Member Case Study: Pulled Hamstring

author : AMSSM
comments : 1

I have been having a right hamstring issue over the last four weeks or so. I'm pretty sure I just pulled it pretty good but would like some advice. How long does it take for it to completely heal?

Member Question from GTI123

"I have been having a right hamstring issue over the last four weeks or so.  I'm sure I just pulled it pretty good but would like some advice.  I first felt it the day after a run - the pain runs from the middle of my right glute all the way down the hamstring.  After it first happened I laid off running and it seemed to get better but it is still bothering me (I would say on a scale of 1-10, 10 being the most painful when it first happened it is now a 3-4 after I workout) especially after a run but not so much after biking or swimming.  How long does it take for it to completely heal?"

Answer from Sam Schimelpfenig MD FAAP
Member AMSSM

The hamstring is a group of three muscles that take their origin from the ischial tuberosity (the sit bone), run along the back of the upper leg, and attach to the back of the knee.  These muscles can be injured anywhere along their course.   Occasionally the athlete will note a sensation of a ‘pop’ when the injury occurred (a marker of a more serious injury).  Sometimes, athletes will not have a specific event that is associated with the injury, but will develop pain following training activities. 

On exam, there is often tenderness along the posterior thigh in the region where the injury occurred.  Diagnostic imaging is rarely required but occasionally x-rays or MRI can be useful in more severe cases or when the clinical course is not progressing as expected.

Hamstring injuries can often take months to heal in adults.  The muscle has a dual role of hip extension and knee flexion and is under high tension during triathlon training.   In order to facilitate healing and to prevent re-injury, proper rehabilitation should begin as soon as possible and progress only as quickly as healing allows.  A typical rehab regimen begins with therapeutic modalities aimed at reducing pain - compression, ice, and anti-inflammatories as needed.  As the pain improves, gentle stretching and conditioning exercises are begun, with eventual progression to strengthening exercises. 

Return to play centers around symptoms of pain as well as function – there should be no pain, and strength and flexibility should be at near normal levels.  Re-injury can prolong recovery even further which makes it important to allow time for full healing to occur.  I generally recommend that rehabilitation exercises be performed in conjunction with an athletic trainer or physical therapist who can help guide recovery efforts and aid in clinical decision making in regards to returning to activities.

Your situation is actually not uncommon as popular wisdom tells us to rest when it hurts and play again when it feels better.  What is left out is that during that period of ‘rest’, there is much the athlete can and should do to promote recovery and prevent future injuries.  If you are not healing at a rate you are comfortable with, consider seeing your physician or a sports medicine specialist to see if an x-ray or MRI would be useful to make sure your injury is truly just a strained hamstring, and not a more severe injury such as an avulsion fracture.

Best of luck!

Sam Schimelpfenig MD FAAP
Primary Care Sports Medicine
Advanced Pediatric Associates, Denver CO

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date: April 14, 2010

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

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