Hamstring strains are common among runners. Athletes at risk include those with poor flexibility of the hamstring muscles, inadequate pre-participation warm-up, and previous injury. Older athletes are also at higher risk. As with any muscle strain, the amount of force that caused the muscle to tear determines the degree of injury.
The diagnosis is confirmed by finding hamstring pain with knee flexion against resistance as well as on palpation of the posterior thigh. In mild strains, tenderness and mild swelling are present. In more severe strains, ecchymosis, moderate to severe swelling, and poor muscle function caused by pain and weakness are present.
Ice and compression with use of a thigh sleeve should begin as soon as possible. Nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics are prescribed as necessary, and crutches may be required initially if walking is painful.
Once pain begins to resolve, patients should begin gentle hamstring stretching. When the pain has completely resolved, gradual strengthening of the quadriceps and hamstrings is begun.
Only when satisfactory strength has been achieved should patients resume running. Athletes must be made aware that recovery from hamstring injury can often take up to several months, depending on the severity.