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Thigh Injury – Hamstrings

Urgent Care resources

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The two main groups of muscles in the thigh that can be injured:

Quadriceps muscles (front of leg)

Hamstring muscles (back of leg)

Illustration of the pelvis and upper legs highlighting the quadriceps muscles, with labelled parts including the femur, patella, and individual quadriceps muscles such as rectus femoris and vastus medialis.
Illustration of the back of the pelvis and upper legs highlighting the hamstring muscle group, with labels for the biceps femoris, semitendinosus, and semimembranosus muscles.

What is a pulled hamstring?

A pulled hamstring (strain or tear) is damage to the muscles at the back of your thigh. Physiotherapy is an important part of recovery.

How does a pulled hamstring happen?

It usually happens when the muscle contracts while stretched, for example:

  • Running or sprinting.
  • Stretching (e.g. gymnastics, martial arts).

Sprint-related hamstring strains

  • Occur during fast running.
  • Usually affect the lower part of the muscle.
  • Often feel severe at first but heal quicker.

Stretch-related hamstring strains

  • Occur higher up the back of the thigh.
  • Often involve the tendon.
  • Take longer to heal due to poorer blood supply.

Referred pain

  • Pain from the lower back or hip felt in the thigh.
  • Can increase risk of repeated injury.

What are the symptoms of a pulled hamstring?

  • Sudden pain in the back of the thigh.
  • Possible tearing sensation.

You may also have:

  • Muscle spasm.
  • Weakness.
  • Spasm.
  • Reduced movement.

Pain may worsen after activity as swelling develops.

What should I do if I have a pulled hamstring?

The first 24–48 hours are important:

P – Painkillers

  • Use paracetamol and/or ibuprofen if suitable.
  • Follow instructions and check with a pharmacist if unsure.

R – Rest

  • Reduce activity for the first 2 days.
  • Avoid running or heavy activity.
  • Keep the leg gently moving.

I – Ice

  • Apply wrapped ice for up to 20 minutes every 2 hours (first 3 days).
  • Then 3 times daily until swelling settles.
  • Do not place ice directly on skin.

M – Mobilisation

  • Start walking normally as soon as possible.
  • Early movement helps healing.

E – Elevation

  • Keep your leg raised above hip level for the first 2 days.

What shouldn’t I do if I have a pulled hamstring?

For the first few days avoid:

  • Heat (hot baths/showers).
  • Stretching .
  • Massage.
  • Alcohol.
  • Overuse of the leg.

These can increase bleeding and swelling.

Physiotherapy treatment for a pulled hamstring

Physiotherapy helps recovery by:

  • Assessing the injury.
  • Providing a treatment plan and recovery timeline.

Treatment may include:

  • Manual therapy.
  • Exercise programmes.
  • Massage.
  • Sports rehabilitation.
  • Hydrotherapy.

Could there be any long-term effects?

Most injuries heal within 8 weeks. Long-term problems are more likely if:

  • The injury is severe.
  • Early treatment was not followed.

Poor recovery can lead to weakness and repeat injury.

Hamstring strain exercises

Both stretching and strengthening are important:

  • Start stretching only when pain allows.
  • Progress from gentle stretches to movement-based exercises.
  • Add strengthening gradually.

Hamstring stretching exercises

Do not stretch for the first 2–4 days.

Start when walking is pain-free.

Straight leg hamstring stretch

  • Place foot on a surface and lean forward.
  • Keep leg straight and chest up.
  • Hold a gentle stretch (not painful).
  • 3 × 10 seconds, once or twice daily.
A person places one foot on a raised step and leans forward with arms reaching toward the foot, demonstrating a standing hamstring stretch; surrounding circles show joint movement and stretch directions.

Bent leg hamstring stretch

  • Lie on your back and lift your leg slightly bent.
  • Pull until a gentle stretch is felt.
  • 3 × 10 seconds, once or twice daily.
A person lies flat on a mat with legs extended, then lifts one leg straight up while holding the back of the thigh, demonstrating a single-leg raise stretch.

Hamstring strengthening exercises

Start gently and only if pain-free.

Standing knee flexion

  • Bend one knee while standing.
  • Begin slowly.

Build from 3 × 10 reps to 4 × 20

A person stands upright beside a chair for support and bends one knee, bringing the foot up behind to hold the ankle, demonstrating a standing quadriceps stretch.

Hamstring catches

  • Let your leg drop and catch it before it straightens.
  • Start 1 × 10 reps, build to 3 × 15.
A person lies face down on a bench and bends one knee to lift the foot upward, demonstrating a prone hamstring curl exercise.

Bridge exercises

  • Lie on your back, knees bent, lift hips.
  • Start with both legs, progress to one leg.
  • Build from 3 × 8 to 3 × 12.
A two-step illustration of a lying hip bridge exercise. In the first position, a person lies on their back with knees bent, feet flat on the floor, and arms resting by the sides. In the second position, the person lifts the hips upward off the ground, forming a straight line from shoulders to knees, with an arrow indicating the upward movement of the hips.

Seated hamstring curl

  • Use a resistance band.
  • Pull heel towards your buttocks.
  • Build from 3 × 8 to 3 × 12–15.
A person sits upright on a chair performing a seated hamstring exercise: starting with both feet on the floor, then extending one leg forward with the heel resting on the ground or a strap, showing a straightened knee position for stretching or strengthening.

Returning to physical activity

  • Return gradually depending on your job/sport.
  • Staying active helps recovery.
  • Light duties or breaks may be needed.
  • Increase activity as strength and movement improve.

Driving

You can drive when you can:

  • Perform an emergency stop safely.
  • Fully control the vehicle.

Check with your insurance company.

Physiotherapy

If needed, seek physiotherapy support for guidance and recovery planning.

Work

  • You can self-certify sickness for up to 7 days.
  • Provide a self-certification form to your employer.
  • For longer absence, contact your GP.

Possible complications

Seek medical advice if:

  • Pain continues despite treatment
  • You have tingling or numbness
  • You notice swelling, redness, or signs of a blood clot
  • You develop chest pain

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This leaflet has been adapted from one produced by the Northern Care Alliance.