patients can begin physical therapy sometime between one and three weeks after the injury. Physical therapy begins with simple motion exercises, which help circulate fluid out of the thigh. Early motion consists of simple up and down flexion and extension of the hip and knees, and inward and outward hip motion. The first week or two of rehabilitation usually focuses on stretching the leg to prevent shortening of the muscles, which can result from scar tissue forming after the injury. A typical hamstring stretch is to sit with the injured leg straight in front of you and the healthy leg bent, then lean forward towards your toes keeping your back straight and head up. These stretches should be carefully performed. It is important not to push your hamstring muscles during the healing phase. Knowing when to start more vigorous rehabilitation exercises is difficult and should be decided by your physician. If you rush through the rehab process and return to sports before you have completely recovered, you risk reinjuring the hamstring. The second stage of rehabilitation is typically a hamstring-strengthening program. Exercises begin without weights or resistance. A good example is the straight-leg raise, where you lie on your stomach with your legs straight and tighten your thigh muscles to lift your leg off the ground. Rehabilitation then progresses into a weight-training program focused on balancing strengthening between the hamstrings and quadriceps muscles. When the muscles in your injured hamstring are about as strong as muscles in your uninjured leg, rehabilitation becomes more activity-oriented. You usually perform sport specific-exercises and coordination drills under the supervision of a therapist or coach.

The best way to prevent reinjury of your hamstring is to keep your leg muscles strong and flexible. Physicians generally recommend that you make the exercises you learned in rehabilitation part of your everyday exercise routine. You should also maintain cardiovascular fitness so that your legs are prepared for quick starts and stops during physical activities. Training and strengthening routines should work both the quadriceps and the hamstring muscles. You should also stretch your hamstring muscles before and after exercise. When you feel fatigued during an activity, your hamstring muscles may be tightening up, and you should be careful to avoid sudden, explosive movements. It may be helpful to have your physician evaluate your gait when walking and running. Any imbalances in the ankle, knee, or hip may strain your hamstring muscles and put you at risk for repeated injury. When starting a new activity or returning to activities after taking time off, try to begin gradually before competing at full strength. Pain is a sign that your hamstring has not healed. If you feel hamstring pain when returning to activities, you should give yourself more time to rest.