Also called: Pulled hamstring; hamstring tear
Exercise is the main treatment
Strength
Stretch
Massage
A sharp pull at the back of the thigh, usually at high speed. The biceps femoris long head fails most often, prior injury is by far the biggest risk factor, and eccentric strengthening roughly halves the recurrence rate.
How common: The most common injury in running sports; recurrence rate up to 30%
What it is
A hamstring strain is a tear in the muscle or its tendon, most often the long head of biceps femoris near the point where muscle meets tendon. It happens during the late swing phase of sprinting, when the hamstring is lengthening under high force to decelerate the shin.
The dominant fact about hamstring injuries is recurrence. A previous strain is the strongest predictor of the next one, and reinjury rates are high - largely because return to sport is judged on comfort rather than on measured strength and length, leaving a deficit in place.
What it feels like
- A sudden sharp pull or grab at the back of the thigh, usually while sprinting
- Sometimes a pop, and an immediate stop
- Tender to press over a specific area, with bruising appearing over days
- Painful to stretch and to contract against resistance
- Persistent tightness and reduced confidence at speed afterwards
What causes it
Most people have more than one of these at once, and they feed each other. Read the
list looking for the two or three that sound like your week rather than for the one
true answer — the ones that describe you are the ones worth acting on.
- Eccentric overload at high speed
- During late swing the hamstring is lengthening while producing high force to decelerate the shin. That combination produces the highest strain the muscle experiences and is where most tears occur.
- A previous hamstring injury
- The single strongest risk factor by a wide margin. Scar tissue, a persistent strength deficit and altered muscle architecture all contribute, and the risk stays elevated for a long time.
- Eccentric strength deficit
- Low eccentric hamstring strength predicts injury, and eccentric training - Nordic curls in particular - reduces hamstring injuries by around half in trials. It is one of the best-evidenced prevention measures in sport.
- Fatigue
- Injuries cluster in the late stages of games and training sessions, when the muscle's ability to absorb eccentric load has fallen.
- Inadequate warm-up
- Sprinting at maximum effort on a cold, unprepared muscle is a classic setting. Progressive high-speed running in the warm-up matters more than static stretching.
- Reduced hamstring length
- Shorter muscle fascicle length is associated with higher injury risk, and eccentric training increases it. This is one mechanism by which the training protects.
- Weak glutes
- When the glutes under-contribute to hip extension, the hamstrings do more of the work on every stride, arriving at the high-speed demand already loaded.
- Lumbar spine and neural involvement
- Nerve tension from the lumbar spine can alter hamstring function and is associated with injury and with recurrent tightness. It is worth considering in a hamstring that keeps failing.
- Age
- Risk rises with age in athletes, related to reduced muscle quality and accumulated previous injuries.
- Returning too soon
- Return on comfort rather than on measured strength and function is the main modifiable driver of the high reinjury rate.
Who tends to get it
- Sprinters and athletes in sports with high-speed running - football, rugby, athletics, Australian rules
- Anyone with a previous hamstring strain, which is the dominant factor
- Older athletes
- Anyone with low eccentric hamstring strength, which is most people who do not train it
- Athletes in the late stages of a season or of a match
What makes it worse, and what settles it
Makes it worse
- Returning to sprinting before eccentric strength has been restored
- Aggressive stretching in the early phase, which can disrupt healing tissue
- Sprinting at maximum effort without a progressive warm-up
- Training through fatigue with high-speed running
- Judging readiness by absence of pain rather than by testing
Settles it
- Eccentric strengthening - Nordic curls and similar - which reduces injury and reinjury rates by around half
- Progressive loading through range, including work at long muscle lengths
- Glute strengthening so the hamstrings are not doing hip extension alone
- A graded return to running speed, building to maximum before returning to sport
- Objective testing - strength, length and high-speed running tolerance - before return
What actually helps
The short version: Eccentric overload at high speed; the biceps femoris long head fails most often; prior injury is the biggest risk factor
Strength work: Legs: Hamstrings - Nordic curls are the key exercise; Glutes: Max; hip-hinge patterns; Romanian deadlift
Stretching: Legs: Hamstrings; Hips: Flexors - gentle, do not stretch an acute strain
Massage: Legs: Hamstrings; Foam Roller Massage
Also worth doing: Sprint exposure as part of return to play
What the evidence says: Nordic hamstring curls cut hamstring injury rate by roughly half across meta-analyses. One of the best-evidenced prevention exercises that exists.
The names above are the Targets qFIT tracks —
the Muscle Guide explains what each one does, and
Quick Add switches on the Exercises you
already have.
The qFIT routine for this
Ready-made routineMuscle Strain Recovery (Hamstring, Calf, Groin & Quad)
qFIT already has this one built. It runs massage first, then stretching, then
strength — the order that works on a body that is already sore — and every
activity in it carries the reason it is there.
The button below opens your Checklist with this routine already selected, so instead
of your whole list you land on just its Categories, Targets
and Exercises, each with its checkbox, ready to tick as you work through
them.
Have more than one problem? Tick yours under My Problems on
My Profile and your Checklist's Routine list gains
Recommended for my problems — every routine for the problems you picked, merged
into one. Your picks stay private; that filter is the only thing they feed.
Get it checked if…
Sudden pop with bruising high in the buttock may be a proximal avulsion - surgical window is short, refer within days
And whatever the body part: chest pain or unusual breathlessness on
exertion; a fever alongside the pain; unexplained weight loss; pain that is constant and
unrelated to how you move; new numbness, weakness or loss of bladder or bowel control; or
one calf that is swollen, warm and painful. Any of those, stop and get assessed.
How it usually goes
Low-grade strains settle in two to four weeks, higher grades in six to twelve, and tendon-involving injuries considerably longer. The reinjury rate is high and it is the number that matters: eccentric training reduces it substantially and should continue permanently rather than for the rehabilitation period. Returning based on objective testing rather than on how it feels is the single most useful change most athletes can make.
Prevalence basis: Sports injury registries
Others the same routine covers
These share the Muscle Strain Recovery (Hamstring, Calf, Groin & Quad) routine, so the work is the same. If one of them also
sounds like you, that is a reason to expect more from it, not less.
This is general information, not a diagnosis, and it cannot examine you.
If it matches you, use it to ask better questions of a clinician rather than to replace one.