Hamstring pain can be sharp or cause tightness in the back of your thigh. Your hamstring is a group of three muscles on the back of your thigh, and when one or more of these muscles get overstretched or injured, it causes hamstring pain. You might hear it more commonly called "a pulled hamstring."
You may experience mild pain, swelling, and tenderness in your hamstring. Putting weight on the injured leg or walking may be uncomfortable. In more severe cases, you may be unable to stand, sit, walk, or move the injured leg.
Talking to your healthcare provider about hamstring pain can help ensure you get the right treatment and lower the risk of reinjury.
In addition to sharp pain, you may feel muscle tenderness, soreness, and swelling right after your injury. After a few days, you may see bruising or discoloration near your buttocks or on the back of your leg just below the knee. You may also have ongoing hamstring weakness for several weeks.
There are three levels of hamstring injury, determined by the level of strain:
- Grade 1: Mild pain or swelling of your hamstring with no or minimal loss of function
- Grade 2: Moderate pain, swelling, and loss of function from a partial muscle tear from the bone
- Grade 3: Severe pain, swelling, and loss of function from a complete muscle tear from the bone
Potential Causes of Hamstring Pain
The most common cause of hamstring pain is an injury from physical activity. Two injuries that can lead to hamstring pain are:
Hamstring Overload
A hamstring injury can happen during an activity where you overload or strain your muscles. You might experience hamstring overload if one of your muscles is:
- Overstretched
- Stretching and contracting rapidly
- Suddenly challenged with a heavy weight while stretched, also known as eccentric contraction
Some activities when you might experience a hamstring overload are sprinting, soccer, football, basketball, track, and dancing.
Hamstring Tendon Avulsions
Tendon avulsion, a type of muscle tear, is another cause of hamstring pain. It occurs when your tendon, the part of your muscle attached to your bone, partially or completely tears off the bone.
Like a hamstring overload, tendon avulsions can happen when your muscle is weighed down while stretched. The motions performed while sprinting, which stretch the muscle in the leg and put the body's weight onto the foot, can cause tendon avulsions.
A tendon avulsion is the likely cause of your hamstring pain if the pain is close to your buttocks or knee, which are the places where your hamstring muscles connect to bone. Sitting is painful if you have an avulsion. You will usually see a bruise near your buttocks or on the back of the leg below your knee.
Risk Factors
Hamstring injuries occur most often between the ages of 16-25. Your risk is high during adolescence because your body is growing, and your muscles and bones grow at different rates. If your bones grow faster than your muscles, your muscles are pulled tight, causing strain on them.
Other risk factors for hamstring strain include:
- Muscle tightness: When your muscles are tight, they undergo more stress and strain than when relaxed.
- Muscle imbalance: When your hamstring is not as strong as your quadricep (the opposing muscle group at the front of the thigh), or vice versa, the imbalance causes strain.
- Lack of conditioning: When your hamstring is weak, it cannot tolerate the strain of physical activity.
- Muscle fatigue: When your muscles are tired, they are more likely to feel strained.
- Previous hamstring injury: When you already have a strained hamstring, you're more likely to reinjure it.
Editor's Note: Your hamstring pain can sometimes be caused by something other than a hamstring injury. Back issues, such as a herniated disc, can present as hamstring pain.
You should see a healthcare provider as soon as possible for any hamstring pain. A hamstring strain causes a sudden sharp pain no matter what grade your injury is. If you have a grade 2 or 3 injury, you won't be able to walk because you can't use your hamstring.
See your healthcare provider immediately if you have any of the following symptoms:
- Sudden numbness or tingling
- Sudden increase in pain or swelling
- The injury doesn't seem to be healing as expected
How Is Hamstring Pain Diagnosed?
Only your healthcare provider can diagnose the severity of your hamstring injury. They will ask you how your injury happened and press different areas on the back of your thigh with a hand to check for tenderness, bruising, pain, weakness, swelling, or a more severe muscle injury.
They may order imaging tests like magnetic resonance imaging (MRI) and ultrasound to diagnose your hamstring pain. These tests give detailed pictures of your hamstring injury so your healthcare provider can determine what's causing your pain.
Your healthcare provider looks for signs of swelling or bleeding on the imaging tests. An MRI is also used to compare new hamstring injuries to previous ones.
Talk with your healthcare provider to learn the course of treatment for your injury. Your recovery time depends on the severity of your hamstring injury. A grade 1 injury may take 2-5 days to recover, while a grade 2 or 3 injury may take up to a few weeks or a month.
If you have a grade 1 or 2 hamstring injury, your goal for the first 3-5 days is to treat any bleeding, swelling, and pain. The general treatment includes:
- Rest and prevent movement of your injured leg
- Apply ice to your hamstring 2-3 times a day for about 20 minutes
- Compress your hamstring with a compression wrap
- Elevate your injured leg when sitting to reduce swelling
- Reduce inflammation with nonsteroidal anti-inflammatory drugs (NSAIDs) for no more than 5-7 days
- Take pain relief medicines
Consult your healthcare provider before returning to any physical activity. Rushing to return to regular activity can cause reinjury. You can eventually begin some stretching and light physical activity, though you may need to use crutches. You will increase activity gradually until you can move pain-free.
A grade 3 injury requires surgery to reattach your torn muscle. Having surgery sooner rather than later is recommended to reduce the risk of scar tissue forming at or near the site of the tear.
A Quick Review
Hamstring pain is a sudden, sharp tightness in the back of your thigh from an injury to your muscles. The injury can be as mild as a small strain or as severe as a muscle tear. See your healthcare provider for a diagnosis and treatment plan as soon as possible. Following the right treatment plan is important to prevent you from further injury.
