One minute your favorite football player is running for a touchdown, the next they are crumbled on the ground grabbing the back of their leg. Looks like they’ve pulled a hammy!
If you’re a fan of watching sports, then you’ve probably seen an athlete go down once or twice with a hamstring injury. Although not the prettiest sight to behold, hamstring injuries are quite common among runners and athletes—and can even occur with regular daily activities.
Whether you are a weekend warrior or a couch potato, learn more about your potential risk, treatment options and how to prevent injury.
What is a hamstring injury?
A pulled hamstring is usually a strain or tear to the large muscles that run down the back of your thigh. Typically, most occur in the thick, central part of the muscle where tendons and muscle fibers join. Less commonly, you can injure the hamstring tendons themselves. Tendons are soft tissue structures that attach muscle to bone. The most common site of a hamstring tendon injury is at its attachment to your pelvis on the bone where you sit.
If you’ve recently pulled a hammy, you may wonder if it’s a tear or just a strain. But when it comes to differentiating a strain versus a tear, Tyler Collins, MD, an orthopedic sports medicine surgeon at TOCA at Banner Health in Arizona, said they are more or less the same thing but are graded according to their severity.
“A strain is an injury to a muscle, which at the low end is a stretch of a muscle and at the most severe end is a complete tear,” Dr. Collins said. “Hamstring injuries are usually graded from 1 to 3, with a type 1 strain being a stretch of the muscle or minimal tear, a type 2 being a partial tear and a type 3 being a complete tear of the muscle. Tendon injuries are graded in the same way but are referred to as sprains instead of strains.”
What are the symptoms?
As Dr. Collins just mentioned, hamstring injuries are graded 1 to 3 depending on the severity. The symptoms you may experience will depend on the severity, but usually can include some pain, swelling and weakness in your hamstrings.
Grade 1: With a grade 1 injury, you’ll most likely be able to finish that run or game, but not without some swelling and mild pain. It may take only a few days to heal.
Grade 2: With a grade 2 injury, or partial tear, your pain may be more immediate and severe. You may experience swelling and significant pain at the site and loss of some strength in your leg. There may be some mild bruising as well.
Grade 3: With severe hamstring tears, or a grade 3 injury, you may have a “popping” sensation at the time of injury. In this case, the tendon may tear completely away from the bone and may even pull a piece of bone away with it. These usually cause a very severe amount of bruising.
With grade 2 and 3 injuries, it can take a few months to heal on the low end, but as many as 6 months for the most severe injuries.
What causes hamstring injuries to occur?
The main cause of hamstring injuries is due to muscle overload, when your muscle is stretched or pulled beyond its capacity or is challenged with a sudden load.
“You are more likely to strain or tear your hamstring if you subject yourself to riskier activities where you could sustain a sudden stretch or injury to that area,” Dr. Collins said. “Also, if a muscle is not consistently being worked or loaded (if you are more sedentary) you are more likely to sustain a more serious strain with a given injury.
Age, unfortunately, makes any injury more likely as tendon and muscle tissue tends to degenerate with age. We are usually less active as we age as well. Greater activity and strength training/stretching can help mitigate this.
When should I see the doctor?
Severe hamstring injuries are usually very obvious. You’ll likely feel a pop or sudden, sharp pain up near your buttocks and there is usually a larger amount of bruising. Many times, the entire back of your thigh will turn purple or black. If that is the case, you should see someone immediately and get an MRI. Rarely you can tear your hamstring without bruising but you will notice a pop and severe pain in your buttock or thigh.
“In short, if you felt a pop after a significant injury and have pain near your buttock see someone right away,” Dr. Collins said. “If the pain is more mid-thigh and there is no bruising this is usually something that will heal over time so you should only seek treatment if the pain persists and does not improve for several weeks.”
What are my treatment options?
Treatment for hamstring strains or muscle injury generally never involve surgery as muscle tissue will heal just as well with or without surgery. Treatment for hamstring sprains or tendon injuries will vary depending on the severity of the injury. Low grade hamstring sprains heal pretty quickly with non-surgical treatments, while more severe tears may require surgical treatment.
“Many partial tears will heal, but if they do not over a period of 6 to 12 weeks, you can consider more aggressive treatment such as injections or surgery,” Dr. Collins said. “Muscle strains tend to heal over time but can be reaggravated. Sometimes these can linger for months especially if you are involved in sports or higher-level activities.”
With complete tears, if the tendon is retracted more than a few centimeters or you are very active, you will usually do better with surgery. This is best done within a few weeks of the injury as it usually can help restore normal function and strength. If surgery is not done immediately, this can lead to permanent strength loss and continued pain. Later reconstructive surgery is usually not as successful and is higher risk.
How can I prevent them from happening altogether?
“Your best bet to prevent injury is a combination of good stretching and a strengthening program for the core and lower body,” Dr. Collins said. “Good hamstring stretching and strength training tend to prevent or minimize injury.”
If you think you just pulled a hammy, don’t wait. Schedule an appointment with a Banner Health expert. Whether you’re a casual athlete, weekend warrior or professional athlete, our sports medicine doctors provide services for everyone. Visit bannerhealth.com to learn more.