What Is the Treatment for a Pulled Hamstring (Hamstring Injury)?
Strains are initially treated with rest, ice, compression, and elevation (known as RICE). A pulled hamstring is also treated this way. Alternating ice and heat may also be recommended.
- Rest: Since the hamstring is stretched with each step as the knee extends or straightens, walking may be difficult. It may be necessary to rest and even avoid weight-bearing activities for a period of time. Crutches may be used temporarily to help get around.
- Ice: Icing should be done frequently for 15-20 minutes at a time. The ice is placed on the area of injury and pain. It is important that the skin is protected from direct contact with the ice to prevent frostbite.
- Compression: An Ace wrap may be used for compression. Often one or two 6-inch wraps are applied beginning at the knee and circling the thigh until the wrap ends at the hip and groin. The compression should feel firm but not too tight to cause pain. Athletes are often taped to provide the same compression and support to allow them to return to practice and competition more quickly.
- Elevation: Elevating the leg is helpful to decrease swelling. Fluid caused by inflammation can drain back toward the center of the body if the leg is elevated above the level of the heart.
Medications to reduce inflammation, such as ibuprofen (Advil, Motrin, Nuprin), may be helpful in controlling the pain of inflammation. While these are over-the-counter medications, there may be interactions with prescription medications, or there may be underlying medical conditions that may prohibit the use of anti-inflammatory medications. It is wise to check with a healthcare professional or pharmacist before taking any medications.
Grade 1 or 2 injuries may require no further therapy and over a few weeks, the pulled hamstring should gradually improve and return to normal function. It may take a few weeks to recover from a hamstring strain, but if symptoms persist, physical therapy may be recommended.
In rare cases, surgery may be required to repair grade 3 strains that have damaged significant amounts of muscle and tendon. If a large, bony avulsion fragment is present, it may require reattachment.
The recovery of strains goes through three phases. The first phase decreases the inflammation of the pulled muscle, the second returns normal blood supply, and the third begins remodeling and repair of the muscle to allow it to return to full function.
Anytime a muscle is torn, the body repairs itself by forming scar tissue. It may take four to six weeks for the area to completely heal. Aside from return to activity, it will be important to consider rehabilitation at home or with a therapist to return full range of motion and power to the hamstring muscles. If the hamstrings do not return to full function, they are at risk for recurrent injury and developing chronic pain and weakness.
After RICE treatment lasting five to seven days, physical therapy may be considered to increase range of motion and begin gentle stretching and return to activity of the pulled muscle. Electrical stimulation therapy and muscle ultrasound may be used to increase blood circulation and begin the healing phase. This may take two to three weeks and may be followed by muscle strengthening and further stretching.